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Table 3 Overview of studies with quantitative and qualitative data that were 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
Boothby et al. (2011) [14] Indonesia Adequacy survey of decentralised mental health services, and outcome study of effect on patients with Axis I mental health disorders Patients, families, community mental health nurses, sub-district level GPs, volunteer village mental health workers (36 households, number of professionals not specified) Patients surveyed on their perceived mental health pre- and post-decentralisation of services None Other (perceptions): Quantitative patient and carer estimations of mental health and wellbeing pre- & post decentralisation; qualitative staff perceptions on functionality of system, adequacy of system Some progress has been made towards a household-to-hospital continuum of mental health care. Where the system is functioning, it establishes district, sub-district and village levels, which effectively decentralise mental health care services and contribute to community awareness of mental health disorders. Quantitative data: weak
Qualitative data:
Criteria 1, 2, 3, 4, 6, 7, 10, 11, 12: Yes
Criteria 5, 8, 9: No
Liu et al. (2007) [27] China Interviews and surveys of managers of 15 needle exchange programmes, plus interviews with local senior police, peer educators, needles exchange users and patients in compulsory detox 15 managers of needle exchange programmes, plus 15 local senior police, 108 peer educators, 393 needles exchange users, and 86 patients in compulsory detox Peer educators (majority were active drug users) actively involved in dissemination and needle distribution Effects of use of peer educators assessed. System-level (study) (quantitative); Other (attitudes) (qualitative): needle turnover rate, number of clients, attendance, police attitudes, recruitment of peer educators, availability of needles Needle exchange programmes are improving in terms of needle turnover and attendance. Greater cooperation from police, higher wages for peer educators, and wider awareness of the programmes among drug users are needed to increase coverage. Needle turnover was related to peer educator wages. Peer educators less likely to be arrested. More peer-educators needed. Quantitative data: weak
Qualitative data:
Criteria 1, 2, 3, 4, 10, 11: Yes
Criteria 5, 6, 7, 8, 9, 12: No
Ndayanabangi et al. (2004) [32] Uganda Records review, key informant interviews and focus group discussions to collect data analysed by a cross-section of stakeholders using SWOT system to validate and identify strengths, weaknesses, opportunities and challenges. Policy makers, health providers and consumers of mental health services (sample size not specified). Participation in interviews and focus groups None System (country)-level: Quantitative and qualitative data on country mental health services, e.g. number of mental health professionals, mental health funding, policies and legislation, information systems and research Mental health service users are rarely informed of their rights, or how to access their records, and rarely make complaints due to ignorance of their rights. Recent development of consumer organisations, e.g. Mental Health Uganda, Ugandan schizophrenia fellowship, Association for parents of children with learning disabilities and Epilepsy support Associations have led to some increased knowledge of consumers in these areas. There is a need to increase advocacy for mental health and develop capacity for professional mental and general health workers supported by appropriate policies, facilities and finances. Quantitative data: weak (N/A)
Qualitative data:
Criteria 1, 2, 10, 11: Yes
Criteria 3, 4, 5, 6, 7, 8, 9, 12: No
  1. aHeadings in italics denote classification of outcomes in terms of ‘system-level’, ‘service user/caregiver’ level, or ‘other’
  2. bFor quantitative data, the ‘Quality assessment tool for quantitative studies’ by the ‘Effective Public Health Practice Project’ (EPHPP) [10, 11] was used (see also (see Table 2 for further details). For qualitative data, a methodology described by Harden et al. [12] was used (see Table 4 for further details)