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Planning and evaluating mental health services in low- and middle-income countries using theory of change

Published online by Cambridge University Press:  02 January 2018

Erica Breuer ,
Mary J. De Silva ,
Rahul Shidaye ,
Inge Petersen ,
Juliet Nakku ,
Mark J. D. Jordans ,
Abebaw Fekadu  and
Crick Lund
Erica Breuer*
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Mary J. De Silva
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Rahul Shidaye
Affiliation:
Public Health Foundation of India, Bhopal, Madhya Pradesh, India and Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
Inge Petersen
Affiliation:
School of Applied Human Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, South Africa
Juliet Nakku
Affiliation:
Butabika National Mental Hospital, Kampala, Uganda
Mark J. D. Jordans
Affiliation:
HealthNet TPO, Amsterdam, The Netherlands and King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
Abebaw Fekadu
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK and Addis Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Crick Lund
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
*
Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, Cape Town, South Africa, Email: erica.breuer@uct.ac.za
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Abstract

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Background

There is little practical guidance on how contextually relevant mental healthcare plans (MHCPs) can be developed in low-resource settings.

Aims

To describe how theory of change (ToC) was used to plan the development and evaluation of MHCPs as part of the PRogramme for Improving Mental health carE (PRIME).

Method

ToC development occurred in three stages: (a) development of a cross-country ToC by 15 PRIME consortium members; (b) development of country-specific ToCs in 13 workshops with a median of 15 (interquartile range 13–22) stakeholders per workshop; and (c) review and refinement of the cross-country ToC by 18 PRIME consortium members.

Results

One cross-country and five district ToCs were developed that outlined the steps required to improve outcomes for people with mental disorders in PRIME districts.

Conclusions

ToC is a valuable participatory method that can be used to develop MHCPs and plan their evaluation.

Information

Type
Papers
Information
The British Journal of Psychiatry , Volume 208 , Issue s56: Mental health plans in five low- and middle-income countries: PRogramme for Improving Mental health carE (PRIME) , January 2016 , pp. s55 - s62
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Copyright
Copyright © Royal College of Psychiatrists, 2016

Footnotes

This paper was produced as part of the PRogramme for Improving Mental health carE (PRIME) funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies. M.J.D.S. is supported by a Wellcome Trust/London School of Hygiene and Tropical Medicine career fellowship.

Declaration of interest

None.

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