Optimizing treatment cascades for mental healthcare in Mozambique: preliminary effectiveness of the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH).

Health Policy and Planning
Katrin E FabianBradley H Wagenaar

Abstract

Substantial investments are being made to scale-up access to mental healthcare in low- and middle-income countries, but less attention has been paid to quality and performance of nascent public-sector mental healthcare systems. This study tested the initial effectiveness of an implementation strategy to optimize routine outpatient mental healthcare cascade performance in Mozambique [the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)]. This study employed a pre-post design from September 2018 to August 2019 across four Ministry of Health clinics among 810 patients and 3234 outpatient mental health visits. Effectiveness outcomes evaluated progression through the care cascade, including: (1) initial diagnosis and medication selection; (2) enrolling in follow-up care; (3) returning after initial consultation within 60 days; (4) returning for follow-up visits on time; (5) returning for follow-up visits adherent to medication and (6) achieving function improvement. Clustered generalized linear models evaluated odds of completing cascade steps pre- vs post-intervention. Facilities prioritized improvements focused on the follow-up cascade, with 62.5% (10 of 16) monthly system modifications targeting medication ad...Continue Reading

References

Jan 17, 2009·Health Policy and Planning·Inge PetersenUNKNOWN Mental Health and Poverty Research Programme Consortium
Oct 27, 2010·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Charlotte HanlonAtalay Alem
Jul 17, 2013·BMC Health Services Research·Kenneth SherrStephen Gloyd
Jun 3, 2014·Implementation Science : IS·Kenneth SherrUNKNOWN With input from the SAIA Study Team
Apr 19, 2015·Health Policy and Planning·Bradley H WagenaarAlexander C Wagenaar
Jun 18, 2015·Global Health Action·Bradley H WagenaarKenneth Sherr
Jan 7, 2016·International Journal of Mental Health Systems·Palmira Fortunato Dos SantosJair de Jesus Mari
Feb 2, 2016·Psychiatric Services : a Journal of the American Psychiatric Association·Bradley H WagenaarKenneth Sherr
Apr 16, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Alison Silvis RustagiUNKNOWN with input from the SAIA Study Team
Jun 30, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Sarah GimbelUNKNOWN with input from the SAIA study team
Jul 2, 2016·Psychiatric Services : a Journal of the American Psychiatric Association·Bibhav Acharya, Sikhar B Swar
May 16, 2017·Psychiatric Services : a Journal of the American Psychiatric Association·Nadiya SunderjiAmanda Abate
Jun 7, 2019·Implementation Science : IS·Maji HailemariamAmy Drahota
Nov 26, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Anjuli D WagnerKenneth Sherr

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