Incorporating Mental Health In Primary Healthcare

October 12th, 2009 healthwiki Mental Health 0

The incidence of mental disorder is rising by and by. Wave of migration, industrialisation, individualism, changing socio-cultural norms, changing family pattern, over careerist drive and drug addiction are the important factors considered behind this rising trend. In Bangladesh, a community based research on mental illness conducted in 2005 reported that 16.1 per cent adult populations suffer from various mental disorders.

It is the scenario of only from adult population and no research has been conducted among the children. The situation is more scary when we look at the statistics that say there is only one psychiatrist for 1500000 persons. There are only 120 psychiatrists in our country that depicts the pitiable condition.

After calculation, it has been found that there are only 813 psychiatric beds in Bangladesh to serve the whole nation. That means 172000 people share one bed. In 2005 only 0.44 percent was allotted for mental health in total health budget which was obviously insufficient.

In this situation, we will observe World Mental Health Day today. This year, the World Federation for Mental Health has decided the theme “Mental health in primary care: enhancing treatment and promoting mental health”. The theme is intended to emphasise the benefits of enhancing overall health and promoting mental health by integrating healthcare services.

National survey on mental health in Bangladesh reveals, about 14 lacs people have been suffering from major mental disorders (schizophrenia, mood disorders etc.), 65 lacs people have been suffering from depressive disorder and 1 crore 18 lacs people have been suffering from minor mental disorders (anxiety, phobia , conversion disorder etc).

Besides, about 46 lacs to 70 lacs people are drug addicted. Most of these patients are found in general practice, outpatient service at hospital and primary health care centers.

Mental disorder creates a substantial personal burden for affected individuals and their families. They produce significant economic and social hardship that affects the society. Many people suffer from both physical and mental health problems. Integrated primary care services help ensure that people are treated in a holistic manner, meeting the mental health needs of people with physical disorders as well as the physical health needs of people with mental disorders.

If the mental health care is included in the primary healthcare, our mental health service will reach the outreach. Patients and families can avoid indirect costs associated with seeking specialist care in distant locations. Treatment of common mental disorders is cost effective. Investments by governments can bring important benefits.

To include the mental health component in primary health care service, it should be first included in the health policy. There is dire need of intensive attention to mental health.

There is also a need of fundamental training in mental health with ensuring the supply of common psychotropic drugs in field level. To build a healthy nation we should promote mental health by enhancing treatment facilities in primary health care system. To survive on the runway to globalisation we should not observe this World Mental Health Day only as one-day event, rather give cordial effort to realise the theme for healthy nation.

Ensuring Equal Access to Eye Care

October 12th, 2009 healthwiki Eyes 0

Irrespective of gender and age, everyone has the equal right to see the beauty of this world. But access to eye care services for women and girls is not equal to that of men and boys. Only 35 percent of eye care services are received by women and girls who are blind and remaining 65 percent services are received by their male counterparts.

Experts identified gender discrimination, customary social attitude, lack of women empowerment, lack of education and awareness, fissure in national policy for eye health are the barriers to equal access to eye care services.

Nearly two-thirds of blind people worldwide are women and girls. Less access to eye care services than men is one important fact behind the huge number of blind women and girls. Moreover, certain eye conditions like trachoma and cataract affect women more than men contributing the rising number.

The theme of World Sight Day 2009 that was being observed on October 8 was “Gender and eye health — equal access to care”. It was dedicated to ensure gender equality in the access of eye care services, which is unfortunately not the case in Bangladesh.

There is urgent need to step up focus on women and girls who unnecessarily have already become blind or becoming blind where simple interventions can prevent blindness and help them get back their precious sight.

Women and girls face the discrimination in receiving proper eye care services due to certain factors that should be eliminated.

“We have common social attitude that women should always get less priority not only in getting eye care but also in all social services. Male people of the family hold the decision making power and they are reluctant to bring women and girls under eye care services as they are not earning members of the families”, said renowned ophthalmologist Dr M A Muhit, Clinical Research Fellow of International Centre of Eye Health, London.

“Women are also not aware of the fact that they have equal right to access eye care as male. Moreover, many women have accepted the condition as their fate; rather they prefer treatment of their husbands or children. But very few of them know that 80 per cent of the blindness can be prevented with early intervention and sight restoring surgery”, Dr Muhit added.

Although female gender are more in number and deprived more, there is no gender analysis or gender sensitive issue in the national plan for eye health in Bangladesh. Health authorities in the national level need to recognise the existing gender differences in access to eye care services. This could be an important step to reducing the disparity in eye care treatment for women.

Dr Muhit opined that the existing programmes to eradicate avoidable blindness and improve eye health in Bangladesh must give emphasis on counselling, education, awareness and empowering women. Along with women, men as they are considered decision makers, must be motivated and make aware about the significance of sight restoring operations or treatment for women to help them get back their sight.

Blind women cannot contribute to the well-being of the family with ease. Motivating men and women together can have the tremendous impact on community mobilisation. With access to timely treatment of women with impaired vision or avoidable blindness can bounce back and lead more fulfilling lives, Dr Muhit suggested.

Women need better access to eye care services. Without ensuring equal access to eye care for them, we cannot meet the target to eradicate avoidable blindness within 2020. Let’s make a cumulative move to reach the goal.