背景:自1991年军事政权垮台以来,索马里一直没有一个有效的政府。多年的冲突,灾难,由于治理不善,不安全因素导致大多数健康指标的得分非常低,旷日持久的冲突,不发达,经济衰退,贫穷,社会和性别不平等,和环境退化。长达三十年的旷日持久的冲突导致了广泛的社会心理创伤,社会剥夺和药物滥用对心理健康造成毁灭性后果。世界卫生组织的一项研究表明,索马里是世界上精神疾病发病率最高的国家之一。这项研究的主要目的是协助决策者确定设计和实施干预措施的优先事项,以促进索马里的心理健康和社会心理健康。
方法:该研究使用了系统的绘图技术(从1991年1月到2020年5月)和从公共领域收集的数据,收集,整理,并提供主要来自世卫组织全球卫生观察站的精神卫生数据。由于没有索马里公共卫生研究的主要数据库,本研究中用于心理健康的书目数据库包括Medline,PubMed,CINAHL,PsycINFO,谷歌学者。使用用于公共卫生的Web数据挖掘技术来提取数据。
结果:索马里精神卫生相关问题的系统制图显示,与政策相关的决定因素和精神卫生服务占主导地位(74.4%),其次是与灾害相关的决定因素和妇女健康后果(39.3%)。2017年索马里综合医院(每10万人)的精神卫生床位数量为0.5,而东地中海地区(EMR)为6.4,全球为24。内战的最大伤亡之一是医疗保健方面的基本人力资源损失,因为大多数人要么逃离该国,要么是战争的受害者。
结论:索马里心理健康问题的规模巨大,以及为解决本文概述的问题而制定的干预措施的优先指南,索马里政府及其国家/国际伙伴迫切需要优先考虑并强调需要在全国范围内投资预防和治疗精神疾病。
BACKGROUND: Somalia has been without an effective government since the collapse of the military regime in 1991. Years of conflict, disasters, and insecurity have all contributed to very low scores for most health indicators due to poor governance, protracted conflict, underdevelopment, economic decline, poverty, social and gender inequality, and environmental degradation. The three-decade long protracted conflict has led to widespread psychosocial trauma, social deprivation and substance abuse with devastating consequences on mental health. A WHO study showed Somalia has one of the highest rates of mental illness in the world. The main aim of this study is to assist policy makers in setting priorities for the design and delivery of interventions to promote mental health and psychosocial wellbeing in Somalia.
METHODS: The study uses a systematic mapping technique (from January 1991 to May 2020) and data collected from public domain, to collect, collate, and present mental health data mainly from WHO\'s Global Health Observatory. Since there is no primary database for Somalia\'s public health research, the bibliographic databases used for mental health in this study included Medline, PubMed, CINAHL, PsycINFO, and Google Scholar. Data were extracted using techniques for web data mining for public health.
RESULTS: Systematic mapping of mental health-related issues in Somalia showed that policy-related determinants and mental health services dominated (74.4%), followed by the disaster-related determinants and women\'s health consequences (39.3%). The ratio of the number of beds for mental health in general hospitals (per 100,000 population) in Somalia in 2017 is 0.5 compared to the Eastern Mediterranean region (EMR) at 6.4 and globally at 24. One of the biggest casualties of the civil war was loss of essential human resources in healthcare as most either fled the country or were part of the victims of the war.
CONCLUSIONS: The vast scale of the mental health problems in Somalia and the priority setting guidelines for interventions to address the issues outlined in this paper, prompt a dire need that the Somali government and its national/international partners should prioritize and emphasize the need to invest in the prevention and the treatment of mental illness across the country.