Factors Affecting Mental Health Clinic Attendance In Sheema District, South Western Uganda

ABSTRACT Introduction: The study assessed factors affecting mental health clinic attendance in Sheema district, south-western Uganda. Regularity of mental health clinics, socio-economic and health facility factors were determined and assessed. Methodology: A health facility based descriptive cross sectional study design was used for this research. A total of208 mental patients in remission phase were enrolled from four purposively selected health facilities in Sheema district. Additionally eight key infonnants were interviewed. These included health workers working in mental health clinics in the district. The health facilities selected were Mushanga HC III, Kabwohe HC IV, Shuuku HC IV and Kitagata hospital. Data was generated using a questionnaire about social demographic factors, socioeconomic and health facility factors that influenced mental health clinic attendance, and key infonnant interviews provided in depth information on factors influencing regular clinic attendance. Results: Results indicated that majority 41.8% of the respondents were aged between 25-34 years, and more than half (53.4%) were females. Factors affecting regular clinic attendance included, having a care taker, (P-value 0.05) having someone in charge of treatment costs(pvalue 0.002) and having a relative with mental disorder(p-value 0.01) and incurring no cost on transport,(p-value 0.03) Health facility factors affecting clinic attendance included distance to facility, drug availability, health facility accessibility and awareness of service, (p-value 0.005). Conclusion: The study recommends need to develop and promote interventions to economically empower families and people affected by mental illness so that they can sustain themselves and visit mental health clinic regularly to ensure continued stability. Additionally medications should be regularly stocked at the health centers to enable patients be able to access them whenever they visit the clinics for review.

TABLE OF CONTENTS 

DECLARATION ............................................................................................................................. i 

CERTIFICATION .......................................................................................................................... ii 

DEDICATION ............................................................................................................................... iii 

LIST OF TABLES ....................................................................................................................... viii 

OPERATIONAL DEFINITIONS OF TERMS ............................................................................... x 

CHAPTER ONE .............................................................................................................................. ! 

INTRODUCTION ........................................................................................................................... 1 

1.1 Background to the study ............................................................................................................ 1 

1.1.3 Conceptual background .......................................................................................................... 3 

1.1.4 Contextual back ground .......................................................................................................... 4 

1.2 Problem statement ..................................................................................................................... 5 

1.4 Specific objectives ..................................................................................................................... 6 

1.5 Research Questions .................................................................................................................... 6 

1.6 Justification ................................................................................................................................ 6 

1.7.0 Scope of the study ................................................................................................................... 6 

1.7.1 Content scope .......................................................................................................................... 7 

1. 7.2 Geographical scope ................................................................................................................. 7 

1.7.3 Time Scope ............................................................................................................................. 7 

1. 9 Explanation of the conceptual frame work ................................................................................ 9 

CHAPTER TWO ........................................................................................................................... 10 

LITERATURE REVIEW .............................................................................................................. 10 

2.0 Introduction .............................................................................................................................. 10 

2.1 Regularity and Patterns of mental Clinic attendance ............................................................. .1 0 

2.2 Social and economic factors associated with regular Mental health clinic attendance .......... 11 

CHAPTER THREE ....................................................................................................................... 13 

RESEARCH METHODOLOGY .................................................................................................. 13 

3.0 Introduction .............................................................................................................................. 13 

3.1 Study design ............................................................................................................................. 13 

3.2 Study area ................................................................................................................................ 13 

3.3 Study population ...................................................................................................................... 14 

3.4 Sampling Method ..................................................................................................................... 15 

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3.5 Sample size determination ....................................................................................................... l5 

Morgan tables were used to determine Sample size . where byN is the study population=480and 

Sis the sample size =214 ............................................................................................................... 15 

3. 7 Data collection technique ........................................................................................................ 15 

3. 8 Inclusion and exclusion criteria ............................................................................................... 16 

3.8.1. Inclusioncriteria .................................................................................................................. 16 

3.8.2 Exclusion criteria .................................................................................................................. 16 

3.9 Data quality control ................................................................................................................. 16 

3.10 Data analysis and presentation ............................................................................................... 16 

3.11 Study limitations/ delimitations ............................................................................................. 17 

3.12 Ethical considerations ............................................................................................................ l7 

3.12.1. Informed Consent .............................................................................................................. 17 

3.12.2 Benefit and risk ................................................................................................................... 18 

3.12.3 Confidentiality .................................................................................................................... 18 

3.12.4Autonomy ........................................................................................................................... 18 

3.12.5 Respect for human rights: ................................................................................................... 18 

3.13 Justice .................................................................................................................................... 18 

3.14 Dissemination of the findings ................................................................................................ 19 

CHAPTER FOUR ......................................................................................................................... 20 

PRESENT A TTON AND TNTEPRETA TTON OF RESULTS ....................................................... 20 

4.0 Introduction ............................................................................................................................. .20 

4.1 Demographic characteristics of the respondents ..................................................................... 21 

Table 2: Distribution of respondents' demographic characteristics by regularity of attendance . .23 

4 Health Facility factors affecting mental clinic attendance ........................................................ 27 

DISCUSSION, CONCLUSION AND RECOMMENDATIONS ................................................ .29 

5. 0 Introduction .............................................................................................................................. 29 

5.1.2. Socio-Economic Factors influencing mental health attendance ......................................... 30 

5.2. CONCLUSION ...................................................................................................................... .31 

5.4 Areas for further research ....................................................................................................... .32 

REFERENCES .............................................................................................................................. 33 

APPENDIX I: CONSENT FORM ................................................................................................ 41 

APPENDIX II: QUESTIONNAIRE .............................................................................................. 43 

APPENDIX III: KEY INFORMATION INTERVIEW ............................................................... .46 

APPENDIX IV RECORD REVIEW CHECK LIST .................................................................... 47 

APPENDIX V MORGAN TABLES ........................................................................................... 48