24. djibouti.jpg


24. djibouti pic.jpg

Djibouti is a country with an approximate area of 23 thousand sq. km. (UNO, 2001). Its population is 0.712 million, and the sex ratio (men per hundred women) is 99 (UNO, 2004). The proportion of population under the age of 15 years is 43% (UNO, 2004), and the proportion of population above the age of 60 years is 5% (WHO, 2004). The literacy rate is 75.6% for men and 54.4% for women (UNESCO/MoH, 2004).

The country is a lower middle income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 7%. The per capita total expenditure on health is 90 international $, and the per capita government expenditure on health is 53 international $ (WHO, 2004). The main language(s) used in the country is (are) Arabic and French. The largest ethnic group(s) is (are) Somali, and the other ethnic group(s) are (is) Afar. The largest religious group(s) is (are) Muslim.

The life expectancy at birth is 48.6 years for males and 50.7 years for females (WHO, 2004). The healthy life expectancy at birth is 42 years for males and 43 years for females (WHO, 2004).

EPIDEMIOLOGY

There is a paucity of epidemiological data on mental illnesses in Djibouti in internationally accessible literature. Mion and Oberti (1998) found that the prevalence of Khat use among 100 army recruits was 84% with a mean consumption of 400 grams per chew. Khat abuse is believed to be common and associated also with other mental disorders (Mohamed, 2004).

MENTAL HEALTH RESOURCES

Mental Health Policy A mental health policy is absent.

Substance Abuse Policy A substance abuse policy is absent.

National Mental Health Programme A national mental health programme is absent. A national mental health programme is being formulated. This is expected to lead to the development of primary mental health care services, treatment facilities and human resources.

National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. It was formulated in 1997.

Mental Health Legislation An old French legislation forms the basis of legal action. New legislation needs to be formulated.

Details about the year of enactment of the mental health legislation are not available.

Mental Health Financing There are no budget allocations for mental health. Details about expenditure on mental health are not available. The primary source of mental health financing is grants. The country does not have disability benefits for persons with mental disorders.

Mental Health Facilities Mental health is not a part of primary health care system. Actual treatment of severe mental disorders is not available at the primary level. Mental Health will be included with primary care in the new National Mental Health Programme. Regular training of primary care professionals is not carried out in the field of mental health.

There are no community care facilities for patients with mental disorders. Ambulatory care is available following hospitalization and for those for whom hospitalization is not deemed necessary.

Psychiatric Beds and Professionals

  • Total psychiatric beds per 10 000 population
  • Psychiatric beds in mental hospitals per 10 000 population
  • Psychiatric beds in general hospitals per 10 000 population
  • Psychiatric beds in other settings per 10 000 population
  • Number of psychiatrists per 100 000 population
  • Number of neurosurgeons per 100 000 population
  • Number of psychiatric nurses per 100 000 population
  • Number of neurologists per 100 000 population
  • Number of psychologists per 100 000 population
  • Number of social workers per 100 000 population
  • 0.7
  • 0
  • 0.7
  • 0
  • 0
  • 0
  • 0.16
  • 0
  • 0
  • 0

There are 4 nursing attendants. A Chinese psychiatrist is providing services temporarily. Psychiatric assistance is concentrated to the psychiatry department of Peltier Hospital. Besides that, psychiatric services are non-existent.

Non-Governmental Organizations NGOs are not involved with mental health in the country.

Information Gathering System There is mental health reporting system in the country. Data of 1999 is available. The country has no data collection system or epidemiological study on mental health.

Programmes for Special Population No specialized services exist. International organizations like the UNHCR provide help for refugees.

Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: carbamazepine, phenobarbital, phenytoin sodium, sodium valproate, amitriptyline, chlorpromazine, diazepam, haloperidol. These drugs are available only at the general hospital and not at primary care level. None of the anti-parkinsonian drugs are available.

Other Information Magico-religious treatment is present to a great extent. General knowledge about mental disorders is very limited.


Source: World Health Organization Mental Health Atlas