Abiodun O Adewuya1, Tomilola Adewumi2, Bolanle Ola3, Olayinka Abosede4, Abiodun Oyeneyin5, Adedolapo Fasawe6, Olajide Idris6. 1. Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria. Electronic address: abiodun.adewuya@lasucom.edu.ng. 2. Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria. 3. Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. 4. Department of Community Health and Primary Health Care, Lagos University College of Medicine, Idi-Araba, Lagos, Nigeria. 5. Oceanic Health Management Ltd., Lagos, Nigeria. 6. Lagos State Ministry of Health, Alausa, Ikeja. Lagos, Nigeria.
Abstract
OBJECTIVE: This study aimed to evaluate the knowledge, perceived challenges and attitude of primary health care (PHC) workers in Lagos to depression and its management in the PHC. METHODS: Health workers (n=607) from 49 "flagship" PHCs in Lagos were evaluated for their level of knowledge, experience, competence, attitude and perceived challenges to managing depression in the primary care using a case vignette. RESULTS: More than half (56.2%) of the health workers correctly diagnosed depression. The most endorsed causative factors were "Psycho-social" (77.3%), but "spiritual factors" were endorsed by 36.2%. While only 39.4% agreed that the depressed patient is best managed in a PHC, 86.2% would support treating the patient in their PHC if their capacity is enhanced. Top identified challenges were "heavy work schedule" (68.5%) and "lack of competence of the PHC staff" (67.5%). Over 42% had poor attitude towards depressed patient. Having a mental health training was the major factor that predicted good knowledge (OR 4.52, 95%CI 2.96-7.00) and good attitude (OR 2.17, 95% CI 1.48-3.17). CONCLUSIONS: For successful scale up of mental health services in LMICs, the design of mental health training curriculum for PHC workers should consider their knowledge, experience, competence level, perception and attitudes.
OBJECTIVE: This study aimed to evaluate the knowledge, perceived challenges and attitude of primary health care (PHC) workers in Lagos to depression and its management in the PHC. METHODS: Health workers (n=607) from 49 "flagship" PHCs in Lagos were evaluated for their level of knowledge, experience, competence, attitude and perceived challenges to managing depression in the primary care using a case vignette. RESULTS: More than half (56.2%) of the health workers correctly diagnosed depression. The most endorsed causative factors were "Psycho-social" (77.3%), but "spiritual factors" were endorsed by 36.2%. While only 39.4% agreed that the depressedpatient is best managed in a PHC, 86.2% would support treating the patient in their PHC if their capacity is enhanced. Top identified challenges were "heavy work schedule" (68.5%) and "lack of competence of the PHC staff" (67.5%). Over 42% had poor attitude towards depressedpatient. Having a mental health training was the major factor that predicted good knowledge (OR 4.52, 95%CI 2.96-7.00) and good attitude (OR 2.17, 95% CI 1.48-3.17). CONCLUSIONS: For successful scale up of mental health services in LMICs, the design of mental health training curriculum for PHC workers should consider their knowledge, experience, competence level, perception and attitudes.
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