02042nas a2200205 4500000000100000008004100001260004400042653001800086653003000104653003300134653001100167653002600178653002900204100001700233245005000250856007300300490000700373520144200380022001401822 2020 d bSpringer Science and Business Media LLC10aHealth Policy10aPhychiatric Mental Health10aPsychiatry and Mental health10aStigma10aMental health systems10aBarriers for service use1 aMunakampe MN00aStrengthening mental health systems in Zambia uhttps://ijmhs.biomedcentral.com/track/pdf/10.1186/s13033-020-00360-z0 v143 aBackground
Studies in mental health care for low resource settings indicate that providing services at primary care level would significantly improve provision and utilisation of mental health services. Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community. This study aimed to explore the barriers to the use of mental health services in Zambia, suggesting health systems thinking approaches to solving these challenges.

Methods
Primary data were collected through individual interviews from 12 participants; primary caregivers, health workers from public health institutions that treat mental health conditions and policymakers and implementers. The digitally recorded responses were transcribed and analysed using thematic analysis.

Results
Key barriers to care included inadequate funding, few human resources, poor infrastructure and stigma. Barriers to care at policy, facility and individual or community level could be alleviated by strengthening the mental health system. Engagement of community health workers and increasing efforts to sensitise the community about mental health would prove beneficial.

Conclusions
Strengthening the community health systems for mental health could improve access and increase utilisation of services. a1752-4458