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SUCCESSFUL e-HEALTH FACILITATED EDUCATION, TREATMENT, AND REFERRAL FOR MENTAL HEALTH IN RURAL AFGHANISTAN

Scott RE1,2, Khoja S3, Durrani H4, Mohbatali F5, Yousufazi W6. 1NT Consulting – Global e-Health Inc., Calgary, Alberta, Canada; 2University of Calgary, Calgary, Alberta, Canada;3Tech4Life, Milton, Ontario, Canada; 4French Medical Institute for Children, Kabul, Afghanistan;5Aga Khan Health Services, Kabul, Afghanistan;6Shifa International Hospital, Islamabad, Pakistan

Background: Afghanistan has a long history of invasion and war. Evidence suggests 50-60% of the population over 15 years is affected by at least one of four common mental disorders: depression, anxiety, post traumatic stress disorder, or substance abuse. While the Afghan Ministry of Public Health recognises the need for, and has prioritised, enhanced mental health capability, progress is slow. The country, a resource constrained setting, has an impossibly small pool of psychiatrists and mental health trained Community Health Workers and hospital-based nurses; alternative approaches are needed. A multinational team used conventional and e-health facilitated solutions to address the four most common mental health issues within Badakshan Province, Afghanistan. This e-Poster summarises the process and results of the 3-year study from conception to conclusion, including some challenges and opportunities for scaling.

Methods: The methods included face-to-face and virtual networking (using community meetings (populace) and SMS (adolescents)); smartphone-based collaboration tools (for patient registration, assessment, and referral), smartphone-based blended learning tools (for CHW and nurse capacity building); and Internet-based videoconferencing (for psychiatric consultation).

Results: Comparison of baseline, mid-term, and final evaluation data has shown positive change in: awareness of mental health issues, superstition, stigma, and mistreatment of afflicted individuals (amongst the population and healthcare providers); knowledge and capability (amongst healthcare providers); referral and teleconsultation for patients; and implementation of a District Health Information System capability. Ongoing conflict caused some difficulties, and improved consistency in evaluations would have been beneficial.

Conclusion: e-Healthoffers significant potential to address the mental health needs of resource constrained locations, and to do so in a manner that improves popular and health worker based awareness, time to treatment, and access to psychiatric services, and is low cost (using simple technological solutions). Streamlining and scaling of the solution should be pursued.

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