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Patients’ and healthcare professionals’ perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study

Ishaq Khattak, Maria; Dikomitis, Lisa; Firaz Khan, Muhammad; Ul Haq, Mukhtar; Saeed, Umaima; Riaz Awan, Naila; Ul Haq, Zia; Shepherd, Thomas; Mallen, Christian D.; Farooq, Saeed

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Maria Ishaq Khattak

Lisa Dikomitis

Muhammad Firaz Khan

Mukhtar Ul Haq

Umaima Saeed

Naila Riaz Awan

Zia Ul Haq


OBJECTIVE: To explore the perceptions and experiences of schizophrenia from patients, their care givers, health care providers, spiritual and traditional healers to develop a community-based intervention for improving treatment adherence for people with schizophrenia in Pakistan.

METHODS: This qualitative study involved four focus group discussions (FGD) with a total of 26 participants: patients and carers (n = 5), primary care staff (n = 7), medical technicians (n = 8) and traditional and spiritual healers (n = 6). The participants were selected using purposive sampling method. FGDs were audio-recorded and transcribed. A thematic analysis was applied to the data set.

RESULTS: The themes identified were (i) Schizophrenia is not merely a biomedical problem: participants believed that poverty and an inferiority complex resulting from social disparity caused schizophrenia and contributed to non-adherence to medications; (ii) Spiritual healing goes hand in hand with the medical treatment: participants regarded spiritual and traditional treatment methods as an inherent part of schizophrenia patients' well-being and rehabilitation; (iii) Services for mental illness: mental health is not covered under primary health in a basic health unit: participants believed that the lack of services, training and necessary medication in primary care are major issues for treating schizophrenia in community; (iv) Barriers to community-based interventions: primary care staff believed that multiple pressures on staff, lack of incentives, non-availability of medication and lack of formal referral pathways resulted in disintegration of dealing with schizophrenia patients in primary care facilities.

CONCLUSION: The study has identified a number of barriers and facilitators to developing and delivering a psychosocial intervention to support people living with schizophrenia in Pakistan. In particular, the importance of involving spiritual and traditional healers was highlighted by our diverse group of stakeholders.

Journal Article Type Article
Acceptance Date Aug 5, 2022
Publication Date Aug 29, 2022
Publicly Available Date May 30, 2023
Journal PLoS One
Print ISSN 1932-6203
Publisher Public Library of Science
Publisher URL