ArticlePloS one2020
Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana - structural equation modelling.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Resource allocation efficiency in Ethiopian hospitals: technology utilization as mediator and staff competency as moderator.Cost effectiveness and resource allocation : C/E · 2026Article
- Disability in subjects who survive road traffic injuries in 2 regions of southwest Colombia: A causal mediation analysis.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Cross-cultural impact of information anxiety on employee mental health in digital workplaces: a comparative study between Chinese and Western contexts.Frontiers in psychology · 2026Article
- Providers' insight into quality mental health services - Context-Mechanism-Outcome (CMO) approach.BMC health services research · 2025Article
- A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes.BMC health services research · 2021Article
- Article
- Recovery services and expectation of consumers and mental health professionals in community-based residential facilities of Ghana.BMC psychiatry · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIncorporating consumers' perspectives into the quality of mental health service measurement is a growing priority among mental health professionals' and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services. This study, therefore, aims to measure the mediation and moderation effects of health system structure and process on mental health quality in Ghana.
methodsA random sample of 510 consumers were recruited to complete the Verona Satisfaction Scale (54-items), together with the WHO Disability Assessment Instrument (36 items) using the Redcap application. Confirmatory factor analysis (CFA) and Structural Equation Modelling were used to test the hypothesised theory using STATA 15.
resultsThe CFA showed that the hypothesised model had a good fit to the data. The findings confirmed the hypothesis that the process constructs mediate the relationship between the health system structure and the outcome of mental health services. Specifically, the health system structure had a positive and significant causal relationship with the mediator-process (β = 0.60; p<0.01) and outcome (β = 0.47; p<0.01). Additionally, the mediator-process had a positive causal relationship with the outcome of the mental health services (β = 0.32; p<0.01). Insurance status (β = 0.07; p>0.05) and type of services (β = 0.025; p>0.05) had a positive moderating effect on the relationship between health system structure and outcome but were not significant.
conclusionImprovements to mental health system structure and the process could promote the quality of services as experienced by consumers. Government stakeholders are encouraged to accordingly strengthen health systems with the aim of improving the mental health outcomes for consumers.
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