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Journal articles on the topic 'Mental health services – Zimbabwe'

Author: Grafiati

Published: 4 June 2021

Last updated: 2 February 2022

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1

Mlambo, Tecla, Nyaradzai Munambah, Clement Nhunzvi, and Ignicious Murambidzi. "Mental Health Services in Zimbabwe – a case of Zimbabwe National Association of Mental Health." World Federation of Occupational Therapists Bulletin 70, no. 1 (November 1, 2014): 18–21. http://dx.doi.org/10.1179/otb.2014.70.1.006.

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Dube-Mawerewere, Virgininia, and Sinqobile Patience Ncube-Sibanda. "Service Provider Perspectives on Female Forensic Mental Health Services in Zimbabwe." Journal of Forensic Nursing 16, no. 1 (2020): 47–54. http://dx.doi.org/10.1097/jfn.0000000000000258.

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3

Abas, Melanie, O. Lovemore Mbengeranwa, Iris V. Simmons Chagwedera, Patricia Maramba, and Jeremy Broadhead. "Primary Care Services for Depression in Harare, Zimbabwe." Harvard Review of Psychiatry 11, no. 3 (January 2003): 157–65. http://dx.doi.org/10.1080/10673220303952.

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4

Kurevakwesu, Wilberforce. "COVID-19 and mental health services delivery at Ingutsheni Central Hospital in Zimbabwe: Lessons for psychiatric social work practice." International Social Work 64, no. 5 (July 28, 2021): 702–15. http://dx.doi.org/10.1177/00208728211031973.

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This qualitative study explores the factors affecting mental health services delivery during the COVID-19 pandemic at Ingutsheni Central Hospital. A descriptive phenomenological design was used. Data were collected from 16 participants using interview guides and were analysed through interpretative phenomenological analysis. Participants underlined several factors affecting mental health management and these were, inter alia, the congestion of wards and lack of resources. In riposte, they recommended several solutions towards curtailing these challenges. Based on the findings, the research then elucidates roles that psychiatric social workers can take towards improving mental health services delivery during the pandemic period.

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5

Buchan, Terry. "Two decades of psychiatry in Zimbabwe: 1964–1984." Psychiatric Bulletin 13, no. 12 (December 1989): 682–84. http://dx.doi.org/10.1192/pb.13.12.682.

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The first Pan African Conference in 1961 made a number of recommendations to guide the development of psychiatric services in emergent African countries. The purpose of this paper is to show that the application of these recommendations, admittedly serendipitously at times, led to a considerable measure of success in Zimbabwe.

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6

Sidandi, Paul. "Rehabilitation psychiatry: description of a provincial setting in Zimbabwe." Psychiatric Bulletin 14, no. 9 (September 1990): 552–54. http://dx.doi.org/10.1192/pb.14.9.552.

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Psychiatric services in Zimbabwe are, by African standards, relatively sophisticated and are modelled on the British system. A new patient is assessed using the Maudsley history-taking format modified to suit local situations, and a mental state examination. A physical examination and routine investigations follow. X-ray facilities and basic laboratory work-up such as haematology and microscopy are available at Provincial level. EEG, ultrasonography, echoencephalography, CT scanning and serum anticonvulsant levels are available in Harare and Bulawayo.

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Gudyanga, Denford, Tamaryn Palmer, Nicola Wright, Eileen O'Regan, Charity Shonai, Nefasi Mlambo, Melody Maremera, and Walter Mangezi. "Z Factor: Drama as a tool to tackle mental health stigma: study design and protocol for community and public engagement in rural Zimbabwe." Wellcome Open Research 6 (February 8, 2021): 26. http://dx.doi.org/10.12688/wellcomeopenres.16262.1.

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Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group’s composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Conclusions: Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.

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DUBE-MAWEREWERE, VIRGININIA. "A medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe." Journal of Forensic Practice 17, no. 2 (May 11, 2015): 134–48. http://dx.doi.org/10.1108/jfp-10-2014-0036.

