Indicators for routine monitoring of effective mental healthcare coverage in low- and middle-income settings: a Delphi study.
High-quality information to measure the need for, and the uptake, cost, quality and impact of care is essential in the pursuit of scaling up mental health care in low- and middle-income countries (LMIC). The aim of this study was to identify indicators for the measurement of effective coverage of mental health treatment. We conducted a two-round Delphi study (n = 93 experts from primarily LMIC countries Ethiopia, India, Nepal, Nigeria, South Africa and Uganda), in order to generate and prioritize a set of indicators. First, 52 unique indicators were generated (based on a total of 876 responses from participants). Second, the selected indicators were then scored for significance, relevance and feasibility. Mean priority scores were calculated per indicator (score range, 1-5). All 52 indicators had a weighted mean score that ranged from 3.20 for the lowest ranked to 4.27 for the highest ranked. The 15 highest ranked indicators cover the different domains of measuring effective mental health treatment coverage. This set of indicators is highly stable between the different groups of experts, as well as between the different participating countries. This study provides data on how mental health service and financial coverage can be assessed in LMIC. This is an important element in the move to scale-up mental health care.
Department of Research and Development, HealthNet TPO, Lizzy Ansinghstraat 163, 1073 RG Amsterdam, The Netherlands Institute of Psychiatry, Psychology and Neuroscience, Center for Global Mental Health, King's College London, De Crespigny Park, London SE5 8AF UK mark.jordans@hntpo.org.
Mark J D
MJ
Jordans
Department of Mental Health and Substance Abuse, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Dan
D
Chisholm
Institute of Psychiatry, Psychology and Neuroscience, Center for Global Mental Health, King's College London, De Crespigny Park, London SE5 8AF UK.
Maya
M
Semrau
Transcultural Psychosocial Organization (TPO), CPC 612, Kathmandu, Nepal.
Nawaraj
N
Upadhaya
Department of Psychiatry, University of Ibadan, Queen Elizabeth Road, 1205. Ibadan, Nigeria.
Jibril
J
Abdulmalik
Public Health Foundation of India, Plot Number 47, Sector 44, Gurgaon 122002, Delhi, India.
Shalini
S
Ahuja
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Tikur Anbessa Hospital, PO 9086 Addis Ababa, Ethiopia.
Atalay
A
Alem
Institute of Psychiatry, Psychology and Neuroscience, Center for Global Mental Health, King's College London, De Crespigny Park, London SE5 8AF UK Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Tikur Anbessa Hospital, PO 9086 Addis Ababa, Ethiopia.
Charlotte
C
Hanlon
Butabika National Referral and Teaching, Mental Hospital, P.O.Box 7017, Kampala-Uganda, Butabika Road, Kampala, Uganda.
Fred
F
Kigozi
Butabika National Referral and Teaching, Mental Hospital, P.O.Box 7017, Kampala-Uganda, Butabika Road, Kampala, Uganda.
James
J
Mugisha
School of Applied Human Sciences, University of Kwazulu-Natal, Mazisi Kunene Road, Glenwood, Durban, 4001, South Africa.
Inge
I
Petersen
Public Health Foundation of India, Plot Number 47, Sector 44, Gurgaon 122002, Delhi, India CAPHRI School for Public Health and Primary Care, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.
Rahul
R
Shidhaye
Institute of Psychiatry, Psychology and Neuroscience, Center for Global Mental Health, King's College London, De Crespigny Park, London SE5 8AF UK Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, Cape Town, South Africa.
Crick
C
Lund
Institute of Psychiatry, Psychology and Neuroscience, Center for Global Mental Health, King's College London, De Crespigny Park, London SE5 8AF UK.
Graham
G
Thornicroft
Department of Psychiatry, University of Ibadan, Queen Elizabeth Road, 1205. Ibadan, Nigeria.
Oye
O
Gureje
D000349:Africa; D001208:Asia; D003697:Delphi Technique; D003906:Developing Countries; D063005:Health Information Systems / Q000458:organization & administration*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000600:supply & distribution; D009313:National Health Programs / Q000191:economics; D011203:Poverty; D011795:Surveys and Questionnaires
: Delphi study; health information system; indicators; routine monitoring; treatment coverage