Bottlenecks in the provision of quality mental health services in Eritrea

Background: The prevalence of mental disorders is increasing significantly in developing countries due to the frequently occurring major risk factors. There is no published information on the profile of mental health disorder and services in Eritrea. Objective of the study: Follow-up descriptive study was conducted on one hundred and one consecutive children with advanced HIV disease who were put on antiretroviral therapy from September 2005 to October 2006. These patients were followed up at the antiretroviral therapy (ART) clinic of the hospital. Methods: A descriptive cross sectional study was conducted using the WHO-AIMS questionnaire that was administered to relevant stakeholders. Results: There was no comprehensive mental health policy and legislation in Eritrea. Only 5% of the health services budget is allocated for mental health services. Mental health services is free of charge and were provided integrated with Primary Health Care services. Inadequate human resources and inadequate training on mental health for the health workers were among the constraints. Conclusion: The status of mental disorders and the mental health services in Eritrea from the policy to management guidelines requires urgent review. Significant Outcomes: a) In resource limited settings, the integrated primary health care approach for mental health services is cost effective and avoids associated stigma. b) WHO/AIMS tool is a simple tool that provides complete picture of the mental health system of a country, c) Lack of policies and legislation in a country severely affects the mental health system of a country Limitations: This was a cross sectional study where data collection and analysis was partially restricted by the level and quality of information available in the registry books of the health facilities. Key words: WHO-AIMS, integrated primary health care, mental health services