Stakeholders' perceptions of the main challenges facing Zambia's mental health care system: a qualitative analysis

Abstract

Despite radical health transformations in Zambia over the last decade, mental health continues to be marginalized, as reflected in the un-coordinated and under-resourced mental health care system. This paper presents the qualitative results of a situation analysis conducted as part of the first phase of the Mental Health and Poverty Project. The aim of this paper was to explore what a range of stakeholders perceive as the main challenges facing Zambia's mental health system and the primary ways of addressing them. Fifty interviews and six focus group discussions were held with policy makers in and outside of the ministry of health, general and mental health care professionals, users of psychiatric services, teachers, police officers, academics, members of three NGOs and traditional healers. The major challenges identified included: marginalization of mental health; flawed policy development; outdated and harmful legislation; human rights abuses, including stigma; limited mental health services; and inadequate psychiatric professionals. Recommendations included: revamping legislation; promoting greater inter-sectoral collaboration; initiating anti-stigma programs; and addressing the human resources constraints. There is an urgent need for increased consensus and political will within government to place mental health on the national agenda.

Keywords:

• mental health system
• Zambia
• challenges
• qualitative study

Acknowledgements

This research was funded by the UK Department for International Development (DfID) (RPC HD6 2005- 2010) for the benefit of developing countries. The views expressed are not necessarily those of DfID. We would like to acknowledge the respondents for their valuable contributions.