title: Development of a district mental healthcare plan in Uganda.
abstract: BACKGROUND
  Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda.
  
  
  OBJECTIVE
  To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care.
  
  
  METHODS
  Mixed methods using a situational analysis, qualitative studies, theory of change workshops and partial piloting of the plan at two levels informed the MHCP.
  
  
  RESULTS
  A MHCP was developed with packages of care to facilitate integration at the organisational, facility and community levels of the district health system, including a specified human resource mix. The partial embedding period supports its practical application. Key barriers to scaling up the plan were identified.
  
  
  CONCLUSIONS
  A real-world plan for the district was developed with involvement of stakeholders. Pilot testing demonstrated its feasibility and implications for future scaling up.
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India fredkigozi@yahoo.com.
authors.forename: Fred N
authors.initials: FN
authors.lastname: Kigozi
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Kizza
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Juliet
authors.initials: J
authors.lastname: Nakku
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Joshua
authors.initials: J
authors.lastname: Ssebunnya
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Sheila
authors.initials: S
authors.lastname: Ndyanabangi
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Blandina
authors.initials: B
authors.lastname: Nakiganda
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
authors.affiliation: Fred N. Kigozi, MBChB, MMed, Dorothy Kizza, BASS, MSc, Juliet Nakku, MBChB, MMed, Joshua Ssebunnya, BSc, MSc, Butabika National Referral and Teaching Mental Hospital, Makerere University, Kampala, Uganda; Sheila Ndyanabangi, MBChB, MPH, Mental Health Division, Ministry of Health, Kampala, Uganda; Blandina Nakiganda, MBChB, MPH, Health Department, Kamuli District Local Government, Uganda; Crick Lund, BA, BSocSci, MA, MSocSci, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, MRCPsych, PhD, FMedSci, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, Public Health Foundation of India, New Delhi and Sangath, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D003906:Developing Countries; D006297:Health Services Accessibility; D006280:Health Workforce; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010347:Patient Care Planning / Q000592:standards*; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D036301:Qualitative Research; D012424:Rural Population; D014454:Uganda