Abstract
In this invited commentary, the Mental Health and the Neglected Tropical Diseases(NTDs) Program leads in the Nigerian Federal Ministry of Health and Social Welfare share the opportunities that have arisen from recent global progress in normative guidance and political interest in the intersection of mental health and NTDs. They describe the new collaboration that has taken place between their programs, e.g. contributing to the World Health Organization Essential Care Package for Mental Health, Stigma and NTDs and integration of mental health for the first time into the new National NTD Masterplan.
Abstract
Dans ce commentaire invité, le responsable de la santé mentale et le responsable des maladies tropicales négligées (MTN) au sein du ministère fédéral nigérian de la santé et de la protection sociale partagent les opportunités qui sont nées des récents progrès mondiaux en matière d'orientation normative et de l'intérêt politique pour l'intersection de la santé mentale et des MTN. Ils décrivent la nouvelle collaboration qui s'est instaurée entre leurs programmes, par exemple en contribuant au paquet de soins essentiels de l'OMS pour la santé mentale, la stigmatisation et les MTN, et en intégrant pour la première fois la santé mentale dans le nouveau plan directeur national sur les MTN.
Abstract
En este comentario invitado, el director de salud mental y el director de enfermedades tropicales desatendidas (ETD) del Ministerio Federal de Salud y Bienestar Social de Nigeria comparten las oportunidades que han surgido de los recientes avances mundiales en la orientación normativa y el interés político en la intersección de la salud mental y las ETD. Describen la nueva colaboración que ha tenido lugar entre sus programas, por ejemplo contribuyendo al Paquete de cuidados esenciales de la OMS para la salud mental, el estigma y las ETD, y la integración de la salud mental por primera vez en el nuevo Plan Maestro Nacional de ETD.
Background
More than one billion people suffer from at least one neglected tropical disease (NTD) globally,1 and sub-Saharan Africa accounts for >40% of the global burden of NTDs. Among all of the African nations, Nigeria has the greatest number of people infected with NTDs.2 Comorbidity of mental illnesses has been demonstrated among people living with NTDs, leading to additional but unrecognized disability.3,4 Consequently, people affected by NTDs experience neglect, associated stigma and discrimination, poor access to treatment and undiagnosed associated mental health conditions. Although significant progress has been made in the management of NTDs, there remain gaps in management of the mental, neurological and substance use conditions they cause, leading to increased efforts by stakeholders globally to provide integrated and person-centred care for people affected by NTDs.
A global response
The recognition of stigma and mental well-being as concerns of persons affected by NTDs instigated development of global normative guidance for incorporation of support for mental health of affected people. Notable among these are the World Health Organization (WHO) NTD Roadmap 2021–2030,5 the WHO guide to Mental Health and Neglected Tropical Diseases1 and the International Federation of Anti-Leprosy Associations and Neglected Tropical Disease NGO Network guide to Stigma and Mental Wellbeing.6 Along these lines, the development of the Essential Care Package (ECP) for stigma and mental well-being in NTD work became imperative.
A window of opportunities for Nigeria
As part of the process for development of the ECP, Nigeria held a workshop to get stakeholder inputs into the document. A 4-d stakeholders’ workshop was jointly held by the newly established National Mental Health Program (NMHP) and the NTDs division of the Federal Ministry of Health with support from the WHO. The NTDs division has very strong program experience in community-based approaches to eradication of NTDs in Nigeria, and thus brought a lot of experience into the process. Although the workshop was aimed at providing inputs into a global document, it also opened another window of opportunity at the national level for the integration of mental health into the care of NTDs. The review of the National Masterplan for NTDs was ongoing by the time the workshop took place in Nigeria. Both programs agreed to suspend the review process so the outcome of the workshop could be integrated into the process. That singular action has led to integration of mental health into the care of NTDs in Nigeria, evident in the Masterplan, the Case Management Handbook and the inclusion of a mental health focal person in the national Technical Working Group for NTDs.
Since the integration and the development of the strategic policy documents, both local and international opportunities have arisen to strengthen the ongoing efforts. However, it is important to note that these are early days, and all stakeholders, including the government, need to be committed to strengthening and sustaining the gains made so far.
Acknowledgements
Julian Eaton of CBM Global Disability Inclusion for reviewing the initial manuscript draft.
Contributor Information
Tunde M Ojo, Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria; Department of Psychiatry, University of Abuja, Abuja, Nigeria.
Oluwole G Afolayan, Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria.
Morenike O Alex-Okoh, Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria.
Authors’ contributions.
T.M Ojo made the first draft. O.G Afolayan and M.O Alex-Okoh reviewed and made inputs. The three authors agreed on the final version.
Funding
No funding was required for this commentary. The WHO AFRO Regional Office funded the Nigeria national stakeholders’ workshop on the development of an ECP for stigma and mental well-being in NTDs mentioned in the article.
Competing interests
None declared.
Ethical approval
Not required.
Data availability
No original data were used in this commentary.
References
- 1. World Health Organization . Mental health of people with neglected tropical diseases: towards a person-centred approach. Geneva: World Health Organization; 2020. [Google Scholar]
- 2. Hotez PJ, Asojo OA, Adesina AM. Nigeria: “ground zero" for the high prevalence neglected tropical diseases. PLoS Negl Trop Dis. 2012;6(7):e1600. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Bailey F, Eaton J, Jidda M et al. Neglected tropical diseases and mental health: progress, partnerships, and integration. Trends Parasitol. 2019;35(1):23–31. [DOI] [PubMed] [Google Scholar]
- 4. Obindo T, Abdulmalik J, Nwefoh E et al. Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria. PLoS Negl Trop Dis. 2017;11(6):e0005567. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Ending the neglect to attain the Sustainable Development Goals: a roadmap for neglect tropical diseases 2021–2030 . Geneva: World Health Organization; 2020. [Google Scholar]
- 6. International Federation of Anti-Leprosy Associations , Neglected Tropical Disease NGO Network. Guides on stigma and mental wellbeing. 2020. Available from: https://www.infontd.org/toolkits/stigma-guides/stigmaguides [accessed 23 September 2023]. [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
No original data were used in this commentary.