Patients' and healthcare professionals' perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study.

Journal article


Khattak, Maria Ishaq, Dikomitis, Lisa, Khan, Muhammad Firaz, Haq, Mukhtar Ul, Saeed, Umaima, Awan, Naila Riaz, Haq, Zia Ul, Shepherd, Thomas, Mallen, Christian D and Farooq, S. 2022. Patients' and healthcare professionals' perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study. PLoS ONE. 17 (8), p. e0273286. https://doi.org/10.1371/journal.pone.0273286
AuthorsKhattak, Maria Ishaq, Dikomitis, Lisa, Khan, Muhammad Firaz, Haq, Mukhtar Ul, Saeed, Umaima, Awan, Naila Riaz, Haq, Zia Ul, Shepherd, Thomas, Mallen, Christian D and Farooq, S.
AbstractTo explore the perceptions and experiences of schizophrenia from patients, their care givers, health care providers, spiritual and traditional healers to develop a community-based intervention for improving treatment adherence for people with schizophrenia in Pakistan. This qualitative study involved four focus group discussions (FGD) with a total of 26 participants: patients and carers (n = 5), primary care staff (n = 7), medical technicians (n = 8) and traditional and spiritual healers (n = 6). The participants were selected using purposive sampling method. FGDs were audio-recorded and transcribed. A thematic analysis was applied to the data set. The themes identified were (i) Schizophrenia is not merely a biomedical problem: participants believed that poverty and an inferiority complex resulting from social disparity caused schizophrenia and contributed to non-adherence to medications; (ii) Spiritual healing goes hand in hand with the medical treatment: participants regarded spiritual and traditional treatment methods as an inherent part of schizophrenia patients' well-being and rehabilitation; (iii) Services for mental illness: mental health is not covered under primary health in a basic health unit: participants believed that the lack of services, training and necessary medication in primary care are major issues for treating schizophrenia in community; (iv) Barriers to community-based interventions: primary care staff believed that multiple pressures on staff, lack of incentives, non-availability of medication and lack of formal referral pathways resulted in disintegration of dealing with schizophrenia patients in primary care facilities. The study has identified a number of barriers and facilitators to developing and delivering a psychosocial intervention to support people living with schizophrenia in Pakistan. In particular, the importance of involving spiritual and traditional healers was highlighted by our diverse group of stakeholders.
KeywordsHumans; Schizophrenia - therapy; Pakistan; Health personnel; Qualitative research; Delivery of health care; Focus groups
Year2022
JournalPLoS ONE
Journal citation17 (8), p. e0273286
PublisherPLoS
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0273286
Official URLhttps://doi.org/10.1371/journal.pone.0273286
FunderMedical Research Council
National Institute for Health Research (NIHR)
Publication dates
Online29 Aug 2022
Publication process dates
Accepted05 Aug 2022
Deposited12 Sep 2022
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