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Purpose – The purpose of this paper is to develop a medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe. Design/methodology/approach – Grounded theory of the Charmaz (2006, 2014) persuasion was used. An exploratory qualitative design was utilised. The theoretical framework that was used as a point of departure was Pierre Bourdieu’s conceptual canon. Participants were purposefully and theoretically sampled. These included the judiciary, patients, patients’ family, psychiatrists, nurses, social workers, experts in forensic psychiatric practice. They were 32 in total. Findings – The findings reflected a need to realign the dislocation and dissonance between and within the fields of the prison system, medical system, and the judiciary. The realignment was done by co-constructing a therapeutic jurisprudent medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe with participants who were stakeholders in forensic psychiatric rehabilitation. Research limitations/implications – The study was focused on male forensic psychiatric patients rehabilitation and not on female forensic psychiatric patients because there were important variables in the two groups that were not homogenous. However, it is possible that including females in the study could have added perspective to the study. This also limits the generalisation of findings beyond the male forensic psychiatric participants. Services beyond the experience of participants translate to the notion that findings cannot be generalised beyond the parameters of the study. Future research and service evaluation and audit need to be considered. The study findings focused on the “psychiatric” aspect and did not emphasise the “forensic” aspect of the service delivery service. Future research may need to feature physical provisions and progression pathways with reference to “forensic” risk reduction as a parallel goal. Practical implications – The study calls for the following: Transformation of the medico-judicial system, adjusting legislation and restructuring of the public service; changing of public attitudes to enable implementation of the medico-judicial framework; there is need for a step by step process in the implementation of the framework in which training needs of service staff, social workers, community leaders and key stakeholders will need to be addressed; the proposed changes presented by the model will require cultural, financial and infrastructural shifts. Social implications – There is need for policy makers to re-enfranchise or rebrand forensic psychiatric rehabilitation services in Zimbabwe. This could positively involve the marketing of forensic psychiatric rehabilitation to the stakeholders and to the public. This is projected to counter the stigma, disinterest and disillusionment that run through both professionals and public alike. This will foster a therapeutic jurisprudence that upholds the dignity and rights of forensic psychiatric patients. Originality/value – This work is an original contribution to forensic psychiatry in Zimbabwe. Research in that area is prohibitive because of the complexity of processes that are followed. This research is therefore ground breaking.

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Mazwi, Nicola, Bongani Seremani, Tsungai Kaseke, and Clemencia Lungu. "PSYCHO-SOCIAL EXPERIENCES OF YOUTHS DURING THE COVID-19 LOCKDOWN: INSIGHTS FROM HARARE, ZIMBABWE." Business Excellence and Management S.I., no. 1 (October 15, 2020): 46–59. http://dx.doi.org/10.24818/beman/2020.s.i.1-04.

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The COVID-19 pandemic that started in Wuhan, Hubei province in China in December 2019 has brought about varied psycho-social experiences to youths during the COVID-19 lockdown period. World Health Organisation warned that the coronavirus and the restrictive measures around it would have negative effects on people’s mental health and well-being. Current scientific literature reveals that in China, UK and Spain COVID-19 outbreak resulted in symptoms leading to psychological disorders while in Africa the 2014 Ebola outbreak resulted in social and economic breakdowns in people’s livelihoods. This qualitative study made use of document analysis as a research design. WhatsApp messages were analysed using thematic analysis. The study sought to explore how youths in Harare, Zimbabwe responded to the lockdown and ways in which the lives of the youths were psychologically and socially affected. Research questions were on; how youths in Harare responded to the lockdown; how the lockdown affected the youths; in what ways the lockdown affected psychological lives of the youths and what can be done in future in order to improve the lives of youths during pandemics. The study revealed that some youths of Harare presented psychological conditions leading to PTSD symptoms such as stress, confusion, anger, anxiety and depression while some embraced COVID-19 Lockdown as it improved family and social ties. It was also noted that youths should be able to access psychological services during epidemics in order to avert surges in mental health illnesses emanating from national lockdowns.

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Rhead, Rebecca, Jocelyn Elmes, Eloghene Otobo, Kundai Nhongo, Albert Takaruza, Peter J. White, Constance Anesu Nyamukapa, and Simon Gregson. "Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe." BMJ Open 8, no. 2 (February 2018): e018751. http://dx.doi.org/10.1136/bmjopen-2017-018751.

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ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

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Wogrin, Carol, Nicola Willis, Abigail Mutsinze, Silindweyinkosi Chinoda, Ruth Verhey, Dixon Chibanda, and Sarah Bernays. "It helps to talk: A guiding framework (TRUST) for peer support in delivering mental health care for adolescents living with HIV." PLOS ONE 16, no. 3 (March 3, 2021): e0248018. http://dx.doi.org/10.1371/journal.pone.0248018.

