Igebe Lempilo Yengqondo Ezifundeni Ezingaphansi Kwemali Etholakalayo

Izifo zengqondo ziveza ingxenye enkulu yomthwalo wezifo zembulunga yonke, kodwa iningi labantu abahlala ezindaweni ezithola imali encane alitholi kwelashwa nhlobo. INhlangano Yezwe Yezempilo (WHO) ilinganisela ukuthi abantu abaphakathi kwamaphesenti angu 76 nangu-85% abanokuphazamiseka okukhulu kwengqondo emazweni aphansi naphakathi atholakele (LMSC) abangenakho ukunakekela. Leligebe liqhutshwa inhlanganisela enkulu yemali enzima ngaphansi kwemali, ukuswelakala okukhulu kochwepheshe, nehlazo elingapheli emphakathini. Eziningi zalezi zindawo, intengo yempilo yengqondo elingana namakhulu ama-irandis.

Izindawo ezihlawulwa kancane ngokuvamile azinazo ngisho nezakhiwo eziyisisekelo zezengqondo. Ngokwesibonelo, ngaphesheya kwe-Saharan Afrika, kunodokotela ababili abasebenza ngezifo zengqondo kubantu abangu-100 000 ngokwesilinganiso, “‘ abaqhathaniswa nabangaphezu kwe 10 kwabangu - 100 000 eYurophu. Abahlengikazi, odokotela abavamile, nezisebenzi zezempilo zomphakathi ngokuvamile bayabizwa ukuba bagcwalise leligebe, kodwa bathola okuncane kakhulu ekuqeqeshelweni okungokomthetho empilweni yengqondo. Lokhu kukhuliswa iqiniso lokuthi izinkonzo zezempilo zengqondo zivame ukuhlanganiswa ezindaweni zasedolobheni, zishiya imiphakathi yasemaphandleni ingenakho ukunakekelwa.

Ngaphandle kokuntuleka kwemithombo yemali, ihlazo lomphakathi liyisithiyo esikhulu. Emazweni amaningi, ukugula kwengqondo kuqondwa njengophawu lobuthakathaka bomuntu siqu noma isiqalekiso, okuholela ekucacisweni nasemahloni. Imikhaya ingafihla amalungu athintekile, futhi abantu abafuni usizo ngenxa yokwesaba ukukhishwa inyumbazane emphakathini. Lesisihlazo asithinti nje kuphela abantu ukuba bathole ukwelashwa okukhona kodwa sikhubaza ohulumeni nabanikeli bengqondo ngaphambi kokuba bafune impilo engcono njengendaba yezempilo yomphakathi.

Imiphumela engokomnotho yokugula ngengqondo okungelashwa inzima. Ukwehla kwezomnotho nokukhathazeka kukodwa kulahlekisela umnotho wembulunga yonke iUS yizigidi eziyizigidi eziyi - 1 ngonyaka ekulahlekelweni umkhiqizo. Ezimweni eziphansi, lapho imikhaya ivame ukuthembela khona eholweni lansuku zonke, ukungakwazi ukusebenza ngenxa yesifo sengqondo kubangela imikhaya ukuba ibe nobumpofu obukhulu. Lokhu kudala umjikelezo obhubhisayo: ubumpofu bubangela ukucindezeleka kwengqondo, kuyilapho ukugula ngengqondo kubangela ubumpofu. Ukulawula lomjikelezo ngempumelelo, ukungenela kokusiza akuyona nje imfuneko engokokuziphatha kuphela kodwa futhi nesidingo sezomnotho.

Indima Yosizo Lwezizwe Zonke Ekunqandeni Igebe

Usizo lwezizwe zonke luye lwaba umshayeli ogxekayo ekulinganiseni izinkonzo zempilo yengqondo ezisezindaweni ezimpofu kakhulu emhlabeni. Nakuba ingqikithi yosizo lwentuthuko empilweni yengqondo ihlala iyingxenyana encane yosizo lwempilo oluphelele − cishe 1%/_____izinhlelo ezifakiwe zibonise ukuthi ngisho nokutshala imali ngesilinganiso esiphansi kungaveza intuthuko ephawulekayo. Usizo lusiza ekwakheni izisekelo eziningi, kusukela ekwakheni izakhi ezingokomzimba kuya ekushintsheni izimo zengqondo zomphakathi.

