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Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia.

Publication ,  Journal Article
Abayneh, S; Lempp, H; Alem, A; Kohrt, BA; Fekadu, A; Hanlon, C
Published in: Int J Ment Health Syst
2020

BACKGROUND: The involvement of service users and caregivers is recommended as a strategy to strengthen health systems and scale up quality mental healthcare equitably, particularly in low-and-middle-income countries. Service user and caregiver involvement is complex, and its meaningful implementation seems to be a worldwide challenge. Theory of Change (ToC) has been recommended to guide the development, implementation and evaluation of such complex interventions. This paper aims to describe a ToC model for service user and caregiver involvement in a primary mental health care in rural Ethiopia. METHODS: The ToC was developed in two workshops conducted in (i) Addis Ababa with purposively selected psychiatrists (n = 4) and multidisciplinary researchers (n = 3), and (ii) a rural district in south-central Ethiopia (Sodo), with community stakeholders (n = 24). Information from the workshops (provisional ToC maps, minutes, audio recordings), and inputs from a previous qualitative study were triangulated to develop the detailed ToC map. This ToC map was further refined with written feedback and further consultative meetings with the research team (n = 6) and community stakeholders (n = 35). RESULTS: The experiential knowledge and professional expertise of ToC participants combined to produce a ToC map that incorporated key components (community, health organisation, service user and caregiver), necessary interventions, preconditions, assumptions and indicators towards the long-term outcomes. The participatory nature of ToC by itself raised awareness of the possibilities for servicer user and caregiver involvement, promoted co-working and stimulated immediate commitments to mobilise support for a grass roots service user organization. CONCLUSIONS: The ToC workshops provided an opportunity to co-produce a ToC for service user and caregiver involvement in mental health system strengthening linked to the planned model for scale-up of mental health care in Ethiopia. The next steps will be to pilot a multi-faceted intervention based on the ToC and link locally generated evidence to published evidence and theories to refine the ToC for broader transferability to other mental health settings.

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Published In

Int J Ment Health Syst

DOI

ISSN

1752-4458

Publication Date

2020

Volume

14

Start / End Page

51

Location

England

Related Subject Headings

  • 4203 Health services and systems
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences
 

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ICMJE
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Abayneh, S., Lempp, H., Alem, A., Kohrt, B. A., Fekadu, A., & Hanlon, C. (2020). Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia. Int J Ment Health Syst, 14, 51. https://doi.org/10.1186/s13033-020-00383-6
Abayneh, Sisay, Heidi Lempp, Atalay Alem, Brandon A. Kohrt, Abebaw Fekadu, and Charlotte Hanlon. “Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia.Int J Ment Health Syst 14 (2020): 51. https://doi.org/10.1186/s13033-020-00383-6.
Abayneh, Sisay, et al. “Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia.Int J Ment Health Syst, vol. 14, 2020, p. 51. Pubmed, doi:10.1186/s13033-020-00383-6.
Journal cover image

Published In

Int J Ment Health Syst

DOI

ISSN

1752-4458

Publication Date

2020

Volume

14

Start / End Page

51

Location

England

Related Subject Headings

  • 4203 Health services and systems
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences