看護とケアのジャーナル

Collaborating with the Community for Quality Mental Health Care: Exploring the Possibilities of Nurses’ Roles in Northern Nigeria

Abstract

Emmanuel Ejembi Anyebe*, Murtala HH, Igbinlade SA, Ejidokun A, Umar JN and Leslie T

Providing quality mental health care in the community level requires collaboration between the community and health workers including nurses. This study explored the community-primary health care system link in forty-seven health centres and their host communities in three purposively selected states in Northern Nigeria. A mixed-research method was employed to obtain data from 191 PHC workers, and 18 community members including Traditional Medicine Men (TrMM). Data were collected through a questionnaire and in-depth interviews. Quantitative analyses was done descriptively using SPSS Version 20 while the qualitative analysis was carried out thematically. These were synergised to meet research objectives. Findings show that 55.0% of the workers said there is no collaboration with the community, while another 42.0% claimed that communities are involved. Nurses and midwives constitutes 23.5% (n=45) of the PHC workforce. Further survey findings indicated 53 (33.0%) of respondents reported collaboration between the traditional and the modern health practitioners; 84 (44.0%) reported absence of it; others (n=44; 23.0%) were uncertain. Qualitative data supported these divergent views. Community leaders in two of the three states revealed community collaboration; some community leaders were even made chairmen of PHC committees in their respective domains. However, responses from the TrMM were mixed. While some TrMM said they invited modern medical practitioners (like nurses in Gombe State) to treat the physical conditions of their mental patients, some others even established an occupational therapy collaboration with specialist neuro-psychiatric hospitals (like in Kaduna State). Yet others vehemently refused even visits from modern mental health workers to their centres (in Kaduna State) for various reasons. These findings present PHC workers including nurses/midwives) with diverse challenges of collaborating with the community’s traditional medical system, which need to be overcome to achieve effective community mental health care. The need for continual enlightenment and advocacy on collaboration to attain this is paramount. Health care professionals should continue to brainstorm on the appropriate models to adopt for a more robust collaboration to make the scarce community mental health services available to communities.