Ukusekela Izakhiwo Nokuthwala Inkonzo

Enye yeminikelo ebonakalayo kakhulu yosizo ukwakhiwa nokuhlonyiselwa kwezempilo yengqondo. Emazweni anjenge-Liberia, i-Sierra Leone, ne-Nepal, izimali zokusiza ukunikela ziye zasiza ekwakheni amaqembu empilo yengqondo asekelwe emphakathini ezibhedlela ezivamile, esikhundleni sokuthembela ezikhungweni zezingane zezingane zengqondo. La zinhlangano zinikeza ukunakekelwa kokubeletha, isikhathi esifushane esisele, futhi zilandela izinkonzo zokusebenza ezimweni ezikhubazekayo. Imali isekela futhi ukuthengwa kwemithi yengqondo edingekayo, ngokuvamile enqatshelwa ukubiza noma engekho ngemigede yokwane yokuthunyeza. I-Mental Healthgatemmote Act Programme (mGA) iye yaba usizo ekuqondiseni iminikelo enikeza izindleko ezibizayo, ubufakazi obuyinzuzo kakhulu.

Ukuqeqesha Nokwakha Izisebenzi Ezinakekela Impilo

Izinhlelo zosizo zigxila kakhulu ekuqeqesheni izisebenzi zezempilo ezingezona ezekhethelo `isu lokuqeqesha'' kanye ne'[FLT'' elaziwa ngokuthi ukuphatha umsebenzi-mkhakha]. Ezinhlanganweni eziningi ezithola imali ephansi, azikho nezezazi zezifo zengqondo ezanele ukuhlangabezana nesidingo. Izinhlangano zomhlaba wonke njenge i-STICYNS ne-[FLT] Impilo yengqondo ye-Innoctive [[FLTY]] Networket [[[FLTLT:3]] ixhase izinhlelo zokuqeqesha abahlengikazi, izisebenzi zezempilo, ngisho nothisha ukuba baqaphele iziphazamiso ezivamile, ukunikeza iseluleko esiyisisekelo, futhi balawule imithilo. Lezi zinhlelo eziklanywe kahle, ukuvumelana nokunakekela impilo okukhona manje, kunokuncike kakhulu kwemisebenzi.

Ukuqapha Komphakathi Nemikhankaso Yokunciphisa Izifo

I-Aid futhi imikhankaso yezezimali yomphakathi ehlasela ngokukhethekile ihlazo. Ngokwesibonelo, e-Ethiopia, umkhankaso "Bona Mina, Noyisifo Sami" wasebenzisa umsakazo, izixoxi zomphakathi, nezincwadi zokuphikisa izinganekwane ngokugula ngengqondo. Isekelwa yi-comium yabanion yabanikeli bezwe lonke, lomkhankaso wafinyelela izigidi futhi wahlanganiswa nokwanda okungalungiseki kokuziphatha kokufuna ukwelashwa. Izindlela ezifanayo e-Uganda naseKenya ziye zasebenzisa osaziwayo basendaweni kanye nabaholi benkolo njengabakhulumi, zenza isigijimi sibe esibaluleke kakhulu ngokwesiko. Lokhu kungenisa inzuzo engokolwazini; ngaphandle kokunciphisa ihlazo, ngisho nezinkonzo zokwelapha eziphambili ziyo ziyohlala ziseza ngaphansi kokusetshenziswa.

Ukuthola Imithi Yezifo Zengqondo Ebalulekile

Ngisho noma imitholampilo nezisebenzi eziqeqeshiwe zikhona, iziguli azinakululama ngaphandle kwemithi. Amazwe amaningi athola imali ephansi ahlushwa ama-stock asemahlalakhona alwa nokucindezeleka, izithiyo, kanye nezingasindisi zemizwelo. Usizo lwezizwe zonke lusiza ekuqiniseni ukunikezelwa kwamaketanga ngokuhlela izinto ezinkulu ezithengwa, ukuxhasa izitolo eziphakathi zezokwelapha, nokusekela ukukhiqizwa kwendawo lapho kunokwenzeka khona. Izinhlangano ezinjenge [[FLT:]] AmaManagements as as sciences zempilo [ ziye zabambisana nezinhlangano zempilo ezithuthukisa ukubikezela nokusakaza izimiso zempilo, kuqinisekisa ukuthi imithi ebalulekile ifinyelela ezimbonini zempilo ezikude. Aid isekela futhi ukukhiqiniswa kwemithi yezifo zezifo zempilo ezisemgangazweni ezidingekayo, inqubo ehambayo elungele ukulondolozwa.

