INTEGRATION OF PSYCHOLOGICAL SERVICES WITHIN PRIMARY HEALTH CARE SYSTEM IN EASTERN ETHIOPIA: ASSESSMENT OF EXISTING PRACTICE AND ATTITUDE By Tamrat Z. Teshome

Abstract

Human minds and bodies are closely linked. When one feels bad physically, he or she often feels bad emotionally, too. The reverse is also true. More than 300 studies have found that psychological distress can weaken the human immune system. Studies also reveal that psychological interventions with heart patients can reduce the risk of further cardiac events by 75% compared to those who receive only medical care and medication. There are evidences that Psychology, as the science of behaviour, has much to offer to enhance health promotion and disease prevention and address health disparities. However, even if Psychology has vital roles including and beyond assessment and treatment in primary care and other health care settings, there are no studies that explored the Ethiopian condition with this regard.

A cross sectional study design using a literature review was conducted on the existing practice of and attitude toward integration of psychological services with PHC system in Eastern Ethiopia. Next, data was collected from 3 primary care units (general hospitals) in Somali and Harari National Regional States and Dire Dawa City Administration. Practice and attitude information was collected from 37 various health professionals within each hospital using interview and FGD techniques. Observational data and interview was also used in order to assess 57 patient’s attitude towards receiving psychological support and care besides the medical treatment they got in these hospitals.

The study result indicated that fact that 80.7% of the patients needed psychological service besides the medical service they received in the hospital.90.9% of the respondents answered “No” to the question that was posed to them to see if there is an established system to integrate psychological service within the medical treatment they are giving in hospitals. Out of these, 54.5% reasoned out this is due to lack of clear guideline that encourages the culture of integration as well as shortage of skilled manpower in the area. 81.8% of the respondents (health professionals) indicated that they have good attitude toward the importance of integrating psychological services as an integral part of the medical care treatment trend in public hospitals. The major importance the respondents stated out has to do with serving to the whole need of patients adequately.

It is concluded that integrated care brings together health-care teams who can treat the whole person. Instead of working separately, physicians, psychologists, nurses and other providers will have to collaborate. If so, they can better work together to diagnose patients’ problems, plan and provide treatment and evaluate whether that treatment is effective.

Keywords: Psychological service, Primary health care.

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