Online Program

Employing a public private partnership (PPP) to treat mental anguish in the massively traumatized population in northern Uganda

Tuesday, November 5, 2013

Ethel Nakimuli-Mpungu, MMED (Psych), PhD, The Peter C. Alderman Foundation, Bedford, NY
Stephen Alderman, MD, The Peter C. Alderman Foundation, Bedford, NY
Theresa Betancourt, ScD, MA, FXB Center for Health and Human Rights; Department of Global Health and Population, Harvard University / Harvard School of Public Health, Boston, MA
Background: Northern Uganda endured two decades of war. Thirty thousand children were kidnapped by the Lord's Resistance Army and 1.7 million people interned in internally displaced persons camps. Up to 70% of the population developed traumatic depression and PTSD. The mental health care (MHC) system, overwhelmed by disease burden, collapsed. PPPs have been used to establish health care services in resource-constrained societies around the world. In 2006, Peter C. Alderman Foundation and the Ugandan government formed a PPP to deliver sustainable MHC and for the massively traumatized population in the North. Aims: To provide sustainable, universal, effective MHC to northern Uganda and to bring MHC to scale by enabling the government to integrate it into its package of primary health care. Methods: The PPP established psycho-trauma clinics in five districts in northern Uganda and training programs for indigenous mental health professionals. Quantitative/qualitative methodology was employed to determine demographics, clinic outputs and patient outcomes. Outcomes: The PPP has treated 2868 patients and trained 1000 indigenous mental health professionals at five annual African Psycho-trauma Workshops. It has locally validated the Self-reported Questionnaire-20 and the Harvard Trauma Questionnaire to measure depression and PTSD respectively. It has developed a contextually-sensitive function tool for trauma victims with mental disorders. Serial measurements with these at baseline and at three-month intervals in patients following psychotherapy and/or pharmacotherapy demonstrated 80% reduction in symptom loads of depression and PTSD with a concomitant improvement in function. Conclusion: A committed PPP can deliver effective, culturally sensitive, sustainable MHC in northern Uganda.

Learning Areas:

Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate that a public-private partnership between the government of Uganda and an non-governmental organization, The Peter C. Alderman Foundation, can be employed to deliver effective sustainable mental health care to a massively war traumatized population in northern Uganda.

Keyword(s): Mental Health System, Public/Private Partnerships

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a contributing author.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.