Contradictions hindering the provision of mental healthcare and psychosocial services to women experiencing homelessness in Addis Ababa, Ethiopia: service providers’ and programme coordinators’ experiences and perspectives

BMC Health Services Research

Research

Yemane Berhane¹  Hannah Bradby²  Mats Målqvist³  Sibylle Herzig van Wees⁴  Kalkidan Yohannes⁵ 

[1] Addis Continental Institute of Public Health, Addis Ababa, Ethiopia;International Child Health and Nutrition- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden;Department of Sociology, Uppsala University, Uppsala, Sweden;SWEDESD, Department of Women’s and Children’s Health, Uppsala University, SE-751 85, Uppsala, Sweden;SWEDESD, Department of Women’s and Children’s Health, Uppsala University, SE-751 85, Uppsala, Sweden;Department of Global Public Health, Karolinska Institute, Stockholm, Sweden;SWEDESD, Department of Women’s and Children’s Health, Uppsala University, SE-751 85, Uppsala, Sweden;Department of Women’s and Children’s Health, WoMHeR– Women’s Mental Health during the Reproductive Lifespan, Uppsala University, Uppsala, Sweden;Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia;

关键词: Qualitative research;    Mental healthcare;    Psychosocial support;    Street homelessness;    Women of reproductive age;    Low- and middle-income countries;    Service provider perception;    Ethiopia;   

DOI  :  10.1186/s12913-023-09810-z

 received in 2022-11-21, accepted in 2023-07-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women’s mental health and psychosocial needs. Therefore, we explored service providers’ and programme coordinators’ perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.MethodsWe conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.ResultsFour themes were derived from the analysis. The first of these was “divergent intentions and actions”. While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed “problem-solution incompatibility”, which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation’s complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, “the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges”. The fourth theme, “mismatched resources,” indicated structural and systemic barriers to providing services to homeless women.ConclusionsConflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

【 授权许可】

CC BY   
© The Author(s) 2023

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