Ukuhlola Izinhlelo Zosizo Eziphumelelayo

Ithonya lezinhlelo zosizo ezihlelwe kahle lingabonakala ekuthuthukisweni kwendlela yokwelapha nemiphumela yeziguli ezisezindaweni eziningi. Ngezansi kunezibonelo ezimbili eziningiliziwe ezibonisa indlela izindlela ezihlukene eziye zaphumelela ngayo emongweni ohlukahlukene.

I-Sub-Saharan Afrika: Izinkonzo zempilo yengqondo zomphakathi ezisekelwe eZimbabwe

EZimbabwe, iprojekthi yoMhlangano we-Bonice Bench inikeza isibonelo esishukumisayo sendlela yokusiza abantu abanokuphazamiseka kwengqondo okuvamile ukusingatha igebe lokuphatha ngokwesilinganiso. Ekuqaleni yasungulwa ngokusekela kwe-National Institutes of Health ne-Zimbabwe, uhlelo luqeqesha ogogo nogogo .ukunikeza abantu abanomphakathi inqubo yokwelapha edinga izinkinga zengqondo. "Bantamo" bayizibalo ezithenjwayo emiphakathini yabo, ezisiza ekunciphiseni ukuhlazeka. Uhlelo luye lwaboniswa emithola imisha engaphezulu kwama-70 ezweni lonke, futhi ukucwaninga okukhishwe ku-Globalw Health [[FLT] [FLT:] [1] [ikhulu] [ikhulu] kubonisa ukuthi abakhona abakhona bezwa ukuncishiswa okukhulu kwezimpawu zokucindezeleka nokukhathazeka. Ukusekela kwemithola i-Alenadiands, ukusekela nokuqondisa i-ogogo, njengokuhlolwa kokwelashwa kokwelashwa kokwelashwa.

Esinye isibonelo esiphawulekayo yi-Mental Health and Poverty Project eGhana, exhaswe yi-UK Department for International Development (manje i-Ofesi Yomphakathi Wangaphandle, i-Commonwealth ne-Dropulment). Lo msebenzi uhlanganisa impilo yengqondo nezindawo ezintathu eziyinhloko, uqeqesha abahlengikazi nezikhulu zezempilo zomphakathi ezingaphezu kuka-2 000. Ekupheleni kwalo msebenzi, inani labantu abagula kakhulu engqondweni lisuka ku-10% kuya ku-50%. Lo msebenzi futhi wabonisa ukuthi impilo yengqondo incike kumama nakubantwana abakhona ingabiza futhi iqhubeke, isibonelo esiye sathathwa kwamanye amazwe aseNtshona Afrika.

ENingizimu - mpumalanga Asia: Ukuthuthela Ekhaya Eliyi - Primary Care eNepal

I-Nepal, elinye lamazwe ampofu kakhulu e-Asia, iye yabhekana nezinselele ezinkulu ekunikezeni izinkonzo zempilo yengqondo, ikakhulukazi ngemva kokuzamazama komhlaba ngo-2015. Usizo lwezizwe zonke, kuhlanganise neminikelo evela kwiNhlangano Yezwe Yezempilo, i-Australian Government, nezinhlangano ezingezona zezohulumeni njenge SANGAth[, iye yasetshenziselwa ukuvuselela nokuguqula ukunakekelwa kwengqondo. Icebo eliyinhloko liye laba ukuqeqesha izisebenzi eziyinhloko zokunakekela impilo yezempilo emithanjeni ye-mGAP, kanye nokumisa iziqondiso zezindlela ezihambela phambili eziphethe izingxenye zezengqondo eziphethe izifunda. Ukuhlola okungu 2019 kwathola ukuthi inani labantu abathola ukunakekelwa kwengqondo ezindaweni ezihlanganyela ezindaweni eziphethe isigaba seminyaka emithathu.

