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“We Are Not Really Marketing Mental Health”: Mental Health Advocacy in Zimbabwe

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Listed:
  • Reuben Hendler
  • Khameer Kidia
  • Debra Machando
  • Megan Crooks
  • Walter Mangezi
  • Melanie Abas
  • Craig Katz
  • Graham Thornicroft
  • Maya Semrau
  • Helen Jack

Abstract

Introduction: Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. Methods: We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country’s mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Results: Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy’s importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate (“targets”), what they advocate for (“asks”), how advocates reach their targets (“access”), how they make their asks (“arguments”), and the results of their advocacy (“outcomes”). Discussion: Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

Suggested Citation

  • Reuben Hendler & Khameer Kidia & Debra Machando & Megan Crooks & Walter Mangezi & Melanie Abas & Craig Katz & Graham Thornicroft & Maya Semrau & Helen Jack, 2016. "“We Are Not Really Marketing Mental Health”: Mental Health Advocacy in Zimbabwe," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-19, September.
  • Handle: RePEc:plo:pone00:0161860
    DOI: 10.1371/journal.pone.0161860
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    References listed on IDEAS

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    1. Mark Tomlinson & Crick Lund, 2012. "Why Does Mental Health Not Get the Attention It Deserves? An Application of the Shiffman and Smith Framework," PLOS Medicine, Public Library of Science, vol. 9(2), pages 1-4, February.
    2. Reich, Michael R., 1995. "The politics of health sector reform in developing countries: three cases of pharmaceutical policy," Health Policy, Elsevier, vol. 32(1-3), pages 47-77.
    3. Mark Tomlinson & Crick Lund, 2012. "Why Does Mental Health Not Get the Attention It Deserves? An Application of the Shiffman and Smith Framework," Working Papers id:4819, eSocialSciences.
    4. Jeremy Shiffman & Stephanie Smith, 2007. "Generation of Political Priority for Global Health Initiatives: A Framework and Case Study of Maternal Mortality," Working Papers 129, Center for Global Development.
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