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Advances in Social Sciences Research Journal – Vol. 8, No. 11
Publication Date: November 25, 2021
DOI:10.14738/assrj.811.11201. Ghangha, G. J., Fobellah, N. N., Ateghang-Awankem, B., & Atang, N. S. (2021). Knowledge and Pattern of Mental Health Care
Practices in Buea Health District. Advances in Social Sciences Research Journal, 8(11). 197-210.
Services for Science and Education – United Kingdom
Knowledge and Pattern of Mental Health Care Practices in Buea
Health District
Ghangha Jamin Ghangha
Faculty of Health Sciences, University of Buea, Cameroon
Nkengafac N. Fobellah
St. Monica University Institute, Buea, Cameroon
Bernadette Ateghang-Awankem
Pan African Health Systems Network, Nussloch. Germany
Ndeso Sylvester Atanga
Faculty of Health Sciences, University of Buea, Cameroon
St. Monica University Institute, Buea, Cameroon
ABSTRACT
Background: According to the WHO, mental health is “a state of well-being in which
the individual realizes his or her own abilities, can cope with the normal stresses of
life, can work productively and fruitfully, and is able to make a contribution to his
or her community”. Healthcare providers especially in primary health care play a
major role in the management of individuals who are mentally challenged. This
study describes the knowledge and mental health care delivery patterns in the Buea
Health District. Methods: We conducted a hospital- based cross-sectional study in
15 randomly selected health care facilities in the Buea Health district. Structured
questionnaires were administered to healthcare providers (doctors, nurses and
counselors/psychologists) in the selected health facilities to assess their level of
knowledge and type of mental health care rendered to clients in Buea community
of the south west region of Cameroon. Results: Out of a total of 300 questionnaires
distributed, 292 were returned giving a response rate of 99.3%. Of the 292
participants, 117 (40.1%) health care providers had low knowledge levels of mental
health disorders. Similarly, 114 (39.0%) of HCP (Health Care Providers) did not
practice mental health care delivery in conformity to acceptable standards. HCP
who had attained the Masters level of education and who had 7-10 years of work
experience were more likely to have good knowledge on mental health disorders
(OR = 1.33, CI = 0.10-6.56, P-value = 0.030 and OR = 0.51, CI = 0.19-0.59, P-value =
0.001 respectively), compared to less trained professionals. Regarding practice,
being a female was a most likely factor for good practice of mental health care (OR
= 0.82, CI = 0.49 – 0.38, P-value = 0.024) compared to being a male. Conclusion:
Knowledge levels among practitioners of mental disorders and practiced care in the
Buea Health District is below acceptable standards. There is an urgent need to train
HCPs in mental health and ideal practice situations for the improvement of mental
health care delivery in the district and the region.
Key words: Healthcare Providers, Mental Health, Mental disorder, Practice.
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Advances in Social Sciences Research Journal (ASSRJ) Vol. 8, Issue 11, November-2021
Services for Science and Education – United Kingdom
BACKGROUND
The World Health Organization (WHO) defines mental health as “a state of well-being in which
the individual realizes his or her own abilities, can cope with the normal stresses of life, can
work productively and fruitfully, and is able to make a contribution to his or her community
[1]. Psychiatric disorders are a major burden of illness worldwide, often treated by health
providers who are not specialized in managing mental health illnesses in general health
facilities. In these facilities, once patients are seen by non-specialist in mental issues, referral to
psychiatrists or other mental health expert is imperceptible [2]. This arises in most
circumstances for reasons which are attributed to: greater patient comfort with non- psychiatric workers in general health facilities; the desire to avoid being labeled mentally ill;
and a long waiting period for a psychiatric consultation. It is therefore important to
acknowledge that non-psychiatric health workers in general health facilities play a pivotal role
in the diagnosis and management of patients with mental illnesses [3]. Despite the existence of
a mental health policy for children and adolescents, Cameroon still remains one of the countries
in Africa whose mental health sector remains underdeveloped. It is worth noting that there are
only two recognized state owned psychiatric centres (Hôpital Jamot de Yaoundé and Hôpital La
quintinie in Douala) in the country [4]. Each Regional Hospital in the country has a mental
health unit headed by one or two psychiatric nurses. However, with regard to the burden of
mental health disorders in Cameroon which stands at 6.1%, the number of personnel deployed
to the regional level remains appalling and insignificant [5]. The field of mental health and
psychiatry is one which has been stigmatized by the lay man and even by some health care
providers. The training curricula of medical doctors and nurses is biased towards infectious
diseases with very little attention to mental healthcare [6]. This training gap may affect
knowledge and practices of mental health in one way or the other in the South West Region of
Cameroon.
