Indicators, frameworks, and influencing factors for evaluating the performance of mental health programs in primary health care: a scoping review
摘要
Mental disorders represent a major challenge for global health systems due to their substantial disease burden. With the integration of mental health services into the primary health care system, evaluating the effectiveness of these programs is essential. This study aimed to conduct a systematic scoping review to examine the indicators, frameworks, and influencing factors related to performance evaluation of mental health programs in primary health care.
Materials and methodsThis study was a systematic scoping review conducted based on the PRISMA-ScR framework. A comprehensive search was performed in international databases including PubMed and Scopus, as well as supplementary sources such as Google Scholar, national databases (Magiran and SID), and relevant institutional websites including the World Health Organization (WHO). A total of 541 initial records were identified. The search strategy used combinations of main keywords “mental health”, “primary health care”, and “performance evaluation”. In total, 49 studies were included in the final analysis.
ResultsThe study identified eight categories of performance evaluation frameworks, including macro-level health system frameworks, primary care frameworks, performance management tools, specialized mental health tools, indigenous Iranian frameworks, rapid evaluation methods, hybrid frameworks, and community-based frameworks. Factors affecting performance were categorized into four dimensions: contextual-policy, organizational-managerial, human resources, and infrastructure-technology. In addition, 117 indicators were identified across six domains: efficiency, effectiveness, equity, quality and responsiveness, access, and outcomes.
ConclusionThis scoping review synthesizes existing evidence on performance evaluation of mental health programs in primary health care and highlights gaps in integrated evaluation frameworks. By mapping key indicators, frameworks, and influencing factors, the findings can inform the development of more coherent evaluation approaches in different health systems, including countries such as Iran.