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POSTNATAL DEPRESSION Raising Awareness and Developing a Model of Care in Vanuatu  Naumu Josy Stephen 1, Jane Allnutt 2, Trish Boss 2, Sue Webster 2 

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Presentation on theme: "POSTNATAL DEPRESSION Raising Awareness and Developing a Model of Care in Vanuatu  Naumu Josy Stephen 1, Jane Allnutt 2, Trish Boss 2, Sue Webster 2 "— Presentation transcript:

1 POSTNATAL DEPRESSION Raising Awareness and Developing a Model of Care in Vanuatu  Naumu Josy Stephen 1, Jane Allnutt 2, Trish Boss 2, Sue Webster 2  1 Lenakel Hospital, Tanna Island, Vanuatu  2 Australian Catholic University, Sydney

2  Vanuatu has 83 islands of which about 63 are permanently inhabited  These islands are grouped into 6 provinces.  2009 census recorded a total population of 245,000 people  Capital is Port Vila (Pop. 30,000)  Official languages English, French and Bislama; with 113 indigenous languages  Adult literacy rate = 57% M 48% F  33% of the population is aged under 15 years of age

3 Model of care  5 Hospitals  20 Health Centre clinics  >25 dispensaries  >20 Aid-Post HW demography  46 doctors  279 Nurses Nursing & Medical Training  Nurses- VCNE  Doctors (90%)– FSM, Fiji National University (Medical training)

4  Cultural influences  Shortage of human resource  Lack of skills or specialized nurses  Lack of resources (finance)  Geographical distribution

5  There is increase in mental disorders  Social practices contributing to mental health problems (high consumptions of kava, marijuana, alcohol)  Unemployment  Population increase

6 Mission: To improve mental health of all people in Vanuatu through raising awareness, developing services through training of professionals in mental health and involving the community in the process of prevention, promotion and care. Areas for Action: National Mental Health Committee, Financing, Legislation and Human Rights, Service organisation, Human resources, Essential medicines, Information systems, Quality, Advocacy, Evaluation.

7  With support from PIMHnet developed Vanuatu Mental Health Policy and Strategic Plan  Launched on 9 th October MENTAL HEALTH IN VANUATU. MENTAL HEALTH POLICY

8 The vision for Vanuatu is for awareness at all levels of community and Government of the importance of investing in the mental component of health as defined by the World Health Organization, to realise to a mentally healthy nation, and commitment to equity and accessibility for humane community care for the mentally ill. Vanuatu Mental Health Policy and Strategic Plan

9 Currently There are about 46 doctors but there is no psychiatrist to look after mentally ill patients and so, the physician normally looks after the patient with two nurses implementing mental health services in the referral hospital. 9 nurses implementing mental health services in 2 Referral Hospitals and 4 provincial hospitals. Only three trained 3 months training overseas 6 underwent 1 months training locally. 1 Ni- Van Doctor has an interest in mental health and is looking forward to commencing training in Psychiatry next year.

10 One Ni- Van completed studies in mental health law. 1 RN currently studying mental health nursing in Fiji. At the moment no psychiatric nurse, no Psychiatrist in Vanuatu despite 9 years pleading. There is a 2 bed unit within the medical ward at Vila Central Hospital, and one bed in Santo not operational full time.

11 By 2014, Vanuatu aims to have:  2 psychiatrists  4 specialist psych nurses  45 SRNs with 3 months local training plus ongoing mentoring and support  21 doctors with 1-3 months local training plus ongoing mentoring and support

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13  Total number of beds= 48  Total number of staff =36

14 STAFFING  One(1) Doctor  Six(6) Nurse Practitioners  Three(3) Midwifes  Sixteen(16) Nurses  Six (6) Nurse Aids  Total – 36 (for a population of approx 33,300) LENAKEL HOSPITAL TAFEA PROVIENCE VANUATU

15 PROVINCEISLANDMALESFEMALESTOTAL TAFEAANEITYUM ,047 ANIWA ERROMANGO1, ,060 FUTUNA TANNA14,70014,46029,160 TOTAL TAFEA 16,82216,47933,301

16 POSTNATAL DEPRESSION RAISING AWARENESS AND DEVELOPING A MODEL OF CARE IN LENAKEL HOSPITAL TANNA VANUATU

17  July to October 2011 had an Aus-aid funded scholarship at ACU North Sydney  Theoretical units done at ACU  Clinical attachments in various settings, including public and private hospitals, a rural inpatient setting, Aboriginal Health, perinatal mental health service, and Ambulance.