This study therefore aimed at determining the knowledge of and practices towards mental
disorders among hospital staff among health facilities in the Buea Health District (BHD).
Findings from the study can be useful in revising training and mental health practice policy for
better patient outcomes in the district and at the regional level.
MATERIALS AND METHODS
Study Design and Setting
The Buea Health District (BHD) is one of the largest health districts in the South West region of
Cameroon with an estimated population of about 300,000 inhabitants on a surface area of over
870 square kilometers [7]. There are 7 health areas namely Muea, Molyko, Buea Road, Buea
Town, Bokwaongo and Tole. There are 38 functional health facilities within the 7 health areas.
These health facilities include health centers and hospitals which represent the peripheral and
intermediate levels of the Cameroon health system classification. Data on the exact number of
health personnel in these health facilities is unavailable. There are two mental health nurses
and one clinical psychologist within the BHD with all of them localized at the Regional Hospital
Buea.
We conducted an observational cross-sectional study of health care providers in 5 health areas
in the BHD who consented voluntarily to participate. Health care providers were selected by a
consecutive convenience sampling.
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Ghangha, G. J., Fobellah, N. N., Ateghang-Awankem, B., & Atang, N. S. (2021). Knowledge and Pattern of Mental Health Care Practices in Buea
Health District. Advances in Social Sciences Research Journal, 8(11). 197-210.
URL: http://dx.doi.org/10.14738/assrj.811.11201
Participants and Sampling
The target population was made up of health care providers (medical doctors, nurses and
psychologist/counselors). This study population was deliberately chosen because they are
expected to provide primary health care which includes early detection of mental disorders.
Nurses and psychologists/counselors were included in this study because they are most likely
to receive clients from medical doctors presenting with mental health issues for follow up and
management either by way of pharmacotherapy, psychotherapy or counseling. In the health set
up, medical doctors also receive cross referrals from the nurses and psychologists/counselors.
Eligible participants were HCPs who had at least 3 years of work experience and who provided
informed written consent. Those with less than 3 years of work experience were excluded from
the study because they were likely no to have experienced or managed a good number of cases.
Participants were enrolled at their workstations between January to July 2020. Every eligible
participant available was approached by the principal investigator either for the administration
of the structured questionnaire or for the In-depth Interviews (IDI).
Participation was voluntary and anonymous questionnaires were administered to participants
who gave their consent and were to be returned within a one-week period. Questionnaires were
anonymous. The questionnaire was pilot tested prior to the survey proper. A total of 300 health
care providers agreed to participate in this study but only 292 returned completely filled
questionnaires.
Data Collection, Variables and Measurements
Data was obtained using a structured questionnaire which was self-administered. The
questionnaire was divided into three main sections. Section 1; which collected information on
the key socio-demographic variables of the PHCPs (age, gender, professional category, religion
and years of work experience). Section 2 had 12 questions which assessed the knowledge of
health care providers about mental health disorders. Section 3 handled key items as regards
their practices of mental health care. Knowledge and practice questions were selected from
questions found in other studies [8, 9] and the questions were modified or rephrased for better
understanding and adapted to our study.
Data Management and Statistical Analysi
Questionnaires were cross-checked to make sure that they were completely filled by the
participants. Questionnaires with a response rate of less than 20% were rejected.
Data from the questionnaires were entered into an Epi Info version 7.2.2.6 (Epi InfoTM, Division
of Health Informatics & Surveillance (DHIS), Center for Surveillance, Epidemiology & Laboratory
Services (CSELS)) and exported to MS Excel 2016 (Microsoft Corporation. Microsoft Excel
[Internet]. 2018. Available from: https://office.microsoft.com/excel ) for cleaning. Finally, it was
exported to IBM SPSS software version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for
Windows, Version 25.0. Armonk, NY: IBM Corp) for analysis. Continuous variables such as age
and years of work experience were analyzed using frequencies and proportions. Participants’
responses were categorized using relative and absolute frequencies and some key findings
were represented on bar charts and pie charts. Logistic regression analysis was used to identify
the sociodemographic factors associated with knowledge and practice. What do you mean? To
determine the level of knowledge and practice, an average score was set at 50% wherein
participants who had a grade of <50% of the questions on the knowledge and practice sections