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Table 3 Ranking of the multi-group outputs of challenges for integrating mental health services into HIV/AIDS care

From: Opportunities and challenges to integrating mental health into HIV programs in a low- and middle-income country: insights from the Nigeria implementation science Alliance

Groups

Ranked List of Challenges

Group 1

1. Poor awareness of mental health by individuals, health care providers, and communities (including detection of early signs)

2. Double stigma’ (HIV and Mental Health)

3. Absence of a National Health Policy on Mental Health in HIV/AIDS

4. Inadequate capacity and/or human resources for mental health care

5. Absence of policy on service integration, integrating mental health and HIV/AIDS

Group 2

1. Cultural beliefs about negative spiritual connotations of mental disorders

2. Poor funding for mental health services

3. Absence of national strategic plan on mental health issues, guidelines

4. Inadequate human resources for health care

5. Inadequate number of skilled health workers to offer mental health services

6. Sociocultural barriers like culture and religion

7. Lack of willingness of staff to take on mental health work

Group 3

1. Limited capacity and work overload for existing health workers

2. Difficulty in assessing mental health care in the existing system

3. Poor knowledge and skill of health care workers to provide mental health care services

4. Lack of government and donor support for mental health services

5. Poor social care system

6. Poor health-seeking behaviour on mental health issues

10. Knowledge gap from both health care providers and clients

11. Stigmatization of HIV patients

Group 4

1. Lack of structures/facilities for mental healthcare management

2. Fragmentation of different units and functions

3. Lack of mental health specific funding

5. Research gap in mental health

6. Affordability of mental health care

Group 5

1. Inadequate number of healthcare workers

2. Weak health systems to support mental health care

4. Data paucity for informed decision at the facility level

5. Lack of political will to implement policies

6. Lack/Inadequate policies/guidelines/protocols and guidelines for mental health

7. Getting the buy-in of policy makers

8. Cultural and religious beliefs about mental health

Group 6

1. High cost of mental health care