Family perceptions in caring for children and adolescents with mental disabilities: a qualitative study from Tanzania

Observations have shown that the provision of services to children and adolescents with mental disability (CAMDs) is not responding to the needs of this population. This community based study was carried out in Temeke Municipality in Tanzania and aimed to explore factors that influence family perspectives in the provision of care to CAMDs. This is a qualitative study of 52 respondents from 29 families involved in the daily care of CAMDs, chosen through convenient sampling. A semi-structured questionnaire was used in the interviews. The text was analysed using thematic content analysis. The results of the study revealed family characteristics; deficient knowledge about mental disability (MD); and lack of health care facilities and resources for caring for CAMDs. The community and families of CAMDs had poor knowledge on MD and appropriate care, and about availability of resources and quality care. Families were not supported in the care of their children. Some children in consequence did not receive adequate health care. Some suffered from physical problems due to inadequate care; others were being locked in their room during periods when no-one was able to look after them. These factors were related to socio-economic characteristics of the families as well as to lacking service facilities. "Patient"-oriented, community/family-based health services to support management of chronic or life-long conditions such as MD are needed. The support of caregivers to children with MDs has to be improved. A well worked-out strategy would improve health care of CAMDs through provision of guidance and supervision to the families. Community and family/home-based care in the study area would benefit families of CAMDs.