ECambodia, i-Transcultural Psychoconial Psychocial Organization (TPO) yaseCambodia iye yasungula izinhlelo zezempilo zengqondo zomphakathi ezixhaswe yizisebenzi zomphakathi. I-TPO iqeqesha izisebenzi zokuzithandela zendawo ukuba zihambele ekhaya, zinikeze usizo lokuqala olungokwengqondo, futhi zisiza amaqembu asekela abantu abanokuphazamiseka okuguquguqukayo nokucindezeleka nesifo sokucindezeleka (----acementalsss) ezivamile ekuhlaseleni kohlanga lwe-Khmer Rouge ne-testrigian elandela i-antervement. Lo hlelo luye lwaphumelela kakhulu ekufinyeleleni amaqembu amaqembu ezinhlanga nabantu asemaphandleni asemaphandleni. Ukuxhasa izinhlangano ezinjenge-Europe Union ne-USAID kuye kwenza isimiso sanweba ngaphezu kwengxenye yezifunda zezwe, futhi lesimo se-fakela kwezinye izimo zempi ezisengxenyenishini ezisezindaweni zasemaphandleni.

Izinselele Ezibhekene Nezinhlelo Zempilo Yengqondo Zosizo

Naphezu kwale mpumelelo, indlela yokunakekela ingqondo eqinile ezindaweni ezithola imali encane igcwele izithiyo. Ukuqaphela lezi zinselele kubalulekile ekuklameni izinhlelo zosizo eziphumelelayo esikhathini eside.

Izithiyo Zempucuko Nokufaneleka Kwazo

Impilo yengqondo ayiyona inqubo ebumbene. Lokho okuhlanganisa ukugula, nendlela okumelwe kwelashwe ngayo, kuyahlukahluka kakhulu kuzo zonke izimpucuko. Izinhlelo zosizo ezingenisa nje izigaba zokuhlolwa kweze-Western kanye nezindlela zokwelapha zingahlangabezana nokwenqaba noma ukuzwela. Ngokwesibonelo, emiphakathini eminingi yase-Afrika, ukucindezeleka kwengqondo ngokuvamile kuboniswa ngezimpawu ze-somatic (amakhanda, ukukhathala) futhi kuthiwa zibangelwa izimbangela ezingokomoya. Izinhlelo ezingazinaki lezi zimiso zenkolelo zendawo zingaba sengozini yokuthatha futhi zibangele ngisho nokulimala. Izindlela eziphumelelayo zisebenzisa isikhathi sokucwaninga, zisebenzisa izithakazelo zendawo, futhi zivumelanisa ukungenela kwazo ukuze zifanelane nezimpawu ezikhona. Lokhu kudinga ukuguquguquka kosizo ezinikelayo, ezingase zithanda izimpawu ezivamile, ezisheshayo.

Ukusekela Imali Nokuncika Kuyo

U-Aid uvame ukuthatha isikhathi esifushane, uxhunyiwe emisebenzini ethile elinganiselwe. Uma iphela izimali, izisebenzi eziqeqeshiwe zingahamba, izinhlelo zivalwe, futhi zidilike. Izindlela eziningi zempilo yengqondo ezindaweni ezitholakele eziphansi ziye zazama ukuqinisa izimali zikahulumeni eziqhubekayo ngemva kokusekela kosizo losizo lwezibonelelo. Ukulwa nalokhu, usizo lwezizwe ngezizwe kufanele luhlelwe ukuze kuqinisekiswe izimiso zempilo yasekhaya futhi kwakhe izinhlangano zezezimali zasekhaya. Lokhu kuhlanganisa ukukhuthazwa kwempilo yengqondo ukuze ihlanganiswe ezimishuwaneni zempilo yesizwe, njengoba kuye kwenziwa ngosizo lwaseGhana naseRwanda. Izibopho ezithatha isikhathi eside ezivela kubantu abanikela iminikelo nezimali eziningi, njengeNguquko yezempilo yezengqondo (okukhona kusekhona ukuthutha i-atmouse) kusedingeka nangemva kwemisebenzi ye-semouse.

