Article Text

Protocol
Protocol for integrating mental health services into primary healthcare facilities: a qualitative study of the perspectives of patients, family members and healthcare providers in rural Bangladesh
  1. Aliya Naheed1,
  2. Mir Nabila Ashraf1,
  3. Nantu Chakma1,
  4. Hannah Maria Jennings2,3,4,
  5. Papreen Nahar5
  1. 1Initiative for Noncommunicable Diseases, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
  2. 2Department of Health Sciences, University of York, York, UK
  3. 3Hull York Medical School, York, UK
  4. 4Institute for Global Health, UCL, London, UK
  5. 5Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
  1. Correspondence to Dr Aliya Naheed; anaheed{at}icddrb.org

Abstract

Introduction In Bangladesh, Non-communicable diseases (NCDs) account for 67% of all deaths. Mental health services are not available in routine healthcare at the primary facilities in Bangladesh. The protocol is for a qualitative study that seeks to understand the perceptions, beliefs and norms regarding common mental disorders (CMDs) among patients with NCD with and without CMDs to identify barriers to accessing mental health services in rural communities in Bangladesh. We also aim to explore the feasibility of integrating mental healthcare into routine NCD services at primary health facilities in rural Bangladesh.

Methods and analysis This study will be conducted at the outpatient departments in two subdistrict hospitals and one district hospital in Munshiganj district in Bangladesh. We will purposefully select patients with hypertension and diabetes from the patient inventory generated from a recently completed randomised control trial titled ‘Control of Blood Pressure and Risk Attenuation Bangladesh, Pakistan, Sri Lanka’ in two subdistricts in Munshiganj district in Bangladesh. The selected participants will be screened for CMD using the Depression, Anxiety and Stress Scale - 21 Items (DASS-21) over the telephone. Sixty in-depth interviews with patients and family members, 8–10 key informant interviews with healthcare providers and 2 focus group discussions with community health workers will be held following consent.

The study is conceptualised under Levesque et al’s framework. Thematic analysis will be applied following the study objectives and key issues, and commonly emerging topics generated by the data. The findings will be presented anonymously to corroborate the interpretation.

Ethics and dissemination Approval has been obtained from the Institutional Review Board at icddr,b (PR-19108) and the University of York (HSRGC/2020/382/F). Written informed consent or audio recording consent form in Bangla will be obtained. For dissemination, we will invite representatives of the collaborating institutions to share the findings in national or international conferences and peer-reviewed journals.

  • mental health
  • public health
  • primary care
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • MNA and NC contributed equally.

  • Contributors AN conceived the study and the study design and drafted the protocol. PN, HMJ, MNA and NC contributed to finalising the design. All authors contributed to writing the manuscript.

  • Funding This work was partly funded by the UK National Institute for Health Research (NIHR) Global Health Research as part of the IMPACT project (Project Number 17/63/130). This research was commissioned by the NIHR using Official Development Assistance (ODA) funding.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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