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Introduction Adolescents living with HIV have poor treatment outcomes, including lower rates of viral suppression, than other age groups. Emerging evidence suggests a connection between improved mental health and increased adherence. Strengthening the focus on mental health could support increased rates of viral suppression. In sub-Saharan Africa clinical services for mental health care are extremely limited. Additional mechanisms are required to address the unmet mental health needs of this group. We consider the role that community-based peer supporters, a cadre operating at scale with adolescents, could play in the provision of lay-support for mental health. Methods We conducted qualitative research to explore the experiences of peer supporters involved in delivering a peer-led mental health intervention in Zimbabwe as part of a randomized control trial (Zvandiri-Friendship Bench trial). We conducted 2 focus group discussions towards the end of the trial with 20 peer supporters (aged 18–24) from across 10 intervention districts and audio recorded 200 of the peer supporters’ monthly case reviews. These data were thematically analysed to explore how peer supporters reflect on what was required of them given the problems that clients raised and what they themselves needed in delivering mental health support. Results A primary strength of the peer support model, reflected across the datasets, is that it enables adolescents to openly discuss their problems with peer supporters, confident that there is reciprocal trust and understanding derived from the similarity in their lived experiences with HIV. There are potential risks for peer supporters, including being overwhelmed by engaging with and feeling responsible for resolving relationally and structurally complex problems, which warrant considerable supervision. To support this cadre critical elements are needed: a clearly defined scope for the manageable provision of mental health support; a strong triage and referral system for complex cases; mechanisms to support the inclusion of caregivers; and sustained investment in training and ongoing supervision. Conclusion Extending peer support to explicitly include a focus on mental health has enormous potential. From this empirical study we have developed a framework of core considerations and principles (the TRUST Framework) to guide the implementation of adequate supportive infrastructure in place to enhance the opportunities and mitigate risks.

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Stewart, Miriam, Kaysi Eastlick Kushner, CindyLee Dennis, Michael Kariwo, Nicole Letourneau, Knox Makumbe, Edward Makwarimba, and Edward Shizha. "Social support needs of Sudanese and Zimbabwean refugee new parents in Canada." International Journal of Migration, Health and Social Care 13, no. 2 (June 12, 2017): 234–52. http://dx.doi.org/10.1108/ijmhsc-07-2014-0028.

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Purpose The purpose of this paper is to examine support needs of African refugee new parents in Canada, and identifies support preferences that may enhance the mental health of refugee parents and children. Design/methodology/approach In all, 72 refugee new parents from Zimbabwe (n=36) and Sudan (n=36) participated in individual interviews. All had a child aged four months to five years born in Canada. Refugee new parents completed standardized measures on social support resources and support seeking as a coping strategy. Four group interviews (n=30) with refugee new parents were subsequently conducted. In addition, two group interviews (n=30) were held with service providers and policy influencers. Findings Separated from their traditional family and cultural supports, refugee new parents reported isolation and loneliness. They lacked support during pregnancy, birth, and postpartum and had limited interactions with people from similar cultural backgrounds. Refugees required support to access services and overcome barriers such as language, complex systems, and limited financial resources. Support preferences included emotional and information support from peers from their cultural community and culturally sensitive service providers. Research limitations/implications Psychometric evaluation of the quantitative measures with the two specific populations included in this study had not been conducted, although these measures have been used with ethnically diverse populations by other researchers. Practical implications The study findings can inform culturally appropriate health professional practice, program and policy development. Originality/value The study bridges gaps in research examining support needs and support intervention preferences of African refugee new parents.

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Haas, Andreas D., Cordelia Kunzekwenyika, Stefanie Hossmann, Josphat Manzero, Janneke van Dijk, Ronald Manhibi, Ruth Verhey, et al. "Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study." BMJ Open 11, no. 7 (July 2021): e049824. http://dx.doi.org/10.1136/bmjopen-2021-049824.

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ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

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Ouansafi, Ilhame, Dixon Chibanda, Epiphania Munetsi, and Victoria Simms. "Impact of Friendship Bench problem-solving therapy on adherence to ART in young people living with HIV in Zimbabwe: A qualitative study." PLOS ONE 16, no. 4 (April 22, 2021): e0250074. http://dx.doi.org/10.1371/journal.pone.0250074.

