Factors Influencing the Uptake of Mental Health Services to Genocide Victims :

Abstract

This study was done to determine the factors that influence the uptake of mental health services to genocide victims, with a case study of Gasabo district, Kigali city, Rwanda. The main objective of the study was to investigate the factors influencing the uptake of mental health services to genocide victims in Rwanda. The specific objectives of the study were to explore client factors that influence the delivery of mental health services, to examine the institutional factors that influence the uptake of mental health services to genocide victims, to investigate the geographical factors that influence the uptake of mental health services to genocide victims and to determine the social, cultural and economic factors that influence the uptake of mental health services to genocide victims. Despite the fact that many studies on post conflict issues, for instance the onset of post-traumatic stress disorder post conflict, very few studies have been carried out in sub Saharan Africa. This means a big knowledge gap still exists in many of these countries, necessitating this study.

The study was a cross sectional descriptive study, employing quantitative data collecting methods using two instruments. A self-administered questionnaire was designed and distributed randomly to 300 survivors of genocide with a consent form. On the other hand, a self-administered questionnaire was also randomly distributed to 85 health workers. Of the 300 and 85 copies distributed respectively, all of them were retrieved with hundred percent response rates. SPSS version 15 was used to analyze the data, and Pearson ® correlation coefficient was used to test the significance of the relationships between the variables.

The results of the study indicated that most of the respondents were knowledgeable, as regards treatment of mental illness (62.3%), availability of mental health services (83.3%), and the efficacy of the treatment 79%. More so it found out that stigma still exists in Rwanda, for instance 71% of the respondents reported that mental illness is not considered as other illnesses, which is indicative of stigma, explaining why many of the known mentally ill patients in the community do not access care. Furthermore it indicated that many people see government health facilities as being more convenient (55.3%), the challenge is that many reported having to wait for long hours to be attended to (72%). It also found out that there is some health education provided to the community. The study also found that many of the respondents (73.7%) could provide their daily living needs but few of them were able to spare the resources for their health care needs (36.7%). On the side of service delivery it was found that health facilities are not adequately equipped to handle all the psychiatric problems; interestingly 64.7% of the respondents reported that mental health services were offered in Gasabo district. The same was also reported by health workers 82.4%, but the challenge is that a big number of health workers were dissatisfied with salaries.

The study recommends that the government of Rwanda and her partner organizations should increase funding to the health sector in general and the mental health care in particular; this is because nearly all issues in service uptake, for instance training of health workers, staffing, remuneration of health workers, health education, equipment of health facilities, to mention but a few revolve around funding. I recommend that studies such as this, be carried out in rural districts of Rwanda to see whether the results can be replicated.