Background: Few studies have evaluated the implementation and impact of real-world
mental health programmes delivered at scale in low-resource settings.
Aims: To describe the cross-country research methods used to evaluate
district-level mental healthcare plans (MHCPs) in Ethiopia, India,
Nepal, South Africa and Uganda.
Method: Multidisciplinary methods conducted at community, health facility and
district levels, embedded within a theory of change.
Results: The following designs are employed to evaluate the MHCPs: (a) repeat
community-based cross-sectional surveys to measure change in
population-level contact coverage; (b) repeat facility-based surveys to
assess change in detection of disorders; (c) disorder-specific cohorts
to assess the effect on patient outcomes; and (d) multilevel case
studies to evaluate the process of implementation.
Conclusions: To evaluate whether and how a health-system-level intervention is
effective, multidisciplinary research methods are required at different
population levels. Although challenging, such methods may be replicated
across diverse settings.
This research is supported by the Department for International Development’s Programme for Improving Mental Health Care (PRIME) which is led by University of Cape Town
de Silva, M.J.; Rathod, S.D.; Hanlon, C.; Breuer, E.; Chisholm, D.; Fekadu, A.; Jordans, M.; Kigozi, F.; Petersen, I.; Shidhaye, R.; Medhin, G.; Ssebunnya, J.; Prince, M.; Thornicroft, G.; Tomlinson, M.; Lund, C.; Patel, V. Evaluation of district mental healthcare plans: the PRIME consortium methodology. British Journal of Psychiatry (2015) 208 (s56) s63-s70. [DOI: 10.1192/bjp.bp.114.153858]
Evaluation of district mental healthcare plans: the PRIME consortium methodology