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Background Adolescents and young people globally are highly vulnerable to poor mental health especially depression, and they account for 36% of new HIV infections in Eastern and Southern Africa. HIV services remain inadequate for this population and their adherence to ART is low. The Friendship Bench (FB), an evidence-based model developed in Zimbabwe to bridge the mental health gap, is a brief psychological intervention delivered on benches in primary care facilities by lay health workers (“grandmothers”) trained in problem-solving therapy. This study explored the experience of young people living with HIV attending FB, and their perception of how problem-solving therapy impacted their adherence to ART. Methods Semi-structured interviews were conducted in July 2019 with 10 young people living with HIV aged 18–24 years, who had recently completed FB counselling in Harare. Participants were purposively sampled and recruited from three primary care facilities. Interviews were conducted in Shona, audio-recorded, transcribed verbatim and translated into English. Transcripts were analysed in NVivo12 using inductive thematic analysis. Results Study findings revealed a clear emotional denial towards HIV, particularly for young people infected perinatally, and a resulting low adherence to ART. The study also unpacked the issues of internal stigma and how young people living with perinatally acquired HIV are informed of their HIV status. Participants reported that FB had a critical role in helping them accept their HIV status. Grandmothers’ empathic attitude was key during counselling on adherence to ART, to demystify the disease and treatment, normalize the reality of living with HIV, encourage young people to socialize with peers and free them of guilt. Interviewees unanimously reported improved ART adherence following FB counselling, and many described enhanced health and wellbeing. Conclusion Participants saw FB as a strong contributor to their general well-being, evident in decreased symptoms of depression and improved adherence to ART. FB problem-solving therapy should be rolled out to further support young people after post-test counselling or HIV serostatus disclosure for perinatally acquired HIV, for acceptance of HIV status and adherence to ART.

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Duffy, Malia, Melissa Sharer, Helen Cornman, Jennifer Pearson, Heather Pitorak, and Andrew Fullem. "Integrating Mental Health and HIV Services in Zimbabwean Communities: A Nurse and Community-led Approach to Reach the Most Vulnerable." Journal of the Association of Nurses in AIDS Care 28, no. 2 (March 2017): 186–98. http://dx.doi.org/10.1016/j.jana.2015.09.003.

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Lund, C., A. Alem, M. Schneider, C. Hanlon, J. Ahrens, C. Bandawe, J. Bass, et al. "Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM." Epidemiology and Psychiatric Sciences 24, no. 3 (April 2, 2015): 233–40. http://dx.doi.org/10.1017/s2045796015000281.

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There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

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Hollander, D. "Zimbabwe: MENTAL HEALTH." Lancet 328, no. 8500 (July 1986): 212–13. http://dx.doi.org/10.1016/s0140-6736(86)92504-3.

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Mangezi, Walter, and Dixon Chibanda. "Mental health in Zimbabwe." International Psychiatry 7, no. 4 (October 2010): 93–94. http://dx.doi.org/10.1192/s1749367600006032.

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Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-economic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken prece dence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.

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Mashamba, Alethea, and Elsbeth Robson. "Youth reproductive health services in Bulawayo, Zimbabwe." Health & Place 8, no. 4 (December 2002): 273–83. http://dx.doi.org/10.1016/s1353-8292(02)00007-2.

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Kidia, Khameer, Debra Machando, Walter Mangezi, Reuben Hendler, Megan Crooks, Melanie Abas, Dixon Chibanda, Graham Thornicroft, Maya Semrau, and Helen Jack. "Mental health in Zimbabwe: a health systems analysis." Lancet Psychiatry 4, no. 11 (November 2017): 876–86. http://dx.doi.org/10.1016/s2215-0366(17)30128-1.

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Mitchell, Duncan. "Mental health services." Learning Disability Practice 9, no. 6 (July 2006): 28. http://dx.doi.org/10.7748/ldp.9.6.28.s26.

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Hendler, Reuben, Khameer Kidia, Debra Machando, Megan Crooks, Walter Mangezi, Melanie Abas, Craig Katz, Graham Thornicroft, Maya Semrau, and Helen Jack. "“We Are Not Really Marketing Mental Health”: Mental Health Advocacy in Zimbabwe." PLOS ONE 11, no. 9 (September 8, 2016): e0161860. http://dx.doi.org/10.1371/journal.pone.0161860.

