Persons with mental and neurological disorders (PMNDs) are among the most marginalised groups in developing countries, as they are socially excluded and overlooked in most developmental efforts. Due to high levels of stigma and other operational difficulties, PMNDs are often marginalised in routine enumeration exercises. Health and Demographic Surveillance System is an important public health research platform especially in countries that lacks reliable data systems, as it registers and monitor basic demographic and health events such as births, deaths and migration in a geographically defined population. This information is essential for policy development and resource distribution and service delivery. We aim to document the reasons for not counting PMNDs in our communities and demonstrate the usefulness of the Kintampo Health and Demographic Surveillance Systems (KHDSS) platform in counting PMNDs over time. We also documented strategies in providing vital information that helps in establishing the rights of PMNDs.
As a longitudinal study, psychiatric case register was established. Both quantitative and qualitative data collection techniques were used to solicit responses from stakeholders regarding the non-consideration of PMNDs as part of household membership in the study area. PMNDs were identified using the KHDSS and followed every 6 months. The “targeted” (actively searching for PMNDs) and “service provision” (providing medical treatment for PMNDs) approaches were adopted to enhance the identification of PMNDs.
Stigma was the main reason cited for the non-counting of PMNDs in the area. Following a “targeted” and “service provision” approach, the number of PMNDs enrolled into the psychiatric case register went up to 68% in 2010; as against the previous levels of 49 and 54% in 2005 and 2008 respectively. The study highlights the intrinsic value of such an approach for social inclusion of PMNDs.
Stigma against PMNDs was report in this study. We provided evidence that the KHDSS platform is useful for identification of PMNDs for service provision. The paper highlights evidence for policy formulation and implementation.
WHO. Fact Sheet: The World Health Report 2001. Geneva; 2001.
Group, L.G.M.H. Scale up services for mental disorders: a call for action. Lancet. 2007;370(9594):1241–52. CrossRef
Amering M, Schmolke M. Recovery in mental health: reshaping scientific and clinical responsibilities, vol. 7. New York: Wiley; 2009. CrossRef
Ae-Ngibise KA, et al. The experience of caregivers of people living with serious mental disorders: a study from rural Ghana, vol. 8. Atlanta: Global Health Action; 2015.
WHO. Ghana: a very progressive mental health law. The country summary series. 2007. http://www.who.int/mental_health/policy/country/GhanaCoutrySummary_Oct2007.pdf.
Gaisie S, Gyau-Boakye P. Population growth, water/sanitation and health. Population, health and development in Ghana: attaining the Millennium Development Goals; 2007. pp. 91–134.
Doku V, et al. Stakeholders’ perceptions of the main challenges facing Ghana’s mental health care system: a qualitative analysis. Int J Cult Ment Health. 2011;4(1):8–22. CrossRef
Mwageni E, et al. Socio-economic status and health inequalities in rural Tanzania: evidence from the Rufiji demographic surveillance system. Measuring health equity in small areas—findings from demographic surveillance systems. Aldershot: Ashgate Publishing Limited; 2005. p. 28–9.
Owusu-Agyei S, et al. Demographic patterns and trends in Central Ghana: baseline indicators from the Kintampo Health and Demographic Surveillance System. Glob Health Action. 2012;5:1–11. PubMed
Read UM, Doku V. Mental health research in Ghana: a literature review. Ghana Med J. 2013;46(2):29–38.
Awenva AD, et al. From mental health policy development in Ghana to implementation: what are the barriers? Afr J Psychiatry (Johannesbg). 2010;13(3):184–91.
Hutchison AJ, Johnston LH, Breckon JD. Using QSR-NVivo to facilitate the development of a grounded theory project: an account of a worked example. Int J Soc Res Methodol. 2010;13(4):283–302. CrossRef
Doku V, et al. Phase 1. Country report: a situation analysis of mental health policy development and implementation in Ghana. Phase 1. Country report: a situation analysis of mental health policy development and implementation in Ghana; 2008.
Ae-Ngibise KA, et al. Prevalence and risk factors for Active Convulsive Epilepsy in Kintampo, Ghana. Pan Afr Med J. 2015;21(29). doi: 10.11604/pamj.2015.21.29.6084.
Herman AA, et al. The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders. SAMJ South Afr Med J. 2009;99(5):339–44.
GSS. Ghana Statistical Service: 2010 Population and Housing Census (PHC). 2012.
- “Making the Mentally Ill Count”, lessons from a Health and Demographic Surveillance System for people with mental and neurological disorders in the Kintampo districts of Ghana
Kenneth A. Ae-Ngibise
Obed Ernest A. Nettey
Victor Christian Korley Doku
Kwaku Poku Asante
- BioMed Central