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Review
. 2016 Jul 1:3:e21.
doi: 10.1017/gmh.2016.17. eCollection 2016.

Challenges and opportunities to improve autism services in low-income countries: lessons from a situational analysis in Ethiopia

B Tekola  1 , Y Baheretibeb  2 , I Roth  1 , D Tilahun  2 , A Fekadu  2 , C Hanlon  2   3 , R A Hoekstra  1   4
Affiliations
Review

Challenges and opportunities to improve autism services in low-income countries: lessons from a situational analysis in Ethiopia

B Tekola et al. Glob Ment Health (Camb). .

Abstract

Background: Little has been reported about service provision for children with autism in low-income countries. This study explored the current service provision for children with autism and their families in Ethiopia, the existing challenges and urgent needs, and stakeholders' views on the best approaches to further develop services.

Methods: A situational analysis was conducted based on (i) qualitative interviews with existing service providers; (ii) consultation with a wider group of stakeholders through two stakeholder workshops; and (iii) information available in the public domain. Findings were triangulated where possible.

Results: Existing diagnostic and educational services for children with autism are scarce and largely confined to Ethiopia's capital city, with little provision in rural areas. Families of children with autism experience practical and psychosocial challenges, including severe stigma. Informants further raised the lack of culturally and contextually appropriate autism instruments as an important problem to be addressed. The study informants and local stakeholders provided several approaches for future service provision expansion, including service decentralisation, mental health training and awareness raising initiatives.

Conclusions: Services for children with autism in Ethiopia are extremely limited; appropriate care for these children is further impeded by stigma and lack of awareness. Ethiopia's plans to scale up mental healthcare integrated into primary care provide an opportunity to expand services for children with autism and other developmental disorders. These plans, together with the additional strategies outlined in this paper can help to address the current service provision gaps and may also inform service enhancement approaches in other low-income countries.

Keywords: Africa; autism; child; mental health services; stigma.

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Figures

Fig. 1.
Fig. 1.
Service providers for children with autism and their families in Ethiopia. Note: Dashed lines refer to informal diagnostic services and diagnostic referral.
See this image and copyright information in PMC

References

    1. Abera M, Robbins JM, Tesfaye M (2015). Parents’ perception of child and adolescent mental health problems and their choice of treatment option in southwest Ethiopia. Child and Adolescent Psychiatry and Mental Health 9, 40. - PMC - PubMed
    1. Alem A, Jacobsson L, Araya M, Kebede D, Kullgren G (1999). How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia. Acta Psychiatrica Scandinavica 100 (Suppl. 397), 40–47. - PubMed
    1. Alem A, Pain C, Araya M, Hodges BD (2010). Co-creating a psychiatric resident program with Ethiopians, for Ethiopians, in Ethiopia: the Toronto Addis Ababa Psychiatry Project (TAAPP). Academic Psychiatry 34, 424–432. - PubMed
    1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association: Washington, DC.
    1. Bakare MO, Munir KM (2011). Autism spectrum disorders in Africa In A Comprehensive Book on Autism Spectrum Disorders (ed. Mohammadi M.-R.), pp. 183–194. InTech, Rijeka.

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