Browsing by Author "Twesigye, Justus"

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    Explanatory models for the care of outpatients with mood disorders in Uganda : an exploratory study
    (Stellenbosch : Stellenbosch University, 2014-04) Twesigye, Justus; Kagee, S. A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: The growing burden of mental illnesses in low- and middle-income countries, such as Uganda, necessitates effective interventions to promote mental and social well-being among their populations. Mood disorders contribute more substantially to the global burden of mental illnesses than do other forms of mental disorders. The substantial global burden of mental illnesses is projected to grow more rapidly in low- and middle-income countries than in high-income countries in the future. Because experiences of and responses to mood disorders are invariably patterned by social and cultural contexts, as argued in the growing field of cross-cultural psychiatry, health care systems, especially in low- and middle-income countries, need to design and deliver culturally relevant interventions that effectively deal with this problem. However, there is generally a paucity of suitable evidence to guide the planning and delivery of such interventions in countries like Uganda. As a response to the apparent knowledge and research gaps regarding experiences of mood disorders and care in Western Uganda, I conducted a qualitative study involving outpatients and their care providers, that is, outpatients’ families, psychiatric health workers, religious healers and traditional healers. Using purposive and snow ball sampling techniques, I selected participants, that is, outpatients as well as psychiatric health workers, outpatients’ families, religious healers and traditional healers involved in the care of the outpatients from the Mbarara Regional Referral Hospital (MRRH) and the “Greater Mbarara” region, respectively. The aim of this study is to explore explanatory models that outpatients and care providers in Western Uganda use in responding to mood disorders. I analysed the data collected in the fieldwork using ATLAS.ti 6.2, a computer-software programme designed to support qualitative data analysis. Results from the study indicate that outpatients and their care providers hold complex, diverse and contradictory explanatory models regarding mood disorders and care, which are shaped by their unique social and cultural contexts. Additionally, poor relationships and communication between patients and their care providers, especially between outpatients and psychiatric health workers, are strongly evident; structural barriers significantly hinder the provision and utilisation of care; care is generally inadequate, although it is conceptualised broadly to include biomedical, popular and folk treatments; and outpatients generally exhibit inconsequential (weak) agency in managing distress, which is primarily caused by mood disorders and care-seeking challenges. The results of the current study suggest several implications regarding mental health practice, training, policy and research.
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    Language, culture, and task shifting - an emerging challenge for global mental health
    (Co-Action Publishing, 2014-02) Swartz, Leslie; Kilian, Sanja; Twesigye, Justus; Attah, Dzifa; Chiliza, Bonginkosi
    Language is at the heart of mental health care. Many high-income countries have sophisticated interpreter services, but in low- and middle-income countries there are not sufficient professional services, let alone interpreter services, and task shifting is used. In this article, we discuss this neglected issue in the context of low- and middle-income countries, where task shifting has been suggested as a solution to the problem of scarce mental health resources. The large diversity of languages in low- and middle-income countries, exacerbated by wide-scale migration, has implications for the scale-up of services. We suggest that it would be useful for those who are working innovatively to develop locally delivered mental health programmes in low- and middle-income countries to explore and report on issues of language and how these have been addressed. We need to know more about local challenges, but also about local solutions which seem to work, and for this we need more information from the field than is currently available
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    Perspectives of patients and caregivers on the logistical barriers to providing mental health services in Uganda
    (Stellenbosch University, 2016) Twesigye, Justus; Kagee, Ashraf
    ENGLISH ABSTRACT: Mental disorders contribute substantially to the global burden of disease. Although mental disorders can be treated effectively, logistical barriers constrain the provision of evidence-based treatment in low- and middle-income countries. However, little is known about these barriers to treatment of patients in Uganda. We interviewed patients and care providers about their views on logistical barriers to the provision of mental health services. Results indicate that inadequate staffing, irregular medical supplies and the use of inferior medication constrained the delivery and utilisation of mental health services. Implications of these barriers include burnout among care providers and non-adherence to medical treatment among patients.