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Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

Roxanne Keynejad
Maya Semrau
Mark Toynbee
Sara Evans-Lacko
Crick Lund, Oye Gureje
Sheila Ndyanabangi
Emilie Courtin
Jibril O. Abdulmalik
Atalay Ale
Abebaw Fekadu
Graham Thornicroft
Charlotte Hanlo
October 2016

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Background

Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs.

Methods

We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review.

Results

Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors.

Conclusions

This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.

Malawi : DoDMA exploring indigenous knowledge on disasters

KAZEMBE, Ida
May 2015

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This article contains an interview with Mulder Mkutumula, Mitigation Officer at the Department of Disaster Management Affairs in Malawi. Mr. Mkutumula discusses the importance of raising awareness and understanding of disaster risk reduction in Malawi, especially in the context of the 2015 floods

Evolution of victim assistance within Handicap International

HANDICAP INTERNATIONAL
April 2013

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"This Viewpoints piece describes the development and elaboration of victim assistance within HI. It highlights, in particular, the interplay between programming, research, and policy development. Drawing on examples from South Sudan and Libya, the reflection also describes how HI has integrated its approach by incorporating survivors of gun violence into existing victim assistance and disability projects, and increasingly focuses on injury prevention"
Viewpoint Series, No 2

RIO+20, sustainable development goals and post-2015 decisions

WILSON, Lynn
2012

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"The Millennium Development Goals, RIO+20, and the emerging sustainable development goals (SGDs) are intricately interwoven with one another and with the initiatives of other agencies and UN regimes. This paper develops those interrelationships and positions the roles of nongovernmental organizations as the boundary institutions that encourage those goals to be mobilized into action at the local and global levels"

Improved and standardized method for assessing years lived with disability after injury

HAAGSMA, JA
et al
2012

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"This article presents the results of study that aimed to develop a standardized method for calculating years lived with disability (YLD) after injury. The method developed consists of obtaining data on injury cases seen in emergency departments as well as injury-related hospital admissions, using the EUROCOST system to link the injury cases to disability information and employing empirical data to describe functional outcomes in injured patients. The novel method for calculating YLD after injury can be applied in different settings, overcomes some limitations of the method used to calculate the global burden of disease, and allows more accurate estimates of the population burden of injury"
Bull World Health Organ, 90

What comes after the MDGs?

WILLIAMS, Leo
2011

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This article highlights the discussion about what will replace the millennium development goals (MDGs) after their expiry date in 2015

Bridging the gaps between research, policy and practice in low- and middle-income countries a survey of researchers

LAVIS, John N
et al
May 2010

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This article describes the findings from a study which examined efforts to bridge the gaps between research, policy and practice in 10 low- and middle-income countries in which researchers conducting research in one of four clinical areas relevant to the Millennium Development Goals: prevention of malaria (Ghana, Laos, Senegal and Tanzania), care of women seeking contraception (China, Kazakhstan, Laos and Mexico), care of children with diarrhoea (Ghana, India, Pakistan and Senegal) and care of patients with tuberculosis (China, India, Iran and Mexico) were surveyed

Don’t just do it, do it right : evidence for better health in low and middle income countries

THARYAN, Prathap
March 2010

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This article puts forward the argument that evidence for better health outcomes involves a two-step process: getting the right sort of evidence - evidence that is convincing and is for low- and middle-income countries - and getting this evidence used - through access to reliable evidence (such as the Cochrane Library) to getting evidence into policy and practice

Where disability meets climate change

ANSEL, Kate
December 2009

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This article highlights how climate change will affect disabled people. It presents the importance of ensuring that disability is on the agenda in global environmental discussions and raises the importance of including disability in policy through consultation with disabled people

The fields of HIV and disability : past, present and future

HANASS-HANCOCK, Jill
NIXON, Stephanie A
November 2009

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This article gives a historic overview of the two fields of disability and of HIV. The first field involves people living with HIV and their experiences of disability brought on by the disease. The second field involves people with disabilities and their experiences of vulnerability to, and life with, HIV. The authors argue that although these two fields have evolved relatively independently over time, the divide between them is collapsing, with the result that new understanding about shared concerns and the mutual benefits that may be gained from integrating policies. This resource would useful for people interested in the field of disability and HIV in general

Meeting report of the international policy dialogue on HIV/AIDS and disability

PEAKE, Sharon
November 2009

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The International Policy Dialogue on HIV/AIDS and Disability ..."provided a forum for stakeholders from governments, academia, and non-governmental and multilateral organizations to explore the issues and evidence related to HIV/AIDS and disability, and to chart a way forward in terms of policy and programme development." The objectives..."were: to explore the place of disability in the changing nature of the global HIV/AIDS epidemic and the required response; to share and learn from participants' experiences; and to build and reinforce the partnerships needed to sustain a comprehensive global response to HIV/AIDS, which includes issues related to disability"

Beyond 2015

SUMNER, Andy
2009

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This article presents the global post-2015 debate and the need for global and participatory discussions Issue 14

The care economy : gender and the silent AIDS crisis in Southern Africa

URDANG, Stephanie
March 2006

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This article considers the impact of AIDS on women’s roles and responsibilities within the household ‘care economy’. In particular, it emphasises that all interventions aimed at reversing the AIDS epidemic need to take into account the excessive work-load that members of the household, usually women, shoulder in responding to the needs of sick family members. Most notably, gender equality and care economy issues need to be identified by development programmes. There is also a need to implement policies that focus on issues such as treatment, prevention, education, economic empowerment and violence against women. The article argues that unless the care economy and the relations of gender inequality within the household are included in the design, implementation, monitoring and evaluation of such interventions, results will be compromised

The utilisation of health research in policy making : concepts, examples and methods of assessment

HANNEY, Stephen R
et al
January 2003

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The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. In this article, these issues are explored in conjunction with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Factors potentially enhancing utilisation can be identified by examining: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. The article concludes by saying that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies

The political economy of disablement : advances and contradictions

RUSSEL, Marta
MALHOTRA, Ravi
2002

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This article researches the processes that create disability in capitalist societies. The article discusses different areas affecting disabled people such as employment, wages, social security and disability rights movements. The article will be of interest to researchers who are exploring different disability models.

25 years of community-based rehabilitation

HELANDER, Einar
2000

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Community-based rehabilitation (CBR) started to be evolved in 1974. Since then CBR has developed from a concept to a policy and to a programme. In this article, a short personal account is given of how this occurred, and some of the lessons learned along the road

Linking participation and local governance

INSTITUTE FOR DEVELOPMENT STUDIES (IDS)
October 1999

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Briefly describes a number of approaches that different people and organisations have developed to strengthen citizenship participation. Includes a list of relevant resources and upcoming events

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