Skip to main content

Table 2 Overview of quantitative data studies included in the review

From: Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review

Authors

Countries involved

Study design

Participant group and sample size

Area and level of service user involvement

Type of evaluation of involvement (if any)

Outcomesa

Summary of findings

Assessment of qualityb

Aznar et al. (2012) [26]

Argentina and Chile

Development of a scale for the rights of people with intellectual disabilities (ID); cross-sectional comparison between people with ID and controls

37 participants in Delphi group; 51 in pilot study; 705 people with ID in Chile and 524 control University students

People with ID and their families involved in the development of the scale (Delphi group and pilot study)

None

Other (study: scale development): Rights fulfilment score on the devised scale plus 10 individual items on scale; Cronbach’s alpha

The scale may be an appropriate scale to monitor rights, though further development needed. Family relationships, community participation, living arrangements and level of disability affect experience of rights among people with ID. With structured supports, people with ID appear able to exercise their rights to a level comparable to peers without ID.

weak

Malakouti et al. (2009) [22]

Iran

Non-randomised quasi-experimental intervention

12 psychology graduates, plus 9 Consumers’ Family Members (CFM) of people with schizophrenia trained as case managers, of which 6 persons (i.e. 12 in total) from each group were selected as case managers; 129 people with schizophrenia case managed

Training of CFM to be a case management group with 6 family members case managing patients with schizophrenia

CFM group had the potential to be trained as case-managers in mental health, especially if limited resources.

Service user/caregiver: Number of hospitalisations of people case-managed by CFMs versus mental health workers plus caregiver burden, knowledge, Quality of Life, general health of caregivers; psychopathology and social skills of schizophrenia patients

Most clinical variables were improved without significant differences between groups. The hospitalization rate was reduced by 67 %. Selection of family of people with severe mental illness should be done with scrutinized criteria considering the refusal rate of 35 % of the subjects in the CFM group (17 % in mental health workers).

weak

McBain et al. (2012) [13]

63 LAMICs and country regions

Data from countries that completed WHO’s Assessment Instrument for Mental Health Systems (WHO-AIMS); multiple regression analyses to investigate role of mental health legislation, human rights implementations, mental health care financing, human resources, and role of advocacy groups on availability and affordability of psychotropic medicines

63 countries/regions, and advocacy groups

Study used ‘yes/no’ questions identifying whether associations of service users or people affected by mental illness were involved in the formulation of mental health legislation

None

System (country)-level: Access to psychotropic medicines (availability and affordability) (multiple regression analyses)

Participation of family-based organizations in the development of mental health legislation associated with 17 % greater availability of psychotropic medication

N/A (as between-country comparison rather than individual-level comparison)

Singh et al. (2005) [30]

India

Semi-structured questionnaire on efficiency, punctuality and behaviour of doctors and other staff, waiting time, supply of drugs, and cleanliness of hospital etc.

88 service users and 20 family members from National Drug dependence Treatment Centre Outpatients

Answering of semi-structured questionnaire

Not described

Other (satisfaction data (service users and caregivers)): e.g. efficiency, waiting staff, quality of care, general atmosphere, stigmatisation, communication

Over 90 % of patients and their attendants appreciated services provided. 90–94 % were satisfied with the supply of drugs, quality of clinical care and cleanliness of the hospital. Measures for improvement were also suggested.

weak

Tripathy et al. (2010) [23]

India

Cluster-randomised controlled trial

36 clusters in three districts in Jharkhand and Orissa (18 clusters each per intervention and control arm); participants were women who were between 15 to 49 years old, living in the project area, and had given birth during the 3-year study period

Women in intervention clusters participated in groups to support participatory action and learning for women, and to facilitate the development and implementation of strategies to address maternal and newborn health problems

No direct evaluation of involvement, though women’s group intervention included an assessment cycle. Also health committees (with village representatives) and workshops with government health staff included a qualitative assessment by participants at the end of each training session.

Service user: Primary outcomes: neonatal mortality rate (NMR); maternal depression scores. Secondary outcomes: stillbirths; maternal and perinatal deaths; uptake of antenatal and delivery services; home care practices during and after delivery; health-care-seeking behaviour.

Women’s groups led by peer facilitators reduced NMR by 32 % during the 3 years overall and by 45 % in years 2 and 3, and moderate maternal depression by 57 % in year 3 (though no significant effect on maternal depression overall), at low cost in largely tribal, rural populations of eastern India.

moderate

  1. aHeadings in italics denote classification of outcomes in terms of ‘system-level’, ‘service user/caregiver’ level, or ‘other’
  2. bThe ‘Quality assessment tool for quantitative studies’ by the ‘Effective Public Health Practice Project’ (EPHPP) [10, 11] was used for the assessment of quality and risk of bias (see also http://www.ephpp.ca/tools.html). Studies were assessed according to i) likelihood of selection bias; ii) study design; iii) whether confounders were controlled; iv) whether blinding took place; v) validity and reliability of data collection methods; vi) number of withdrawals and drop-outs; vii) intervention integrity; and viii) methods of analyses. A global quality assessment rating of ‘strong’, ‘moderate’ or ‘weak’ was assigned based on the responses within each of those eight categories