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Kurebwa, Jeffrey. "Adolescent Sexual Reproductive Health Services in Bindura Urban of Zimbabwe." International Journal of Patient-Centered Healthcare 9, no. 2 (July 2019): 1–20. http://dx.doi.org/10.4018/ijpch.2019070101.

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This study seeks to understand the capacity of adolescent-friendly reproductive health services (AFRHS) in promoting sexual reproductive health (SRP) among adolescents in Bindura Urban of Zimbabwe. The data collection methods used allowed the researcher to get insight on adolescents' experience and the factors associated with their accessing SRH services from AFRHS, the meaning of AFRHS for adolescents, healthcare providers' attitudes towards adolescents seeking SRH services, and community perceptions and readiness to accept AFRHS. The findings showed that both socio-cultural and health facility factors influence utilisation of SRH services. Many of these factors stem from the moral framework encapsulated in socio-cultural norms and values related to the sexual health of adolescents and healthcare providers' poor value clarification. This study provides an empirical understanding of the reasons and factors associated with SRH service utilisation, which goes much deeper than program provision of AFRHS in Zimbabwe.

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Bloom, Gerald. "Two Models for Change in the Health Services in Zimbabwe." International Journal of Health Services 15, no. 3 (July 1985): 451–68. http://dx.doi.org/10.2190/kv70-akeg-y1je-klne.

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The health situation in pre-Independence Zimbabwe was much as elsewhere in the Third World. While the majority suffered excess mortality and morbidity, the affluent enjoyed a health status similar to that of the populations of developed countries. The health services also showed the familiar pattern, with expenditure concentrated on sophisticated facilities in the towns, leaving the rural majority with practically no services at all. With the coming of Majority Rule, the previous pattern of controlling access to facilities on the basis of race could not continue. Two broad routes forward were defined. On the one hand, the private doctors, the private insurance companies, and the settler state proposed a model based on improving urban facilities, depending on a trickle-down to eventually answer the needs of the rural people. On the other hand, the post-Independence Ministry of Health advocated a policy of concentrating on developing services in the rural areas. The pattern of the future health service will depend on the capacity of the senior health planners and on the enthusiasm of front-line health workers but, of overriding importance will be the political commitment to answer the needs of the majority and the outcome of the inevitable struggle for access to scarce health sector resources.

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Dehne, Karl L., and J. Hubley. "Health education services in developing countries: the case of Zimbabwe." Health Education Research 8, no. 4 (1993): 525–36. http://dx.doi.org/10.1093/her/8.4.525.

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WINSTON, C. M., and V. PATEL. "Use of Traditional and Orthodox Health Services in Urban Zimbabwe." International Journal of Epidemiology 24, no. 5 (1995): 1006–12. http://dx.doi.org/10.1093/ije/24.5.1006.

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Bottomley, Virginia. "UK mental health services." Lancet 342, no. 8883 (November 1993): 1366. http://dx.doi.org/10.1016/0140-6736(93)92277-z.

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UYEDA, MARY K., PATRICK H. DeLEON, ROBERT PERLOFF, and ALAN G. KRAUT. "Financing Mental Health Services." American Behavioral Scientist 30, no. 2 (November 1986): 90–110. http://dx.doi.org/10.1177/000276486030002003.

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Shaw, Jenny, and Naomi Humber. "Prison mental health services." Psychiatry 6, no. 11 (November 2007): 465–69. http://dx.doi.org/10.1016/j.mppsy.2007.09.002.

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Kingdon, David. "Transforming mental health services." British Journal of Psychiatry 199, no. 1 (July 2011): 1–2. http://dx.doi.org/10.1192/bjp.bp.111.092247.

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SummarySpecialist teams have had a major impact on service delivery in England. Their effectiveness is now being questioned and integrated teams are developing in some areas. However, the gains made in terms of improved access, engagement and early intervention must not be lost.

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Kisely, S. "Commissioning mental health services." Journal of Epidemiology & Community Health 51, no. 3 (June 1, 1997): 342. http://dx.doi.org/10.1136/jech.51.3.342-b.

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Knapp, Martin, and Jeni Beecham. "Costing mental health services." Psychological Medicine 20, no. 4 (November 1990): 893–908. http://dx.doi.org/10.1017/s003329170003659x.

