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Eritrea is a country with an approximate area of 118 thousand sq. km. (UNO, 2001). Its population is 4.296 million, and the sex ratio (men per hundred women) is 99 (UNO, 2004). The proportion of population under the age of 15 years is 45% (UNO, 2004), and the proportion of population above the age of 60 years is 4% (WHO, 2004). The literacy rate is 67.3% for men and 44.5% for women (UNESCO/MoH, 2004).

The country is a low income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 5.7%. The per capita total expenditure on health is 36 international $, and the per capita government expenditure on health is 23 international $ (WHO, 2004). The main language(s) used in the country is (are) Tigrigna, Tigre, Saho, Afar, Bilen, Kunama, Nara, Hidarib and Arabic. The largest ethnic group(s) is (are) Tigrinya and Tigre. The largest religious group(s) is (are) Muslim, and the other religious group(s) are (is) Eritrean Orthodox Christian. The life expectancy at birth is 55.8 years for males and 59.3 years for females (WHO, 2004). The healthy life expectancy at birth is 49 years for males and 51 years for females (WHO, 2004).

EPIDEMIOLOGY

There is a paucity of epidemiological data on mental illnesses in Eritrea in internationally accessible literature. Wolff and Fesseha (1998, 1999) followed a group of 4-7 year old war orphans and compared them to a group of refugee children living in a nearby camp with one or both parents. Behavioural problems were significantly more common among the orphans compared to the refugee children, but their cognitive performance was better. Though their behavioural manifestations had diminished at 5-years followup they continued to exhibit emotional distress. Their cognitive performance was at least as good as comparison groups from other residential settings (these children were not exposed to war). Orphans who lived in a setting where the entire staff participated in decisions affecting the children, and where the children were encouraged to become self-reliant through personal interactions with staff members, showed significantly fewer behavioural symptoms of emotional distress than orphans who lived in a setting where the director made decisions, daily routines were determined by explicit rules and schedules and interactions between staff members and the children were impersonal.

MENTAL HEALTH RESOURCES

Mental Health Policy A mental health policy is present. The policy was initially formulated in 1997. The components of the policy are advocacy, promotion, prevention, treatment and rehabilitation.

Substance Abuse Policy A substance abuse policy is absent. The Government has issued a proclamation to provide for Tobacco Control in the Gazette of Eritrean Laws (Proclamation 143/2004, Vol. 13/2004 No. 7, August 23) in 2004.

National Mental Health Programme A national mental health programme is absent.

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 The country has no mental health legislation except those mentioned in the penal code. 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. Details about sources of financing are not available. The country does not have disability benefits for persons with mental disorders.

Mental Health Facilities Mental health is a part of primary health care system. Actual treatment of severe mental disorders is available at the primary level. Severe mental disorders are primarily treated at the tertiary level (at St. Mary’s Psychiatric Hospital). However, limited care is available at secondary and primary levels.

Regular training of primary care professionals is carried out in the field of mental health. In the last two years, about 50 personnel were provided training. Training of primary care clinicians (physicians and nurses) started in 2004. There are community care facilities for patients with mental disorders. The community-based rehabilitation programme run by the

Ministry of Labour and Human Welfare gives the opportunity for priority rehabilitation and also referral for those severely ill patients who need active treatment.

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
  • 0.64
  • 0.64
  • 0
  • 0
  • 0.03
  • 0.03
  • 0.18
  • 0
  • 0
  • 0

There are 2 psychiatrists (1 Dutch and 1 Eritrean). Both neurosurgeons are expatriates. Post basic training for psychiatric nursing (14 months full time) has started. Sixteen students are undergoing training.

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. The Health Management nformation System collects data routinely from all health facilities. The country has no data collection system or epidemiological study on mental health.

Programmes for Special Population There are no programmes for special populations.

Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: phenobarbital, chlorpromazine, diazepam. The essential drug list is revised every 3 years. The next revision is due in January 2005. 


Source: World Health Organization Mental Health Atlas