Objective: The aim of this study was to conduct a situational analysis as part of formative work to inform the development of community-based mental health services for children and adolescents at a district level. The purpose of the situational analysis was to determine the current state of child and adolescent mental health (CAMH), the available resources for CAMH, the range of services provided, and the existing pathways to CAMH care in a low-resource district with a view to developing a district mental health plan to improve access to CAMH services. Methods: Data for this situational analysis was collected from a rural district in the KwaZulu-Natal province using mixed methods. The qualitative component explored various stakeholders' (n = 26) perspectives using semi-structured interviews. The quantitative data for the study was collected using an adaptation of the situation analysis tool developed by the PRIME consortium. Results: The findings revealed the need to strengthen all the basic building blocks of the health system due to the weaknesses identified in the current CAMH care system in the district. The result of the situational analysis revealed that the provision of CAMH services in the district is sparse, uncoordinated, and not prioritised. Discussion: The findings of the study highlighted a severe shortage of specialised CAMH services in the district, poor integration of CAMH services into primary health care, and at the community platform there are deficits in the integrated school health programme. Further, the lack of a coordinated intersectoral collaborative system and well-defined referral pathways were revealed. Conclusion: The study highlights various challenges facing CAMH services at the Amajuba district. While these are not new, the study contributes to our understanding of the district level factors that may hinder the development of a district CAMH plan.

中文翻译：

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南非农村地区儿童和青少年心理健康干预措施的规划：一种情况分析。

目的：本研究的目的是进行情况分析，作为形成工作的一部分，以为地区一级的儿童和青少年提供基于社区的心理健康服务。情势分析的目的是为了确定儿童和青少年心理健康（CAMH）的当前状况，CAMH的可用资源，所提供的服务范围以及资源贫乏地区CAMH护理的现有途径，以期制定地区精神卫生计划，以改善获得CAMH服务的机会。方法：采用混合方法从夸祖鲁-纳塔尔省的一个农村地区收集了这种情况分析的数据。定性部分使用半结构化访谈探讨了各种利益相关者的观点（n = 26）。该研究的定量数据是使用PRIME财团开发的情况分析工具改编的。结果：调查结果表明，由于该地区当前CAMH护理系统中发现的弱点，有必要加强卫生系统的所有基本组成部分。情况分析的结果表明，该地区提供CAMH服务的位置稀疏，不协调且没有优先级。讨论：研究结果强调了该地区专用CAMH服务的严重短缺，CAMH服务与初级卫生保健的整合不佳，在社区平台上，综合学校卫生计划存在不足。此外，发现缺乏协调的部门间协作系统和定义明确的推荐途径。结论：该研究突出了Amajuba地区CAMH服务面临的各种挑战。尽管这些都不是新鲜事物，但该研究有助于我们理解可能会阻碍地区CAMH计划制定的地区层面因素。