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SynopsisIn this paper four principal topics are addressed: (a) the policy and political contexts in which demands arise for cost information; (b) the nature and phasing of those demands; (c) the basic rules of empirical costs research for meeting those demands; and (d) concomitant implications for the design, execution and interpretation of their research. Mental health care policy or practice changes which ignore costs, or which embody cost information without obeying or recognizing the four basic rules, can only be of dubious validity, or can only be used to answer a limited range of questions. But, as the illustrative studies show, it need not be an horrendous, or ideologically compromising or scientifically complex task to add a cost dimension to the evaluation of mental health services. There are enough examples in the literature of bad costs research to demonstrate that it is not as simple as some people think, but there are also enough examples of good research t o encourage further attempts.

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Piper, Ed. "Broken Mental Health Services." Health Affairs 32, no. 6 (June 2013): 1171. http://dx.doi.org/10.1377/hlthaff.2013.0275.

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34

Wilkinson, Greg. "Mental Health Services Planning." Bulletin of the Royal College of Psychiatrists 9, no. 7 (July 1985): 138. http://dx.doi.org/10.1192/s0140078900022161.

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A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.

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35

Harrison, Lyn. "Integrating Mental Health Services." Journal of Integrated Care 7, no. 3 (June 1999): 15–25. http://dx.doi.org/10.1108/14769018199900015.

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Lindow, Vivien. "Integrating Mental Health Services." Journal of Integrated Care 7, no. 3 (June 1999): 26–28. http://dx.doi.org/10.1108/14769018199900016.

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37

Brown, Maureen, Natalie Mills, Carmel McCalmont, and Susan Lees. "Perinatal mental health services." Primary Health Care 19, no. 8 (October 2009): 36–39. http://dx.doi.org/10.7748/phc2009.10.19.8.36.c7303.

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38

Friedrich, M. J. "Afghan Mental Health Services." JAMA 308, no. 3 (July 18, 2012): 227. http://dx.doi.org/10.1001/jama.2012.7729.

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39

Leung, Paul K. "Multicultural mental health services." New Directions for Mental Health Services 2000, no. 85 (2000): 105–12. http://dx.doi.org/10.1002/yd.23320008514.

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40

Goldberg, David. "London's mental health services." Psychiatric Bulletin 21, no. 2 (February 1997): 65–66. http://dx.doi.org/10.1192/pb.21.2.65.

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Wilkinson, G. "Mental Health Services Planning." Psychiatric Bulletin 9, no. 7 (July 1, 1985): 138. http://dx.doi.org/10.1192/pb.9.7.138.

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42

Parnell, Myrtle, and Jo VanderKloot. "Mental Health Services - 2001:." Journal of Independent Social Work 5, no. 3-4 (November 15, 1991): 183–203. http://dx.doi.org/10.1300/j283v05n03_14.

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43

Tableman, Betty, and Muriel Katzenmeyer. "Infant Mental Health Services." Prevention in Human Services 3, no. 4 (July 17, 1985): 21–33. http://dx.doi.org/10.1300/j293v03n04_04.

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Phillips, D. "Better mental health services." BMJ 302, no. 6791 (June 22, 1991): 1533–34. http://dx.doi.org/10.1136/bmj.302.6791.1533-b.

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Double, D. "Better mental health services." BMJ 302, no. 6791 (June 22, 1991): 1534. http://dx.doi.org/10.1136/bmj.302.6791.1534.

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Barker, I., and R. Gleave. "Better mental health services." BMJ 302, no. 6791 (June 22, 1991): 1534. http://dx.doi.org/10.1136/bmj.302.6791.1534-a.

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Sims, A. C. P. "Better mental health services." BMJ 303, no. 6800 (August 24, 1991): 471–72. http://dx.doi.org/10.1136/bmj.303.6800.471-c.

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Bouras, N. "Better mental health services." BMJ 302, no. 6788 (June 1, 1991): 1339. http://dx.doi.org/10.1136/bmj.302.6788.1339-b.

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Jolley, D. J., and S. M. Benbow. "Better mental health services." BMJ 302, no. 6788 (June 1, 1991): 1339–40. http://dx.doi.org/10.1136/bmj.302.6788.1339-c.

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Chakraborti, D. "Better mental health services." BMJ 302, no. 6788 (June 1, 1991): 1340. http://dx.doi.org/10.1136/bmj.302.6788.1340.

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