ArticleBMC primary care2026
Impact of an mhGAP-based epilepsy training program on primary healthcare providers in Palestine: a quasi-experimental study in an under-resourced setting.
Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn low- and middle-income countries (LMICs) such as Palestine, where healthcare systems are under-resourced and politically constrained, epilepsy is a prevalent neurological illness characterized by significant treatment gaps. Marginalized populations experience these gaps disproportionately. The WHO Mental Health Gap Action Program Intervention Guide (mhGAP-IG) seeks to rectify these disparities by training non-specialist primary healthcare practitioners in the management of priority diseases. This study evaluates the impact of a culturally adapted mhGAP-based epilepsy training on the knowledge, attitudes, and self-efficacy of primary healthcare providers (PHCPs) in the West Bank, Palestine.
methodsSixty-eight primary healthcare providers in the Hebron governorate engaged in a quasi-experimental pre-post design that included a control group. Participants were randomly assigned to an intervention group (n = 32), which received a 3-day mhGAP epilepsy training, or a control group (n = 36), which received no training. Validated assessments were employed to collect data at baseline and three months post-intervention. Outcomes were analyzed using non-parametric tests and Quade’s ANCOVA as the primary analysis, with effect sizes and 95% confidence intervals.
resultsFollowing the adjustment for baseline scores, the intervention significantly enhanced knowledge (p < 0.001, η² = 0.320) and self-efficacy (p < 0.001, η² = 0.106). Attitudes exhibited minimal change, probably due to ceiling effects and the brief follow-up duration. Despite requests for further psychosocial and stigma-reducing resources, participant feedback emphasized enhanced confidence in patient communication and seizure management.
conclusionsIn a politically complex, resource-limited context, mhGAP-based training was associated with significant improvements in provider competence. Due to the lack of epilepsy monitoring units in Palestine and reliance on primary care for epilepsy management, task-sharing strategies are required. This intervention promotes equitable treatment of individuals with epilepsy in poor and rural settings by equipping non-specialist primary healthcare providers with essential skills. Utilizing task-sharing in primary care, the widespread implementation of culturally tailored training in comparable under-resourced settings can significantly reduce global health disparities and promote health equity.
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