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RACHEL JENKINS DAVID KIIMA FRANK NJENGA MARX OKONJI JAMES KINGORA DAMMAS KATHUKU SARAH LOCK 《World psychiatry》2010,9(2):118-120
Integration of mental health into primary care is essential in Kenya, where
there are only 75 psychiatrists for 38 million population, of whom 21 are
in the universities and 28 in private practice. A partnership between the
Ministry of Health, the Kenya Psychiatric Association and the World Health
Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College
London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary
health care staff in the public health system across Kenya, using a sustainable
general health system approach. The content of training was closely aligned
to the generic tasks of the health workers. The training delivery was integrated
into the normal national training delivery system, and accompanied by capacity
building courses for district and provincial level staff to encourage the
inclusion of mental health in the district and provincial annual operational
plans, and to promote the coordination and supervision of mental health services
in primary care by district psychiatric nurses and district public health
nurses. The project trained 41 trainers, who have so far trained 1671 primary
care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative
observations of subsequent clinical practice have demonstrated improvements
in assessment, diagnosis, management, record keeping, medicine supply, intersectoral
liaison and public education. Around 200 supervisors (psychiatrists, psychiatric
nurses and district public health nurses) have also been trained. The project
experience may be useful for other countries also wishing to conduct similar
sustainable training and supervision programmes. 相似文献
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