Ukulinganisela Ekunakekeleni Impilo Okuyisisekelo

Naphezu kwesivumelwano esakazekile sokuthi impilo yengqondo kufanele ihlanganiswe ekunakekeleni okuyinhloko, iqiniso liwukuthi imizamo eminingi yokuhlanganisa ihlala ikha phezulu. Izisebenzi eziyinhloko ezinakekela abaphethwe yizimo eziphansi kakade zithwele izifo ezithathelwanayo, ubumama nezingane, nezifo ezingathatheki. Ukwenezela impilo yengqondo ngaphandle kokusekela okufanelekile, ukuqondisa, nemithombo yemali ingaholela ekuqondiseni inqubo eqinile. Izinhlelo zosizo zidinga ukusingatha sonke isimiso sempilo, ukuhlanganisa ukunikeza amaketanga, ukuqondisa, nokuqoqwa kokwaziswa (ne) kunokuqeqesha nje izisebenzi ezimbalwa. I-WHOMFS ("ingqondo" yokunakekela okuyinhloko) igcizelela ukuthi impilo kumelwe iqiniswa nesimiso esingokwendawo ezungezile esiqinile, lapho usizo lungadlala khona indima engokwengxenye.

Imininingwane Nokuhlola Amagebe

Izindawo ezithola imali encane ngokuvamile zintula ukwaziswa okunokwethenjelwa ngokuphathelene nokuchuma kwempilo yengqondo, ukusebenza, nemiphumela. Ngaphandle kokwaziswa okuqinile, kunzima ukuhlola ithonya lezinhlelo zosizo, ukwabela imithombo ngokuphumelelayo, noma ukusekela ukuxhasa ukuxhasa ngezimali eziqhubekayo. Izinhlelo eziningi zosizo zihlanganisa ingxenye yokucwaninga, kodwa imiphumela ayivamile ukubuyiselwa emiphakathini noma isetshenziselwa ukulungisa ukusetshenziswa kwangempela. Ukucwaninga nokuhlola kwendawo kufanele kube yingxenye ejwayelekile yanoma yisiphi isinyathelo sempilo engokwengqondo. I-Atlas yezempilo ye-MCMY inikeza isakhiwo sezwe se-tekst-tectory, kodwa kudingeka izimali ukuze isebenze esifundeni nasemagunjini ezindawo.

Iziyalezo Zesikhathi Esizayo: Ekuzingeni Kwesimiso Esiqinile Nesinethezekile

Ukuze kusekelwe empumelelweni yangaphambili, imizamo yosizo lwesikhathi esizayo kumelwe isebenzise indlela ehlelekile neyasendaweni yakini. Okulandelayo okuza kuqala kungasiza ekuqinisekiseni ukuthi izinkonzo zezempilo zengqondo ziba inqubo ehlala njalo ezimisweni zezempilo ezihola imali encane kunokuba zibe umsebenzi wesikhashana.

Ukunakekela Impilo Eyisisekelo Njengengxenye Yezikhova

Kunokuba kuphathwe impilo yengqondo njengesimiso esimile, esizimeleyo, usizo kufanele lusekele ukuhlangana kwayo okugcwele ezinhlanganweni eziyinhloko zezempilo. Lokhu kusho ukuqeqesha zonke izisebenzi zokunakekela okuyinhloko − hhayi nje ochwepheshe bezempilo yengqondo (ekuhlolweni nokuphatha), ukusekela okuguquguqukayo okungokwengqondo phakathi kwezinhlelo zezempilo zamama nezingane, kanye nokuhlanganisa impilo yengqondo nokulawula izifo zesikhathi eside (umzz., isifo sikashukela nokucindezeleka ngokuvamile kubangela ukuhlelwa kwemali). Amazwe anjenge-Indonesia ne-Sri Lanka abonise ukuthi ngokusekela okuqhubekayo kwezentengiselwano, ukuhlanganisa isilinganiso somphakathi. Usizo kufanele lusetshenziswe ukubonisa ukufaneleka kwezifo ezinjalo ezibangelwa yizindleko zomphakathi, kudala isimo sokuhlelwa kwemali yasekhaya.

