Reflections on "Building Back Better" Child and Adolescent Mental Health Care in a Low-Resource Postemergency Setting: The Case of Sierra Leone.

摘要: Over the past three decades, Sierra Leone has experienced two major humanitarian crises: an armed conflict (1991-2002) and Ebola virus disease outbreak (2014-2015). In addition to these country-wide crises, capital Freetown a mudslide affecting thousands of people in 2017. response emergencies, donors aid organizations showed increased interest supporting implementing mental health psychosocial support interventions. Despite efforts, infrastructure country remains frail. Specifically, systemic improvements implementation evidence-based care for children adolescents appear be lacking. this article, Interactive Systems Framework Dissemination Implementation is used as tool analyze issues related development sustainable, contextually relevant child adolescent health-care delivery system. The author draws on her long-term experience specialist Leone. Observations hypotheses are tested supplemented by formal informal reports national international literature. systems described explored context Leone: (1) Synthesis Translation, (2) Support, (3) Delivery. Interaction between discussed critical successful dissemination Ample attention given contextual factors that believed paramount article concludes with reflection usefulness interventions low-resource, postemergency settings. It suggested that, funding policies, system could benefit from interventions, improvement capacity-building acknowledgment role community-based practitioners services. Local experts, especially those trained health, should empowered work together culturally competent expatriate professionals improve