Child and adolescent mental health services in Uganda

Introduction Worldwide, one in five children and adolescents suffer from mental health disorders, while facing limited opportunities for treatment and recovery. Growing up, they face multiple challenges that might contribute to the development of mental disorders. Uganda is a developing country with a history of prolonged civil and regional wars associated with child soldiers, large numbers of refugees and internally displaced people due to natural disasters and unrests, and a large infectious disease burden mainly due to acute respiratory tract infections, malaria and HIV/AIDS. Objective This paper aims to examine the current status of child and adolescent mental health services in Uganda. Methodology A scoping review approach was used to select studies on child and adolescent mental health services (CAMHS) in Uganda. A search of MEDLINE, Wiley and PubMed databases was conducted using eligibility criteria. The papers were summarized in tables and then synthesized using the Frameworks for monitoring health systems performance designed by the World Health Organisation (WHO). This was done according to the Preferred Reporting Items for Systematic Review and M-Analyses Extension for Scoping Review (PRISMA-ScR) guidelines. Results Twelve studies were identified; five of them used qualitative methods and focused mostly on the current limitations and strengths of CAMHS in Uganda, while six quantitative studies investigated the effects of new interventions. One study used a mixed-methods approach. In summary, the papers outlined a need for collaboration with the primary health sector and traditional healers to ensure additional human resources, as well as the need to focus on groups such as orphans, HIV/AIDS-affected youth, former child soldiers and refugees. Conclusion Relatively few studies have been conducted on CAMHS in Uganda, and most of those that exist are part of larger studies involving multiple countries. CAMHS in Uganda require improvement and needs to focus especially on vulnerable groups such as orphans, HIV/AIDS-affected youth and former child soldiers.publishedVersio

Child and adolescent mental health services in Uganda

Introduction Worldwide, one in five children and adolescents suffer from mental health disorders, while facing limited opportunities for treatment and recovery. Growing up, they face multiple challenges that might contribute to the development of mental disorders. Uganda is a developing country with a history of prolonged civil and regional wars associated with child soldiers, large numbers of refugees and internally displaced people due to natural disasters and unrests, and a large infectious disease burden mainly due to acute respiratory tract infections, malaria and HIV/AIDS. Objective This paper aims to examine the current status of child and adolescent mental health services in Uganda. Methodology A scoping review approach was used to select studies on child and adolescent mental health services (CAMHS) in Uganda. A search of MEDLINE, Wiley and PubMed databases was conducted using eligibility criteria. The papers were summarized in tables and then synthesized using the Frameworks for monitoring health systems performance designed by the World Health Organisation (WHO). This was done according to the Preferred Reporting Items for Systematic Review and M-Analyses Extension for Scoping Review (PRISMA-ScR) guidelines. Results Twelve studies were identified; five of them used qualitative methods and focused mostly on the current limitations and strengths of CAMHS in Uganda, while six quantitative studies investigated the effects of new interventions. One study used a mixed-methods approach. In summary, the papers outlined a need for collaboration with the primary health sector and traditional healers to ensure additional human resources, as well as the need to focus on groups such as orphans, HIV/AIDS-affected youth, former child soldiers and refugees. Conclusion Relatively few studies have been conducted on CAMHS in Uganda, and most of those that exist are part of larger studies involving multiple countries. CAMHS in Uganda require improvement and needs to focus especially on vulnerable groups such as orphans, HIV/AIDS-affected youth and former child soldiers

Child alcohol use disorder in Eastern Uganda: screening, diagnostics, risk factors and management of children drinking alcohol in Uganda (TREAT C-AUD): a mixed-methods research protocol

Abstract Background Following a finding of alcohol use among children aged 5–8 years old in Mbale, Uganda, this project investigates the magnitude of alcohol and substance use among children ged 6–13 years old and related household, community, school, health system and clinical factors. Methods The project includes four larger work packages (WPs). WP1 comprises management, WP2 and 3 include the scientific components and WP4 includes integration of results, dissemination, policy and implementation advice. This protocol presents the planned research work in WP 2 and 3. WP2 comprises the adaptation and validation of the alcohol use screening tool Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) to the age group and setting. WP3 comprises four substudies (SS). SS1 is a cross-sectional community household survey with an estimated sample size of 3500 children aged 6–13 years and their caregivers. We apply cluster sampling and systematic sampling within the clusters. Data collection includes a structured questionnaire for caregiver and child, measuring social and demographic factors, mental health status, alcohol and substance use, nutrition history and anthropometry. Urine samples from children will be collected to measure ethyl glucuronide (EtG), a biological marker of alcohol intake. Further, facilitators, barriers and response mechanisms in the health system (SS2) and the school system (SS3) is explored with surveys and qualitative assessments. SS4 includes qualitative interviews with children. Analysis will apply descriptive statistics for the primary outcome of establishing the magnitude of alcohol drinking and substance use, and associated factors will be assessed using appropriate regression models. The substudies will be analysed independently, as well as inform each other through mixed methods strategies at the stages of design, analysis, and dissemination. Ethics and dissemination Data protection and ethical approvals have been obtained in Uganda and Norway, and referral procedures developed. Dissemination comprises peer-reviewed, open access research papers, policy recommendations and intersectoral dialogues. Trial registration number Clinicaltrials.gov 29.10.2020 (#NCT04743024)

