Public Health Interventions on mental health service delivery in Malawi
There have been a strong advocacy by the mental health practitioners to strengthen the elements of public health such as public health intelligence, interventions and infrastructure in addressing mental health services during international conferences (11). This has led to the Ministry of Health in Malawi to plan for the interventions dealing with the disease prevention, treatment and rehabilitation of the patients once they have recovered from any condition (4). Although the ministry has no specific mental health strategy and policy, guidelines exist within the Malawian legal framework which have directed major reforms in the health sector since 1964 (7). Nevertheless, the inclusion of mental health services as a priority area in the current health strategic plan indicates the commitment by the ministry to reduce the burden of depressive disorders in Malawi.
Prevention and Control of Depressive Disorders
It is essential to recognise the key determinants of depressive disorders in order to develop an effective prevention plan (17). In the case of Malawi, interventions should be aimed at mitigating the impact of low levels of education, poverty, unemployment, gender based violence and poor access to mental health services. In addition, the health system should strengthen improvements in the control of medical conditions such as HIV and malaria which have been associated with an increased cases of depressive disorders.
Malawi government must continue with the scaling up of the provision of free antiretroviral drugs (ARVS) to the public and improve quality of care for patients with HIV infection. This will stop the progression of simple conditions to severe cases of neurologic and mental diseases, thereby, increasing the burden of depressive disorders. Government’s efforts must be commended especially when it has managed to scale up uptake of antiretroviral drugs from only less than 20,000 people in 2005 to over 450,000 people by the end of 2012 (4). It is therefore, necessary to assess the impact of the scale up of ARVS on the gains in the life expectancy as well as reduction of depressive disorders over the entire period.
Alcohol and illicit drug abuse has been reported globally as one contributing factor towards global deaths (12). Developing countries, Malawi inclusive, have not been spared especially the adolescents (8). It is therefore, essential for the Government of Malawi to work on the legal framework regarding alcohol and drug abuse. This should involve determining the age limits for alcohol consumption, licencing and regulating pubs, putting restrictions on the advertisements for alcohol and promoting awareness on the dangers of alcohol in schools and the media. However, strict laws will put the country to act as a nanny state and issues relating to infringing on human rights and consumer rights are likely to arise. Nevertheless, the benefits of this decision may...