Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda

Abstract

Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.

Keywords: Health information; Health services; Mental; Neurological; Primary health care; Substance use; Utilization.

Fig. 1

Map of Uganda showing Kampala and Wakiso districts

Fig. 2

Number and proportion of MNS cases diagnosed at facilities in Kampala district

Fig. 3

Diagnoses of MNS disorders at HC III in Kampala district

Fig. 4

Diagnoses of MNS disorders at HC IV in kampala district

Fig. 5

Proportion of MNS disorders recorded at different levels of health facilities in Wakiso district

Fig. 6

Diagnoses of MNS disorders at health centre IIs in Wakiso district

Fig. 7

Diagnosis of MNS disorders recorded at various health centre IIIs in Wakiso district

Fig. 8

Diagnosis of MNS disorders recorded at various health centre IIIs in Wakiso district

Fig. 9

Diagnosis of MNS disorders recorded at various health centre IIIs in Wakiso district

Fig. 10

Diagnosed of mental, neurological, substance use disorders recorded at health centre IVs in Wakiso