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Mental Health care in poor resource settings

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Information about Mental Health care in poor resource settings
Health & Medicine

Published on March 7, 2014

Author: lizafathia

Source: slideshare.net

Description

Mental Health care in poor resource settings
what can or should be done?

an experience from Aceh-Indonesia
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Mental Health care in poor resource settings What can be done? An experience from Aceh Indonesia Marthoenis 3 course of NCDs Kobenhavn Universitet rd

The contents  Situation of Aceh before 2004  Tsunami 2004  (Mental) health programmes  Pasung  Now

Indonesia

Aceh  Current Population: 4,5 Million out of 237 millions in Indonesia  29 years military conflict  One the poorest province in Indoenesia  One of the lowest HDI in Indonesia

Tsunami 2004   Banda Aceh, Calang and Meulaboh were among the hardest area hit by tsunami 2004 In total; 170.000 died and 500.000 homeless

Tsunami 2004  Population Before the Tsunami was 4,271,000 (2004) and as of 15 September 2005 was 4,031,589  Infrasctructures and local government were collaps  Main general hospital was destroyed

After the Tsunami  MoU Heilsinski, December 15, 2006

Health care Reconstructions    Building new hospital and health posts Training and re-training the health officers (nurse, midwife, GP) „Mental health programmes“

Pasung!

 We have some 18.000 cases like this, how do we start?

Resources!:  Some 500 CMH nurses  Strong commitment from the local goverment  BUT  Regulation?  Mental Hospital : Only one with 350 beds  6 Psychiatrists for 4.4 million population

12 10 8 Column 1 Column 2 Column 3 6 4 2 0 Row 1 Row 2 Row 3 Row 4

The Programme:  Network between trained nurse  Case finding  Family of the patient  Mental health cadre  Referral system  Local social health Insurance 

Theoretically

The Barriers Saraceno et al 2007  Barrier 1: Low Political will  Barrier 2: Resistence to decentralization  Barrier 3: Difficulties in integrating Mental Health in PHC  Barrier 4: weak Human resurce capacity and development  Barrier 5: Mental health Leadership often lack of public health skills What is missing here?

Aceh Health Insurance (2010)  Social health insurance to ensure all people have access to proper health care!  Premium paid by the local goverment  Problem  Similar number of resource while the demand of health service is inreasing  Moral hazard

However

Messages!  Mental health is sooooooooooooooo much neglected  But we can do something!  Start from now  Start from your self  Start from a small thing

Terima Kasih

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