Identifying the health systems changes necessary to sustain and scale up the integration of mental health services into primary care in Lagos, Nigeria
Medical Research Council
Lagos State Univ Coll of Med LAUSCOM
STATEMENT OF THE PROBLEM: There are policy and ethical implications of developing effective heath programmes without sustainability and scale-up. This feasibility study aims to identify the strategies to facilitate the health system changes necessary to sustain and scale up mental health services in primary care in Lagos, Nigeria. SPECIFIC QUESTIONS TO BE ADRESSED BY THE PROJECT 1) what is the state of implementation of the MeHPriC Project and what are the factors that are currently underlying its implementation?; 2) What are the dynamic interactions between the different components of the programme as regards contexts (inner and outer), implementation processes, implementation actors and intervention outputs and outcomes?; 3) How do these components influence the sustainability of the programme; and 4) What strategies may be required to facilitate the changes necessary for sustainability and scale-up METHODOLOGY There are 5 phases of the study. 1. In Phase 1, Through review of policy documents and in-depth interviews we will develop specific hypothetical pathways that link the programme inputs to processes, outputs and outcomes within the health system 2. In Phase 2, we will conduct a quantitative survey amongst the stakeholders to assess readiness to change, sustainability, feasibility and acceptability 3. In Phase 3, we will conduct a brief process and outcome evaluation of the implementation, and through in-depth interviews, and institutional ethnographies, we will examine the stakeholders' perception about the health systems constraints to delivering, scaling up and sustaining the intervention. 4. In Phase 4, we will conduct a Theory of Change (ToC) workshop to identify health system changes that will improve sustainability in the delivery of the intervention. 5. In Phase 5, we will analysis and present the project report to the funders and the stakeholders
8.1 Organisation and delivery of services / Research Grant