title: Increasing the priority of mental health in Africa: findings from qualitative research in Ghana, South Africa, Uganda and Zambia.
abstract: Despite the high prevalence of mental illness, mental health remains a low priority in Africa. There has been no investigation of the views of stakeholders in Africa on why this is and what can be done. This paper reports a comparison of the views of stakeholders in Ghana, South Africa, Uganda and Zambia, focusing on the priority given to mental health by the government at the national and regional/province levels. We conducted semi-structured interviews with key stakeholders and used a two-stage approach to analysis: firstly framework analysis in each study country, followed by comparative analysis of the country data. Mental health was largely considered a low priority at national and regional/provincial levels in all four countries. We identified nine factors affecting the priority of mental health, which were grouped into three categories: legitimacy of the problem, feasibility of response and support for response. Respondents put forward a range of experiences and suggestions for increasing the priority given to mental health. We conclude with broad suggestions to raise the priority of mental health. These suggestions are particularly relevant as mental health increases in priority on the international agenda, in order to inform advocacy for increased priority for mental health in Africa.
authors.affiliation: Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK. p.k.bird@leeds.ac.uk
authors.forename: Philippa
authors.initials: P
authors.lastname: Bird
authors.forename: Maye
authors.initials: M
authors.lastname: Omar
authors.forename: Victor
authors.initials: V
authors.lastname: Doku
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
authors.forename: James Rogers
authors.initials: JR
authors.lastname: Nsereko
authors.forename: Jason
authors.initials: J
authors.lastname: Mwanza
mesh_terms: D000349:Africa; D006292:Health Priorities; D006801:Humans; D007407:Interviews as Topic; D008605:Mental Health Services; D011640:Public Policy; D036301:Qualitative Research