The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia

Chinese Medicine

Reiner Frank¹  Christine Gruber-Frank¹  Mubarek Abera²  Markos Tesfaye² 

[1] Global Mental Health Group, Centre for International Health, Ludwig Maximilians University, Munich, Germany;Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia

关键词: Program evaluation;    WHO mhGAP intervention guide;    Capacity building;    Teaching;    Ethiopia;    Low income country;    Child mental health curriculum;   

Others  :  790569
DOI  :  10.1186/1753-2000-8-6

 received in 2013-08-06, accepted in 2014-02-18,  发布年份 2014

【 摘 要 】

Background

The lack of trained mental health professionals has been an important barrier to establishing mental health services in low income countries. The purpose of this paper is to describe the development and implementation of child psychiatry training within a graduate program in mental health for non-physician clinicians in Ethiopia.

Methods

The existing needs for competent practitioners in child psychiatry were identified through discussions with psychiatrists working in Ethiopia as well as with relevant departments within the Federal Ministry of Health Ethiopia (FMOHE). As part of a curriculum for a two year Master of Science (MSC) in Mental Health program for non-physician clinicians, child psychiatry training was designed and implemented by Jimma University with the involvement of experts from Addis Ababa University (AAU), Ethiopia, and Ludwig-Maximillian’s University, (LMU), Germany. Graduates gave feedback after completing the course. The World Health Organization’s (WHO) Mental Health Gap Action Program (mhGAP) intervention guide (IG) adapted for Ethiopian context was used as the main training material.

Results

A two-week child psychiatry course and a four week child psychiatry clinical internship were successfully implemented during the first and the second years of the MSC program respectively. During the two week psychiatry course, trainees learned to observe the behavior and to assess the mental status of children at different ages who had a variety of mental health conditions. Assessment of the trainees’ clinical skills was done by the instructors at the end of the child psychiatry course as well as during the subsequent four week clinical internship. The trainees generally rated the course to be ‘very good’ to ‘excellent’. Many of the graduates have become faculty at the various universities in Ethiopia.

Conclusion

Child psychiatry training for non-physician mental health specialist trainees was developed and successfully implemented through collaboration with other universities. The model of institutional collaboration in training mental health professionals in the context of limited resources provides a useful guide for other low income countries where there is scarcity of psychiatrists.

【 授权许可】

   
2014 Tesfaye et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rhode LA, Srinath S, Ulkuer N, Rahman A: Child and adolescent mental health worldwide: evidence for action. Lancet 2011, 378(9801):1515-25.
• [2]Saxena S, Thornicroft G, Knapp M, Whiteford H: Resources for mental health: scarcity, inequity, and inefficiency. Lancet 2007, 370(9590):878-89.
• [3]Russell PS, Mammen P, Nair MKC, Russell S, Shankar SR: Priority mental health disorders of children and adolescents in primary-care pediatric setting in India 1: developing a child and adolescent mental health policy, program, and service model. Indian J Pediatr 2011, 79(S1):19-26.
• [4]Servili C: Organizing and delivering services for child and adolescent mental health. In IACAPAP e-Textbook of Child and Adolescent Mental Health. Edited by Rey JM. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions; 2012.
• [5]Central Intelligence Agency (US): The World Factbook. https://www.cia.gov/library/publications/the-world-factbook/geos/et.html webcite
• [6]World Bank: Ethiopia Overview. http://www.worldbank.org/en/country/ethiopia/overview webcite
• [7]Federal Democratic Republic of Ethiopia Ministry of Health: National Mental Health Strategy 2012/13 - 2015/16. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2012.
• [8]World Health Organization: World Health Organization mental health GAP (WHOmhGAP) intervention guide for mental, neurological and substance use disorders in non-specialized health settings: version 1.0. Geneva: World Health Organization; 2010.
• [9]Patel V, Flisher AJ, Nikapota A, Malhotra S: Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry 2008, 49(3):313-34.
• [10]Alem A: Psychiatry in Ethiopia. Int Psychiatry 2004, 1(4):8-10.
• [11]Fricchione GL, Borba CPC, Alem A, Shibre T, Carney JR, Henderson DC: Capacity building in global mental health: professional training. Harv Rev Psychiatry 2012, 20(1):47-57.
• [12]Alem A, Pain C, Araya M, Hodges B: Co-creating a psychiatric resident program with Ethiopians, for Ethiopians, in Ethiopia: the Toronto Addis Ababa Psychiatry Project (TAAPP). Acad Psychiatry 2010, 34(6):424-32.
• [13]Russell PS, Nair MK: Strengthening the paediatricians project 2: the effectiveness of a workshop to address the priority mental health disorders of adolescence in low-health related human resource countries. Asia Pac Fam Med 2010, 9(1):3. BioMed Central Full Text
• [14]Jimma University: Masters of Science in Integrated Clinical and Community Mental Health Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University. 2009. http://www.ju.edu.et/cphms/node/131?q=node/132 webcite
• [15]Central Statistical Agency: Census 2007. Addis Ababa: Central Statistics Agency; 2007. http://www.csa.gov.et webcite
• [16]Postgraduate Education at Jimma University, Ethiopia - Center of International Health - LMU Munich http://www.international-health.uni-muenchen.de/index.html webcite
• [17]WHO: Human resources and training in mental health. In Mental Health Policy and Service Guidance Package. Geneva: WHO; 2005. http://www.who.int/mental_health/policy/Training_in_Mental_Health.pdf webcite
• [18]Rey JM (Ed): IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions; 2012.
• [19]Frank R, Gegenfurtner G, Steininger C, Kopecky-Wenzel M, Noterdaeme M: What do medical students learn in the elective course in child and adolescent psychiatry? was lernen Medizinstudenten im Wahlfach Kinder- und Jugendpsychiatrie? Z Kinder Jugendpsychiatr Psychother 2009, 37:129-134.
• [20]Nestel D, Tierney T: Role-play for medical students learning about communication: guidelines for maximizing success. Med Educ 2007, 7:1472-6920.
• [21]Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, Araya R, Ntulo C, Thornicroft G, Saxena S: Scale up of services for mental health in low-income and middle-income countries. Lancet 2011, 378(9802):1592-603.
• [22]Teshima J: Teaching child psychiatry in Ethiopia: challenges and rewards. J Can Acad Adolesc Psychiatry 2008, 17:145-9.
• [23]Royal College of Paediatrics and Child Health: A Syllabus and Training Record for General Professional and Higher Specialist Training in Paediatrics and Child Health. London: Royal College of Paediatrics and Child Health; 2000.
• [24]Hanson MD, Szatmari P, Eva KW: The differential impact of clerk interest and participation in a child and adolescent psychiatry clerkship rotation upon psychiatry and pediatrics residency matches. Acad Psychiatry 2011, 35(4):226-31.
• [25]Steinert Y, Mann K, Centeno A, Dolmans D, Spencer J, Gelula M, Prideaux D: A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education. Med Teach 2006, 28(6):497-526.