Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data

South African Journal of Psychiatry

Field Value
Title Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data
Creator Robertson, Lesley J. Bouwer, Jade C.
Subject Psychiatry; Pharmacoepidemiology mental health systems; access to mental and neurological healthcare; public mental health; pharmacoepidemiology; ATC and DDD system; essential medicines; South Africa
Description Background: South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment.Aim: The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system.Setting: The Public health sector, Gauteng province formed the setting for the study.Method: A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing.Results: General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals.Conclusion: In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended.Contribution: This study provides insight into service provision for MNS disorders.
Publisher AOSIS
Contributor Shereen Govender, previously policy specialist in the Directorate of Pharmaceutical Services, Gauteng Department of Health Peter Bouwer, IT specialist Professor Neville Pillay, School of Animal, Plant & Environmental Sciences at the University of the Wi
Date 2024-03-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Secondary analysis of an existing database; ATC/DDD methodology
Format text/html application/epub+zip text/xml application/pdf application/pdf
Identifier 10.4102/sajpsychiatry.v30i0.2157
Source South African Journal of Psychiatry; Vol 30 (2024); 9 pages 2078-6786 1608-9685
Language eng
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Coverage Gauteng province; South Africa April 2017- March 2018 Medicines for mental, neurological and substance use disorders; public health sector procurement
Rights Copyright (c) 2024 Lesley J. Robertson, Jade C. Bouwer