PERCEPTION AND PRACTICES OF NURSES AND COMMUNITY HEALTH WORKERS REGARDING CHILD AND ADOLESCENT MENTAL HEALTH IN ADO AND IREPODUN/IFELODUN AREAS, EKITI STATE, NIGERIA

Abstract

There is a huge gap in the provision of mental health services for children and adolescents in Nigeria primary health centres, where over half of the children in the community access the primary healthcare facilities under the care of nurses and the community health workers (CHEWs and CHOs). Information on the perception and practices of healthcare providers working in these settings could aid effective policy formulation and planning of interventions. Thus, this study was designed to assess the perception and practices regarding child and adolescent mental health among the primary healthcare providers in Ekiti State Nigeria. A hospital-based cross-sectional study was conducted in the selected local government areas using three-stage sampling techniques to select two out of sixteen local government areas. Forty out of the 50 primary health centres in the two local governments were selected and 10 respondents from each of the centres making up to 400 respondents. Information on the socio-demographic, awareness and perception of mental illness in children and adolescents, knowledge on the possible causes of mental illness in children and adolescents, attitude and practices of child and adolescent mental illness were collected using a self-administered semi-structured questionnaire. Respondents who answered no or unsure to all seven questions were classified as having low social distance, respondents with only one affirmative (yes) answer was classified as having medium social distance while those with two or more affirmative responses were classified as having high social distance. Data were analyzed using descriptive statistics, Chi-square test at p=0.05. The respondents were made up of 76.0% females, nurses were 51.5%. About half of the primary healthcare workers have worked for a period of 1-5 years. Most of the PHCP said they first heard of CAMH from school (36.0%), followed closely by 32% of them who first heard about CAMH from home. About two-thirds of the respondents thought that CAMH is somewhat important and a high proportion (92.7%) agreed that depression is a mental health problem in children while 68.5% of the respondents said that “divine punishment/God will are causes of mental illness in children. Nurses had better knowledge of CAMH compared to the community health workers. However, high proportion (73.5%) of the PCHP said they have limited confidence in themselves to recognize when a child or adolescent has a mental illness. The good knowledge of CAMH care among the PHCPs did not translate to actual full involvement in good practice regarding child and adolescent mental health services but the level of practices was worse among the community health workers in Ado and Ifelodun/Irepodun LGAs in Ekiti state. Advocacy and training opportunities are needed to address the problem and regular training programmes in order to address specific needs such as prompt referral and correct treatment for CAMH