The political economy of adolescent mental health in Uganda: a case study among actors and adolescents in Kampala District.

Abstract

Background: More than half of Uganda’s population is below 16 years of age. These children and adolescents have particularly been exposed to increased risk of mental health conditions due to extreme poverty and a history of prolonged armed conflicts. In 2017, Uganda adopted the Child and Adolescent Mental Health Policy to strengthen coordination and collaboration towards promoting mental wellbeing of Ugandan children and adolescents. However, over 5 years later, there is still limited prioritization of mental health services for children and adolescents. Few government agencies and civil society organizations treat AMH as a serious concern, worthy of priority. I embarked on analyzing the political economy of AMH that underpins effective strategies to augment and shift national political priority towards addressing AMH in Uganda. Objective: To explore the political economy factors affecting adolescent mental health in Uganda. Methodology: Methods were based on a review of documents including government policy, reports, peer-reviewed articles on AMH systems in Uganda; key-informant interviews with actors; informal observations of national AMH-related events; and a focus group discussion with adolescent advocates. Drawing on network theory in political science, sociology, and published policy frameworks, I examined the internal dynamics of the national networks that seek to address and advance attention on AMH. The analysis was based on a conceptual and an analytical framework. Results: The findings indicate that actors perceive a major knowledge gap on AMH among stakeholders who have the power to augment political priority towards the issue. Even though many actors agree on the definition of the AMH as a public health problem, coalition building strategies remain weak especially due to gaps in leadership. Even though these were recommended in policy documents, reports and policy briefs, operationalization remains slow. Conclusion: Current efforts among actors to augment priority towards AMH have had little success due to political economy factors such as limited power, weak coordination, and limited funding. Recommendation: Proponents of political priority towards AMH in Uganda will need a strong leading entity to coordinate actor efforts, enhance collective action and frame the communication strategies to enable buy-in from external key stakeholders.