Child alcohol use disorder in Eastern Uganda: screening, diagnostics, risk factors and management of children drinking alcohol in Uganda (TREAT CAUD): a mixed-methods research protocol

Background Following a finding of alcohol use among children aged 5–8 years old in Mbale, Uganda, this project investigates the magnitude of alcohol and substance use among children ged 6–13 years old and related household, community, school, health system and clinical factors. Methods The project includes four larger work packages (WPs). WP1 comprises management, WP2 and 3 include the scientific components and WP4 includes integration of results, dissemination, policy and implementation advice. This protocol presents the planned research work in WP 2 and 3. WP2 comprises the adaptation and validation of the alcohol use screening tool Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) to the age group and setting. WP3 comprises four substudies (SS). SS1 is a cross-sectional community household survey with an estimated sample size of 3500 children aged 6–13 years and their caregivers. We apply cluster sampling and systematic sampling within the clusters. Data collection includes a structured questionnaire for caregiver and child, measuring social and demographic factors, mental health status, alcohol and substance use, nutrition history and anthropometry. Urine samples from children will be collected to measure ethyl glucuronide (EtG), a biological marker of alcohol intake. Further, facilitators, barriers and response mechanisms in the health system (SS2) and the school system (SS3) is explored with surveys and qualitative assessments. SS4 includes qualitative interviews with children. Analysis will apply descriptive statistics for the primary outcome of establishing the magnitude of alcohol drinking and substance use, and associated factors will be assessed using appropriate regression models. The substudies will be analysed independently, as well as inform each other through mixed methods strategies at the stages of design, analysis, and dissemination. Ethics and dissemination Data protection and ethical approvals have been obtained in Uganda and Norway, and referral procedures developed. Dissemination comprises peer-reviewed, open access research papers, policy recommendations and intersectoral dialogues

Child and adolescent mental health services in Uganda

Barn og ungdoms psykiske helsetjenester i Uganda Introduksjon Over hele verden lider 1 av 5 barn av psykisk sykdom, mens de står overfor begrensede muligheter for behandling og restitusjon. Mens de vokser opp, står de overfor flere utfordringer som kan bidra til utviklingen av psykiske lidelser. Uganda er et utviklingsland med en historie preget av langvarige borger- og regionale kriger med barnesoldater, stort antall flyktninger og internt fordrevne på grunn av naturkatastrofer og uro, og en stor smittsom sykdomsbyrde hovedsakelig på grunn av akutte luftveisinfeksjoner, malaria og HIV / AIDS. Alle disse faktorene kan påvirke den unge befolkningen i Uganda både fysisk og mentalt. Formål Dette er et litteratursøk av eksisterende studier om psykiske helsetjenester for barn og unge i Uganda. Metodikk En scoping review-tilnærming ble brukt til å velge studier om psykiske helsetjenester (CAMHS) i Uganda. Søk i MEDLINE-, Wiley- og PubMed-databasene ble utført ved bruk av kvalifiseringskriterier. Studiene ble oppsummert i tabeller og deretter syntetisert ved hjelp av rammene for helsesystemer designet av Verdens helseorganisasjon (WHO). Dette ble gjort i henhold til de foretrukne rapporteringselementene for systematisk gjennomgang og M-analyser Extension for Scoping Review (PRISMA-ScR) retningslinjer. Resultater Tolv studier ble identifisert; 5 av studiene brukte kvalitative metoder og fokuserte mest på de nåværende begrensningene og styrkene til CAMHS i Uganda, mens 6 kvantitative studier undersøkte effekten av nye intervensjoner. En studie brukte en blandet metode-tilnærming. Oppsummert skisserte studiene et behov for samarbeid med primærhelsesektoren og tradisjonelle healere for å sikre ytterligere menneskelige ressurser, samt behovet for å fokusere på grupper som foreldreløse, HIV / AIDS-berørte ungdommer, tidligere barnesoldater og flyktninger. De ble presentert i henhold til WHOs Frameworks for monitoring health systems performance. Konklusjon Det er relativt få studier utført på barn og unges mentale helsetjenester i Uganda, og de fleste av dem som eksisterer er en del av større studier som involverer flere land. I denne studien prøvde vi å inkludere de som er satt i Uganda, og bare en ser på flere land. De mentale helsetjenestene for barn og unge i Uganda krever forbedring og må fokusere spesielt på sårbare grupper som foreldreløse, HIV / AIDS-berørte ungdommer og tidligere barnesoldater. Det kan styrkes via samarbeid med andre sektorer, integrering i primærhelsetjenesten, reduksjon av stigma og styrket arbeidsstyrke