The Effect of Integrating CAMH Into PHC and Traditional Healers' Practice in Uganda: a Randomized Controlled Trial

Study Overview
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Brief Summary
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This randomized controlled trial will compare the effect of a CAMH integration package on yield of CAMH cases compared to non-CAMH integrated sites. It will be conducted among nurses, midwives and clinical officers who provide PHC services to children and adolescents in 42 health centers; and eligible traditional healers.

Detailed Description
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The overall goal of the study is to increase access to mental health services for children and adolescents in Uganda by improving entry through primary health care workers and traditional healers. The main objective of the study is to measure the effect of integrating child and adolescent mental health (CAMH) into primary health care (PHC) and into traditional healers' services on CAMH case identification in 2 districts in Eastern Uganda, so as to improve entry into mental health services. The specific objectives are: To estimate the effect of CAMH integration into PHC on case identification, measured by the number of new non- epilepsy CAMH diagnoses. To assess the feasibility and effect of integrating CAMH into traditional healers practice, measured by the number of CAMH referrals from community to clinics per month. To assess the acceptability of CAMH integration among PHC workers and traditional healers To estimate the costs associated with the integration of CAMH into PHC and traditional medicine

Official Title
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The Effect of Integrating Child and Adolescent Mental Health Into Primary Health Care and Traditional Healers' Practice: a Randomized Controlled Trial in Eastern Uganda

Conditions
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Community Mental Health Services

Intervention / Treatment
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* Other: CAMH training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Public (government health system) 2. No psychiatric nurse allocated Exclusion Criteria: mhGAP training in the previous 3 years
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CAMH training<br>Intervention clinics will receive a CAMH integration package comprising of: Training PHC workers (midwives, nurses and/or clinical officers) on how to screen and refer for CAMH, based on WHO mhGAP implementation guide. Support supervision in the clinics to reinforce training and provide on-job support to PHC staff. Provision of job aids and training materials | Other: CAMH training<br>* Training of PHC workers included in the study for 5 days to screen children and adolescents for CAMH conditions, based in the mhGAP curriculum for non-specialist health providers.<br>|
| No Intervention: No CAMH training<br>Clinics will continue to provide the standard of care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of clinics which recorded at least one non-epilepsy CAMH diagnosis in the intervention compared to the control group. |  | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Child Adolescent Mental Integration PHC Traditional Healers