Zimbabwe Presentation on Policy Perspectives - Global Action against Dementia

Transcription

1 Zimbabwe Presentation on Policy Perspectives - Global Action against Dementia Dorcas ShirleySithole Deputy Director Mental Health Services Ministry of Health & Child Welfare

2 INTRODUCTION Zimbabwe has a multicultural population i.e Black, Asian, White and Persons of mixed blood. Regrettably, only a small proportion of this have an awareness or any insight into the disease. Approximately 70% of pop. live in the rural areas. Belief in witchcraft/spiritual rituals does not help the situation. An estimate people in Zimbabwe suffer from Dementia. These figures are calculated by applying regional estimates (World Alzheimer s Report 2009) to country populations. These figures should be used with caution as they are only estimates and only a small fraction of these people have had a formal diagnosis. Zimbabwe Alzheimer s and Related Disorders Association which was founded in 1998 and is a full member of Alzheimer Disease International. Works to support people with Dementia and their families. This Association is run by a small group of volunteers and an Advisory Board. Their main aim is to disseminate information, counsel families and create awareness. They also offer support groups, art therapy and improving functions for people with Dementia. Training is also available for domestic carers. There is, at this time, only one branch that is located in Harare. Funding resource is from fund raising, membership subscriptions and donations. There are currently no Dementia specific institutions in Zimbabwe. People with Dementia may be placed in an Old Age home which are unaffordable to many families, therefore cared for at home by a family member or carer.

3 Zimbabwe Analysis on Dementia Care The main challenges to making systematic improvements in dementia care faced by my country: Dementia is a disease culturally most often thought of as a normal process of the aging process. Affected members are not brought to medical facilities. Need to raise awareness amongst our society that dementia is a neurological disease. Some of the causes are treatable and those without definitive treatments can be managed symptomatically in a way that improves the quality of life to both patients and caregivers. Resources have been diverted to HIV/AIDS over the last decades, with meagre resources being channelled to non-communicable disease. Need to prioritise dementia as the gains in HIV care have led to increased life expectancy and increased incidence and prevalence of dementia. Even among HIV infected patients who are on treatment, HIV associated neurocognitive disorders (HAND), including dementia, remain unrecognised and therefore untreated. Research in dementia is an absolute priority and could start with simple hospital based and clinic based registries. Collaboration with medical schools would be an ideal way to carry out research in dementia.

4 Zimbabwe Experience I will just share our experiences on dementia. Due to increase in health generally more and more people will live into old age. Although there seems to be more women than men in that view. In Zimbabwe, we have used the MhGap on dementia as our template to first educate our communities through community psychiatry initiatives where we have gone to surrounding rural districts like Seke at Mahusekwe hospital, Bindura hospital, and engaged the community at large including village health worker,s police, teachers,chiefs (Traditional Leaders) and medical staff on training on identification of cases, referral pathways, and care at the point of contact. The challenges have been the resources to fully fund the exercise to do adequate psychoeducation which is key in our set up for the management of dementia. On policy and legislation, we use Mental Health Act, Regulations, Policy, Mental Health Strategy, Mental Health Disorders Treatment Guidelines and Protocols and Essential Drug List in Zimbabwe. There is a Traditional Medicine Department housed in the Ministry of Health and Child Care which plays an important role as most of these patients start there before considering hospital care.

5 WAY FORWARD Dementia needs to be detected in the Community and Primary Care Centres. Mini-mental examination needs adaptation for use in our population Train all cadres in Community and Primary Care Centres in Mini-Mental Status Examination. On Detection improvement, Routinely screen patients above 60 years. Management Care package is needed where all needs on elderly are met at Primary Health Centre. Strengthen advocacy and availing a budget for Dementia and other needs of those above 60 years. Need to develop a Neurological Disorders Guidelines and Policy Increasing Political Commitment in Actions against Dementia Increasing research on Dementia Strengthening issues on partnerships and stakeholders

6 THANK YOU