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Consequences of COVID-19 on access and delivery of mental health care in two rural Ethiopian districts. A mixed method study
Fekadu, Wubalem; Shewangizaw, Seble; Girma, Eshetu; Girma, Eshetu; Fekadu, Abebaw; Fekadu, Abebaw; Hanlon, Charlotte.
  • Fekadu, Wubalem; Bahir Dar University, College of Medicine and Health Sciences, Psychiatry Department. Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences, Addis Ababa. Bahir Dar. ET
  • Shewangizaw, Seble; Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences, Addis Ababa. Addis Ababa. ET
  • Girma, Eshetu; Addis Ababa University, College of Health Sciences, School of Public Health. Addis Ababa. ET
  • Girma, Eshetu; Addis Ababa University, College of Health Sciences, School of Public Health. Addis Abba. ET
  • Fekadu, Abebaw; Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences. Addis Ababa. ET
  • Fekadu, Abebaw; Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences. Addis Ababa University, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa. Brighton and Sussex Medical School, Global Health and Infection Department, Brighton, UK. Addis Ababa. ET
  • Hanlon, Charlotte; Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences, Addis Ababa. Addis Ababa University, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa, Ethiopia. King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK. Addis Ababa. ET
Ethiop. med. j. (Online) ; 60(Supplement 1): 66-74, 2022. tables
Article in English | AIM | ID: biblio-1429019
ABSTRACT

Introduction:

The impact of COVID-19 on people with Severe Mental Health Conditions (SMHCs) has been neglected. We aimed to describe the effect and explore the consequences of COVID-19 on people with SMHCs and mental health services in rural districts of Ethiopia.

Methods:

We conducted a mixed-method study nested within well-characterized population cohorts in Butajira and Sodo districts. We sampled 336 people (168 people with SMHCs, 168 comparisons) in a cross-sectional survey. We conducted qualitative key informant interviews with psychiatric nurses (n=3), primary health care workers (n=3), service users (n=4), family members (n=6) and community members (n=2). We assessed wellbeing (WHO wellbeing index), social support (Oslo social support scale; OSS) and food security quantitatively and used thematic analysis to explore impacts.

Results:

People with SMHCs reported significantly lower wellbeing (WHO wellbeing score 52 vs. 72; p<0.001), less social support (OSS score 8.68 vs. 9.29; p<0.001), worse living standards (47.0% vs. 29.0%; p<0.001) and increased food insecurity (26.0% vs. 12.5%; p<0.001). Household economic status worsened for over one-third of participants. Participants reported increased relapse, exacerbated stigma due to perceived susceptibility of people with SMHCs to COVID-19, and increased restraint. In mental healthcare settings, there was decreased patient flow but an increase in new cases. Innovations included flexible dispensing of medicines, longer appointment intervals and establishing new treatment centers.

Conclusions:

COVID-19 had negative consequences on people with SMHCs and mental health services, which must be anticipated and prevented in any future humanitarian crisis. Adaptive responses used during COVID may increase health system resilience
Subject(s)

Full text: Available Index: AIM (Africa) Main subject: Mental Health / Economic Status / COVID-19 Type of study: Practice guideline / Qualitative research Limits: Female / Humans / Male Language: English Journal: Ethiop. med. j. (Online) Year: 2022 Type: Article Institution/Affiliation country: Addis Ababa University, College of Health Sciences, School of Public Health/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences, Addis Ababa/ET / Bahir Dar University, College of Medicine and Health Sciences, Psychiatry Department/ET

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Full text: Available Index: AIM (Africa) Main subject: Mental Health / Economic Status / COVID-19 Type of study: Practice guideline / Qualitative research Limits: Female / Humans / Male Language: English Journal: Ethiop. med. j. (Online) Year: 2022 Type: Article Institution/Affiliation country: Addis Ababa University, College of Health Sciences, School of Public Health/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences/ET / Addis Ababa University, WHO collaborating center for Mental Health research and capacity building, Department of Psychiatry, College of Health sciences, Addis Ababa/ET / Bahir Dar University, College of Medicine and Health Sciences, Psychiatry Department/ET