Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar 16:3:e9.
doi: 10.1017/gmh.2016.2. eCollection 2016.

Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement

J Abdulmalik  1 , L Kola  2 , O Gureje  2
Affiliations

Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement

J Abdulmalik et al. Glob Ment Health (Camb). .

Abstract

Introduction: A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it.

Methodology: This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG.

Results: The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system.

Conclusion: The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

Keywords: Governance; Nigeria; health systems; mental health; policy & systems.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Illustration of the sequential steps of the study process.
See this image and copyright information in PMC

References

    1. Abdulmalik J, Kola L, Fadahunsi W, Adebayo K, Yasamy MT, Musa E, Gureje O (2013). Country contextualization of the mental health gap action programme intervention guide: a case study from Nigeria. PLoS Medicine 10, e1001501. - PMC - PubMed
    1. Abimbola S, Negin J, Jan S, Martiniuk A (2014). Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries. Health Policy and Planning 29(Suppl. 2), ii29–ii39. doi: 10.1093/heapol/czu069 - DOI - PMC - PubMed
    1. Bossert TJ (2012). Health systems. Health Policy and Planning 27, 8–10. - PubMed
    1. Brewer G, deLeon P (1983). The Foundations of Policy Analysis. Monterey, CA: Brooks/Cole.
    1. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, Angermeyer MC, Bernert S, de Girolamo G, Morosini P, Polidori G, Kikkawa T, Kawakami N, Ono Y, Takeshima T, Uda H, Karam EG, Fayyad JA, Karam AN, Mneimneh ZN, Medina-Mora ME, Borges G, Lara C, de Graaf R, Ormel J, Gureje O, Shen Y, Huang Y, Zhang M, Alonso J, Haro JM, Vilagut G, Bromet EJ, Gluzman S, Webb C, Kessler RC, Merikangas KR, Anthony JC, Von Korff MR, Wang PS, Brugha TS, Aguilar-Gaxiola S, Lee S, Heeringa S, Pennell BE, Zaslavsky AM, Ustun TB, Chatterji S; WHO World Mental Health Survey Consortium (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291, 2581–2590. - PubMed

LinkOut - more resources