Journal article

Developing a task-sharing psychological intervention to treat mild to moderate symptoms of perinatal depression and anxiety in South Africa: a mixed-method formative study


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Publication Details

Author list: Boisits Sonet, Abrahams Zulfa, Schneider Marguerite, Honikman Simone, Kaminer Debra, Lund Crick

Publisher: BMC (part of Springer Nature)

Publication year: 2021

Journal: International Journal of Mental Health Systems

Journal name: International Journal of Mental Health Systems

Volume number: 15

Issue number: 23

Total number of pages: 14

ISSN: 1752-4458

eISSN: 1752-4458

URL: http://dx.doi.org/10.1186/s13033-021-00443-5


Abstract

AbstractBackground:Symptoms of depression and anxiety are highly prevalent amongst perinatal women in low-resource settings of South Africa, but there is no access to standardised counselling support for these conditions in public health facilities. The aim of this study is to develop a task-sharing psychological counselling intervention for routine treatment of mild to moderate symptoms of perinatal depression and anxiety in South Africa, as part of the Health Systems Strengthening in sub-Saharan Africa (ASSET ) study.Methods:We conducted a review of manuals from seven counselling interventions for depression and anxiety in low- and middle-income countries and two local health system training programmes to gather information on deliv-ery format and common counselling components used across task-sharing interventions. Semi-structured interviews were conducted with 20 health workers and 37 pregnant women from four Midwife Obstetric Units in Cape Town to explore perceptions and needs relating to mental health. Stakeholder engagements further informed the interven-tion design and appropriate service provider. A four-day pilot training with community-based health workers refined the counselling content and training material.Results:The manual review identified problem-solving, psychoeducation, basic counselling skills and behavioural activation as common counselling components across interventions using a variety of delivery formats. The interviews found that participants mostly identified symptoms of depression and anxiety in behavioural terms, and lay health workers and pregnant women demonstrated their understanding through a range of local idioms. Perceived causes of symptoms related to interpersonal conflict and challenging social circumstances. Stakeholder engagements identified a three-session counselling model as most feasible for delivery as part of existing health care practices and community health workers in ward-based outreach teams as the best placed delivery agents. Pilot training of a three-session inter-vention with community-based health workers resulted in minor adaptations of the counselling assessment method.


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Last updated on 2021-24-03 at 10:53