Ukusebenza, Ukusebenza Ngomphakathi Namathuluzi Okubhala

Ishumi leminyaka elizayo lizobona ukwanda kwezisebenzi zezempilo ezinakekela umsebenzi ezithembele ezizisebenzini zezempilo zomphakathi, abasekeli bontanga, nabeluleki abaqeqeshiwe. Lokhu akuthathi nje kuphela ukunwebeka kwemithombo yabantu kodwa futhi kuthuthukisa ukuba nomphakathi /ayisici esiyinhloko sokusekela. Amathuluzi emishini yezempilo (umz., i-telepsychiatry) ingasekela ukuqondisa nokunikeza ukusekela izinqumo kubantu abangezona ikhethekile, kodwa kumelwe iklanyelwe ngokucophelela imiphakathi ephansi nezindawo ezizungezile eziphansi. Usizo lungaxhasa ukuthuthukiswa nokuhlolwa kwamathuluzi anjalo ezimweni zangempela, ngezindawo ezivulekile ezingenisa iziteshi eziphansi kakhulu ezingazijwayela ngaphandle kokulungisa isondo.

Ukulwela Ukuhola Nezimiso Zendawo

Ukulondeka ekugcineni kuxhomeke ekuholeni kwezwe okuqinile nasemgomweni wezombangazwe. Izinhlangano zosizo kufanele ziqinise ikhono labasekeli bezempilo yengqondo bendawo, izinhlangano zobuchwepheshe, nezinhlangano zomphakathi womphakathi ukuba zisekele ohulumeni bazo. Lokhu kuhlanganisa ukuqeqesha abacwaningi bendawo ukuba banikeze ubufakazi obukhuluma ngezindawo eziza kuqala zesizwe, basekele ukuthuthukiswa kwamasu engqondo esizwe, futhi basekele ukuthathiswa kwezihambeli ze-LMIC ezimpilweni zengqondo yembulunga yonke. Uma abaholi bendawo benohlelo, basengozini kakhulu yokuhlela imithombo yasekhaya kanye nezimiso ezingokomthetho ezivimbela ukucwasana ngengqondo yempilo yengqondo.

Ukukhokhela I - haul Ende

Umphakathi wezizwe zonke kumelwe ususe imijikelezo yemisebenzi emifushane futhi usebenzise amathuluzi ezimali emide anikeza izimali ezithe ngqo, ezithatha iminyaka eminingi. Izivumelwano ze-Global Fund ye-Mental Health, ezibekwe eMhlabeni wembulunga yonke ephumelelayo ukuze Ulwe nengculaza, isifo sofuba noMalaleveva, ziye zathola inzuzo kodwa zihlale zingakhathazeki. Kule nqubo, abanikela ngezimali zezimali zezimali zesikhathi eside ezinikeza i-ascid dyment sy sy system ezibonectivessss ezibonectivessssss ezibonectivessss (intelligin syndromes). Ngalesosikhathi, amazwe aphansi athola imali engokwempilo, andisa izindleko zempilo futhi asiza ekutholeni.

Isiphetho: Isicelo Sokuzibophezela Okuqinile

Usizo lwezizwe ngezizwe selubonise ukuthi lungathuthukisa ngempela izinga lezempilo yengqondo ezifundeni eziphansi ezitholakele. Kusukela kogogo abanikeza ukwelashwa eZimbabwe kuya ezisebenzini zezempilo zomphakathi ezinikeza ukunakekela emadolobhaneni aqhelile ase-Nepal, ubufakazi bubonisa ukuthi ukungenela okungaguquguquki, okungahleleki kahle, ukungenela okungokomongo kungavala igebe lokwelashwa. Nokho, lentuthuko ihlala iqinile futhi ixhomeke ekunakekeleni okuqhubekayo kosizo kanye namacebo ahlakaniphile. Ngaphandle kokushintshela ekunakekeleni iziguli ezinziwa isikhathi eside, isimiso sezimiso zokuzimela ezibonisa ukusondela kokuzimo ezingcono zomphakathi nokuhlangana kwazo, eziningi impumelelo yamashumi amabili eminyaka adlule. Indlela yangaphambili ayidingi ukunikela kakhulu kuphela izimali, ukubekezela, nokuthuthukisa isimilo, kanye nokuthuthukisa ingqondo kungaba ilungelo lokunakekela izikhundla, kodwa lonke ilungelo lokuceba.