Publications

High quality research supervision is crucial for PhD training, yet it continues to pose challenges globally with important contextual factors impacting the quality of supervision. This article reports on responses to these challenges by a multi-institutional sub-Saharan Africa initiative (CARTA) at institutional, faculty and PhD fellow levels. The article describes the pedagogical approaches and structural mechanisms used to enhance supervision among supervisors of CARTA fellows. These include residential training for supervisors, and supervision contracts between primary supervisors and PhD fellows. The authors reflect on the processes and experiences of improving PhD supervision, and suggest research questions that CARTA and other training programmes could pursue in relation to PhD supervision in Africa and other lower- and middle-income countries. La supervision de recherches de haute qualité est cruciale pour la formation en doctorat, mais elle demeure un problème au niveau mondial, avec des facteurs contextuels importants qui impactent la qualité de la supervision. Cet article rend compte de réponses à ces défis par une initiative multi-institutionnelle pour l’Afrique subsaharienne (CARTA) aux niveaux institutionnel, professoral et des doctorants. Il décrit les approches pédagogiques et les mécanismes structurels que nous avons utilisés pour améliorer la supervision de boursiers à travers le programme CARTA. Ceux-ci incluent la formation résidentielle des superviseurs et les contrats de supervision entre superviseurs principaux et doctorants. Les auteurs réfléchissent au processus et aux expériences d’amélioration de la supervision de doctorants et suggérons des questions de recherche que CARTA et d’autres programmes de formation pourraient approfondir dans la supervision de doctorants en Afrique et dans d’autres pays à revenu faible ou intermédiaire.

© 2017 World Psychiatric Association Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12-month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality (“minimally adequate treatment”). Among the 70,880 participants, 2.6{%} met 12-month criteria for substance use disorders; the prevalence was higher in upper-middle income (3.3{%}) than in high-income (2.6{%}) and low/lower-middle income (2.0{%}) countries. Overall, 39.1{%} of those with 12-month substance use disorders recognized a treatment need; this recognition was more common in high-income (43.1{%}) than in upper-middle (35.6{%}) and low/lower-middle income (31.5{%}) countries. Among those who recognized treatment need, 61.3{%} made at least one visit to a service provider, and 29.5{%} of the latter received minimally adequate treatment exposure (35.3{%} in high, 20.3{%} in upper-middle, and 8.6{%} in low/lower-middle income countries). Overall, only 7.1{%} of those with past-year substance use disorders received minimally adequate treatment: 10.3{%} in high income, 4.3{%} in upper-middle income and 1.0{%} in low/lower-middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.