ArticleInternational journal of mental health systems2019
Implementation of mhGAP in Mozambique: integrating epilepsy care into the primary health care system.
Article in International journal of mental health systems, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Trial
- Integrating neurology in community healthcare in sub-Saharan Africa: experience and outcomes of the 7-year partnership between the Italian Society of Neurology and the DREAM program.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Improving mental health literacy of frontline community health workers in a rural district of Pakistan: mPareshan project.BJPsych open · 2026Article
- Characterizing modifications to the mental health gap action programme (mhGAP) intervention guide during implementation in low- and middle-income countries using the framework for reporting adaptations and modifications to evidence-based interventions: a systematic review of reviews.International journal of mental health systems · 2025Review
- Screening for posttraumatic stress disorder (PTSD) in Mozambique: Validation of the Primary Care Posttraumatic Stress Disorder Screen for Diagnostic and Statistical Manual fifth edition (PC-PTSD-5).Psychological trauma : theory, research, practice and policy · 2025Article
- Contextualization and adaptation of the child and adolescent mental and behavioural disorders module of the mhGAP-IG in Kilifi and Nairobi counties in Kenya.Global mental health (Cambridge, England) · 2025Article
- Does It Matter What Screener We Use? A Comparison of Ultra-brief PHQ-4 and E-mwTool-3 Screeners for Anxiety and Depression Among People With and Without HIV.AIDS and behavior · 2023Article
- Unlocking the hidden burden of epilepsy in Africa: Understanding the challenges and harnessing opportunities for improved care.Health science reports · 2023Article
- Prevalence and associated factors of common mental disorders in primary care settings in Sofala Province, Mozambique.BJPsych open · 2023Article
- A Multi-Site Study of Mental Disorders in the Mozambican Health Care System.Administration and policy in mental health · 2023Article
- Feasibility and preliminary efficacy of training health workers in detecting Priority Mental Health Conditions among adolescents in rural South India.Pilot and feasibility studies · 2022Article
- Article
- The burden of T. solium cysticercosis and selected neuropsychiatric disorders in Mocuba district, Zambézia province, Mozambique.PLoS neglected tropical diseases · 2022Article
- Burden of epilepsy in Latin America and The Caribbean: a trend analysis of the Global Burden of Disease Study 1990 - 2019.Lancet regional health. Americas · 2022Article
- Effectiveness of community health workers on identification and mobilization of persons living with epilepsy in rural Rwanda using a validated screening tool.Human resources for health · 2022Article
- High prevalence of epilepsy in Northern Rwanda: Exploring gender differences.Brain and behavior · 2021Article
- Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence-Based Practices (PRIDE) in Mozambique.Psychiatric services (Washington, D.C.) · 2021Article
- Community health workers to improve adherence to anti-seizure medication in rural South Africa: Is it cost-effective?Epilepsia · 2021Article
- Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities.Parasites & vectors · 2020Review
- Process evaluation of a district mental healthcare plan in Nepal: a mixed-methods case study.BJPsych open · 2020Article
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6 authors.
Funding
Abstract
backgroundEpilepsy remains the most frequent diagnosis in Psychiatric and Mental Health Services in Mozambique. Because it is a major concern, in 2013 a Program for "
methodsThe first step for implementation was advocacy from the Government level to relevant stakeholders in the community. mhGAP training materials were translated and adapted to the local context. Non-specialists health providers and community health workers were trained and supervised regularly. Population awareness raising and community involvement were key for acceptance of the Program.
resultsAfter 4 years of implementation, 177 health professionals and 1161 community health workers were trained and ensured services delivery for people living with epilepsy (PwE). The implementation led to 89,869 consultations, representing an increase of 67% since the Program's inception. From 2015 to 2017 a total of 13,563 new cases were attended and the treatment gap was reduced from 99 to 96%. More than 60% of the new cases are children and adolescents. Awareness actions reached more than 14,000 people per year using all available broadcast means. Preliminary positive results were used as evidence for the Ministry of Health (MoH) to increase the purchase of antiepileptic drugs and improve delivery at district level. DISCUSSION: mhGAP is an important tool for reducing the treatment gap in low-income countries. Adapting guidelines to the country context and involving community stakeholders are key for Program sustainability. As in other settings, the strategy was cost-effective resulting in an increase in new cases and follow-up consultations.
conclusionsImplementation of an adapted mhGAP strategy and the involvement of community stakeholders and commitment of the MoH resulted in significant increase in the number of PwE attending outpatient services in primary health care facilities.
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