Table 1 The research aim and methods applied in this situation analysis to inform on the three different types of need
From: Assessing the need for a mental health services reform in Moldova: a situation analysis
Type of need [26] | Method(s) | Data source(s) | Inclusion and exclusion criteria |
|---|---|---|---|
(1) Comparative need (gap between what services exist in one area and what services exist in another) | (1) Country comparison between Moldova, the South-Eastern European Health Network (SEEHN) countries and the EU 15 average on mental health system indicators | (1) WHO mental health atlas (2011/2014) [27, 28], WHO Mortality database (2014) [29], WHO Health for all database (2014) [30], Global Health Data Exchange tool (2014) [31] and the study of Krupchanka & Winkler (2016) [32] | Indicators inform on the mental health system and data is available from 2014/2011 from Moldova, (some of) the SEEHN countries and the EU15 average |
(2) Normative need (what the expert or professional, administrator or social scientist defines as need) | (2.1) Document review providing an overview of the existing mental health services structure in Moldova in comparison with the norms on the optimal mix of services described by the WHO in the ‘pyramid framework’ | (2.1) National policy documents (n = 5), reports (n = 6), international reports (n = 10), and service provision- and usage data from the Moldovan National Health Management Centre (NHMC) from 2014 | Documents inform on the mental health services structure in Moldova and are written in English between 2007 and 2015 |
(2.2) Content analysis using ‘a priori’ and open coding of interview (n = 23) and qualitative survey data and descriptive analysis of 5-point Likert scale question (n = 70) from professionals involved in the mental health services reform (n = 93) | (2.2) Semi-structured interviews (n = 23) with implementation team members (ITM) (n = 11), health care managers (HCM) (n = 12), and surveys with predominantly open-ended questions among health care practitioners (HCP) (n = 70) collected between May and October 2017 | Professionals involved in the reform as ITM, HCM or HCP1. ITM if they were part of the international MENSANA project team or the local project implementation unit (PIU). HCM and HCP if they worked in their position for at least 3 months in the pilot districts (Soroca, Orhei, Cimislia and Cahul), or in one of Moldova’s three psychiatric hospitals (Chisinau, Balti and Orhei) | |
(3) Felt need (what the population feel they need) | (3) Content analysis using ‘a priori’ and open coding of qualitative survey data and descriptive analysis of 5-point Likert scale question from service users and carers who use the services part of the in the mental health services reform (n = 52) | (3) Surveys with predominantly open-ended questions among service users (n = 23) and carers (n = 23) collected in July 2017 | Service users and carers older than 18 who received care from community mental health care centres (CMHC’s) in the pilot districts (Soroca, Orhei, Cimislia and Cahul), or in one of Moldova’s three psychiatric hospitals (Chisinau, Balti and Orhei) |