title: Health service utilization by patients with common mental disorder identified by the Self-Reporting Questionnaire in a primary care setting in Zomba, Malawi: a descriptive study.
abstract: BACKGROUND
  There has been no study carried out to assess health service utilization by people with common mental disorder (CMD) in Malawi.
  
  
  OBJECTIVE
  The aim of the study was to evaluate health service utilization patterns of patients with CMD in primary health care (PHC) clinics.
  
  
  METHODS
  The study was conducted in two PHC clinics in one of the 28 districts in Malawi. Face-to-face interviews with the Self-Reporting Questionnaire (SRQ-20) were conducted in a sample of 323 PHC attendees aged 18 years and older who attended the PHC clinics for any reason.
  
  
  RESULTS
  The prevalence of probable CMD in the sample was 20.1%. People with probable CMD had a higher mean number of health facility visits in the previous three months compared to those without probable CMD (1.6 vs 1.19, p = .02).
  
  
  CONCLUSIONS
  The study reveals high utilization of health services for people with CMD in the PHC setting. There is a need for PHC workers to improve skills in diagnosing patients with CMD to make PHC services more effective by reducing re-attendance and improving patient outcomes.
authors.affiliation: Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Matieland, South Africa Clinical Psychiatry Department, Zomba Mental Hospital, Zomba, Malawi.
authors.forename: Michael
authors.initials: M
authors.lastname: Udedi
authors.affiliation: Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Matieland, South Africa lswartz@sun.ac.za.
authors.forename: Leslie
authors.initials: L
authors.lastname: Swartz
authors.affiliation: Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Stewart
authors.affiliation: Clinical Psychiatry Department, Zomba Mental Hospital, Zomba, Malawi Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: Felix
authors.initials: F
authors.lastname: Kauye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008295:Malawi / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Common mental disorder; depression; developing countries; health service utilization; primary health care