Developing a competence-based framework for theprovision of mental healthcare in patients with mental health problems and HIV in primary healthcare in Maseru, Lesotho = Ukuthuthukisa uhlaka olususelwa ekukwazini ukuhlinzekela iziguli ezigula ngokomqondo eziphinde zibe negciwane le-HIV ezelashwa ngonakekelo oluphezulu eMaseru, eLesotho.

Abstract

In 2017 there were approximately 792 million people with mental health problems globally. mental health problems are increasing rapidly globally but mental health services are lacking. Approximately 80% of people living with Human immunodeficiency virus have mental health problems yet these disorders have been absent from the global health agenda. Around 90% of people who require MHS do not obtain them in Low and middle-income countries. The aim of the study was to develop a competence-based framework for mental health provision in people living with Human immunodeficiency virus in primary Health Care in Lesotho. A mixed method study was used. In total, 88 questionnaires were returned by the respondents and 50 interviews were conducted. The findings from the quantitative and qualitative study were supportive and used to develop a competence-based framework that would facilitate the provision of mental health services for people presenting with mental health problems and Human immunodeficiency virus in primary health care. The quantitative data was analysed using an appropriate software package, in this case SPSS version 26. Qualitative data was analysed using the software called Nvivo and thematic framework analysis. 92 % of the participants needed competence-based frame work to enable them to successfully manage mental health problems in people presenting with mental health problems and Human immunodeficiency virus however the majority (69.7%) of the participants had inadequate knowledge regarding mental health. Competence-based frame work was developed to enable health professional to successfully manage people with mental health problems and Human immunodeficiency virus. Currently, mental health services are lacking in primary health cares in Lesotho. There was lack of knowledge regarding mental health in health professionals, mental health was also not an in-country priority as the professionals are taught about mental health in colleges, but do not practice it in their professional work. Availability of competence-based framework was seen as a great need by health professionals to manage mental health problems. Many studies emphasized the need to integrate mental health services with Human immunodeficiency virus services as they are related. However, in Lesotho it was still a serious problem during the time of the study.

Iqoqa.

Enyakeni wezi-2017 kwakunabantu abacishe babe yizigidi ezingama-792 abanenkinga yokugula ngokomqondo emhlabeni jikelele. Izinkinga zokugula ngokomqondo zikhula ngesivinini esikhulu emhlabeni jikelele kodwa izindawo zokwelapha ukugula ngokomqondo azanele. Cishe abantu abangama-80% abaphila negciwane lesandulela ngculazi banezinkinga zokugula ngokomqondo nakuba lezi zifo kade zingekho ohlelweni lwezempilo yomhlaba. Abantu abacishe babe ama-90% abadinga i-MHS abayitholi emazweni anengenisomali eliphansi nelimaphakathi. Inhloso yocwaningo wukuphucula uhlaka olugxiliswe ekukwazini ukuhlinzekela impilo yangokomqondo kubantu abaphila negciwane lesandulela ngculazi kweZempilo ezihamba Phambili eLesotho. Kusetshenziswe indlelakwenza engxube. Sekukonke, izinhlumibuzo ezingama-88 ezabuyiswa ababephendula nezimposamibuzo ezingama-50 zenziwa. Okutholakele ocwaningweni lwekhwantithethivu nowekhwalithethivu kweseka kwaphinda kwasetshenziselwa ukuthuthukisa uhlaka olugxile ekukwazini, okuzokwenza kwenzeke ukuhlinzeka izinsiza zokugula ngokomqondo kubantu abanezinkinga zokugula ngokomqondo kanye negciwane lesandulela ngculazi abasonakekelweni oluphambili. Imininingo yekhwantithethivu yacutshungulwa kusetshenziswa iphakheji yesofthiwe eyiyo, okuyi-SPSS uhlobo 26. Imininingo yekhwalithethivu yahluzwa kusetshenziswa uhlelokusebenza olubizwa nge-Nvivo nokuhluza uhlaka lwezindikimba. Ama-92 % ababambiqhaza babedinga uhlaka olugxiliswe ekukwazini ukuze bakwazi ukulawula ngempumelelo izinkinga zokugula ngokomqondo kubantu ababonakala benezinkinga ngokomqondo kanye negciwane lesandulelangculazi kodwa iningi (69.7%) lababambiqhaza banolwazi olungenele olumayelana nempilo yokomqondo. Uhlaka olugxile ekukwazini lwathuthukiswa ukusiza abasebenzi bezempilo ukuba balawule ngempumelelo abantu abanenkinga yokugula ngokomqondo nabanegciwane lesandulelangculazi. Njengamanje, izinsizakusebenza zempilo yokomqondo ezindaweni zokunakekela eziphambili eLesotho zisaswelekile. Kunokuntuleka kolwazi olumayelana nempilo yokomqondo ezisebenzini zezempilo, impilo yokomqondo yayingeyona into ephambili ezweni njengoba izisebenzi bezifundiswa ngezempilo yokomqondo emakolishi, kodwa zingasebenzi ngalokho emsebenzini wabo wansuku zonke. Ukuba khona kohlaka olugxiliswe ekukwazini kwabonakala kuyisidingo esikhulu kubasebenzi bezempilo ukulawula izinkinga zokugula ngokomqondo. Ucwaningo oluningi lugcizelele isidingo sokudidiyela imisebenzi yokwelapha ukugula ngokomqondo nezinsizakusebenza zokwelapha igciwane lesandulela ngculazi njengoba kuhlobene. Kodwa, eLesotho bekuseyinkinga enkulu lokhu ngesikhathi sokwenziwa kocwaningo.