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19  DRINK EVERY NIGHT. KAVA I KOSEM SOCIAL PROBLEM  Famli problem  Financal problem  komitem crime  drugs & substains abuse KAVA I KOSEM SOCIAL PROBLEM  Famli problem  Financal problem  komitem crime  drugs & substains abuse KAVA I KOSEM MENTAL PROBLEM  Tingting I sik  Tingting i no wok gud KAVA I KOSEM MENTAL PROBLEM  Tingting I sik  Tingting i no wok gud KAVA I KOSEM PYSICAL PROBLEM  ol masel I slack  skin I drae mo rough  problem blong ae  problem blong liva mo kidni KAVA I KOSEM PYSICAL PROBLEM  ol masel I slack  skin I drae mo rough  problem blong ae  problem blong liva mo kidni REFERENCES: CHRIS.K.(1996) KAVA:Medicine Hunting In Paradise.park street press. Pictures from Googles images BY: EZEKIEL DANMELIP (RN), NORTHERN PROVINCAL HOSPITAL SANTO (2011) KATEM DAON NAOIA BIFO HEMI HOLEM NEK MO SAREM WIN BLONG YU SIPOS TRINK TUMAS KAVA,HEMI PROBLEM BLONG YU? TOKTOK WETEM HELT WOKA LONG ERIA BLONG YU NAOIA. Hemi tumas sipos yu trink bitem 6 sel evri nite This poster was completed to meet the course requirements of NRSGXXX for Australian Catholic University, Mackillop Campus, completed through an Ausaid ALA Grant. The support of Ausaid, The Australian Catholic University and the Vanuatu Ministry of Health is gratefully acknowledged.

20 Previously in Vanuatu there has been very little awareness, focus on the issue on mental health in pregnancy due to lack of qualified mental health work force. Since 2009 Vanuatu has increase a lot of awareness on mental health disorders, I was interested in depression in prenatal and post natal depression.

21 Depression one of the widespread illness needs to be address so that women should be aware of the early signs and symptoms,treatment and understand it is treatable.(WHO 2012) The number of mental health disorders are on the increase in Vanuatu in particular depression and anxiety. Facts about few mothers killing their babies in early 2000 in capital port Vila

22 My aim  Full training in mental health nursing.  Educate mothers on post natal and antenatal depression.

23  To be able to educate other nurses midwives about mental health issues in pregnancy.  Promote and Educate mothers on other support groups, where there is no professional attention.

24  Mental health clinic sited next to GOPD where it is affordable for every patient.  Operates Wednesday and Thursdays, clinic days  Patients referred from GOPD, Wards and from dispensaries and health centres.

25  Received a lot of positive feedback from antenatal and postnatal mothers after awareness. They learned something new have never heard this message before.  So far four ante-natal mothers and three post-natal mothers have come into the mental health clinic seeking assistance.  Increase number of patients 1-2 to 3-4.  Main conditions depression and anxiety. OUTCOMES

26  Vanuatu Government, through the Ministry of Health, should improve training and start full time clinical services in the Provincial Hospitals.  Work together with RNs and midwives bringing more attention, focus on mental health issues of pregnancy.

27  Ongoing local training for midwives and nurses to be able to diagnose correctly and provide right treatment accordingly.  Ministry of Health to push hard to have a Psychiatrist appointed in Vanuatu  More training overseas opportunities training for nurses to gain more experience until Vanuatu Mental Health services fully developed.

28 Any comments or contributions from colleague nurses from the south Pacific to assist my colleagues and I in Vanuatu to improve mental health services in prenatal and post natal depression will be appreciated.

29  Insufficient resources  Inadequate funds to run programs  Limited staff to implement mental health services.  Attitudes/Behaviors  Cultural beliefs  Smoking/Kava consumption  Non compliance

30  Poor Reporting/Referral System  Geography of place  Political instability

31 RAISING AWARENESS ACTIVITIES  CME – 2days presentation on postnatal depression with Nurses and Midwives  Awareness and distribution of cards to Ante-natal mothers on first visits  Awareness and distribution of cards to post-natal mothers

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33 ARRIVAL OF INVITED GUESTS SPORTS COMPETITION PRESENTATION OF PRIZES HANGING OF SALUSALU

34 FUTURE PLANS  Continuous local training for health professional especially midwifes in identification of cases  Creation of additional posters/brochures…etc for awareness  Improvement in reporting/referral systems  Development of an appropriately trained and resourced work force  Improved availability of resources  Good budgeting and planning to run programs

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