Family Caregiving for Individuals with Mental Disorders in Zambia: Implications for Health Systems Strengthening in a Resource-Constrained Setting

Abstract

Victoria Ngambi, Beatrice Chisashi Mwansa, Kudzai Thelma Munyoro and Thamary Karonga

Mental disorders are a leading cause of disability globally, and the transition toward community-based mental health care has increased reliance on family caregivers, particularly in low- and middle-income countries. In these settings, limited institutional support has shifted substantial caregiving responsibilities onto households, raising critical public health concerns. This study explored the multidimensional burden experienced by family caregivers of individuals with mental disorders and examined its implications for health systems strengthening in Zambia.

A descriptive qualitative design was employed at a national psychiatric referral hospital, where twenty caregivers were purposively selected. Data were collected through semi-structured interviews and analyzed using thematic analysis. The findings revealed that caregiver burden is multifaceted, encompassing psychological distress characterized by anxiety, stigma, and emotional exhaustion; physical strain including fatigue, sleep disruption, and neglect of personal health; and socio-economic challenges such as financial hardship, employment disruption, and barriers to accessing care. These burdens were exacerbated by systemic gaps, including limited mental health infrastructure, inadequate community-based services, and the absence of formal caregiver support mechanisms.

The study concludes that family caregiving represents a critical yet under-recognized component of mental health systems. Addressing caregiver burden requires integrating caregiver support into national mental health strategies, strengthening community-based care, and implementing policies that recognize and support informal caregivers as part of the health workforce.

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