Evidence map›Paper›PMID 41802917›Full record

ArticleHealth policy and planning2026

Government-led scale-up of task-shifted mental health services in Lagos State, Nigeria: a mixed-methods descriptive-explanatory case study.

Abiodun O Adewuya, Bolanle Ola, Olurotimi Coker, Olayinka Atilola, Olushola Olibamoyo, Azizat Lebimoyo, Olabisi Oladipo

Abstract read
In one paragraph

Article in Health policy and planning, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Abiodun O AdewuyaDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.ORCID 0000-0002-7611-6953
Bolanle OlaDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.
Olurotimi CokerDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.
Olayinka AtilolaDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.
Olushola OlibamoyoDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.
Azizat LebimoyoDepartment of Behavioural Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100010, Lagos, Nigeria.
Olabisi OladipoPublic Mental Health Department, Centre for Mental Health Research and Initiative, 3rd Floor, Old Glass House, LASUCOM Complex, Ikeja 10010, Lagos, Nigeria.

Funding

Grand Challenges Canada TTS-0796-05
6 · The paper itself

Abstract

Mental health conditions remain a leading contributor to global disability; however, treatment coverage in low- and middle-income countries (LMICs) stays below 20%; in Nigeria, services are underfunded and largely excluded from primary health care (PHC). This study documents the institutional processes through which the Transition-to-Scale phase of the Mental Health in Primary Care (MeHPriC) initiative scaled up task-shifted mental health services across Lagos State, Nigeria. A retrospective, mixed-methods descriptive-explanatory case study was conducted across 57 PHCs and five general hospitals. The intervention delivered care for five priority mental, neurological, and substance use conditions using the Mental Health Gap Action Programme (mhGAP) framework; 890 health workers were trained, comprising 400 Community Health Extension Workers (CHEWs), 250 nurses, 150 medical officers, 85 lay counsellors, and 5 district psychiatrists, under structured district-level supervision. Data from service registers, supervision checklists, stock audits, provider and client surveys, key informant interviews, focus groups, and policy documents were analysed using descriptive statistics and hybrid deductive-inductive thematic coding organized around the World Health Organization (WHO) Health System Building Blocks and selected Consolidated Framework for Implementation Research (CFIR) constructs. The initiative was associated with institutional changes across governance (establishment of a Mental Health Desk and a multisectoral Stakeholders Council), workforce supervision (fidelity rising from 13% to 92.3% of facilities conducting weekly case reviews), medicines (six psychotropic medications added to the Essential Medicines List; stockouts reduced by 42%), financing (₦75 million allocated through routine government budgeting), service delivery (64 107 clients screened and 9138 initiated on treatment), and health information systems. Interpreted as incremental strengthening within the mental health subsystem, these findings reinforce the feasibility of mhGAP-aligned task-shifted care when supported by structured supervision and governance, while persistent fiscal and operational constraints underscore the fragility of institutional gains.

Indexed as

Mental Health ServicesPrimary Health CareTask ShiftingFocus GroupsHumansMental DisordersNigeriaRetrospective Studiesdigital supervisionhealth systems strengtheningmental health integrationNigeriatask-shifting

Identifiers

PMID41802917
PMCPMC13187677

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.