Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa

dc.contributor.authorNyatsanza, Memory
dc.contributor.authorSchneider, Marguerite
dc.contributor.authorDavies, Thandi
dc.contributor.authorLund, Crick
dc.date.accessioned2016-06-28T07:32:55Z
dc.date.available2016-06-28T07:32:55Z
dc.date.issued2016-05-26
dc.date.updated2016-05-26T18:08:08Z
dc.description.abstractBackground: Perinatal depression is a major public health issue especially in low income settings in South Africa, where there is a shortage of mental health professionals. New psychological interventions delivered by non-specialists are needed to fill the treatment gap. This paper describes the process of developing a manual based task sharing counselling intervention for perinatal depression in Khayelitsha, Cape Town. Methods: Qualitative semi-structured interviews were conducted with 26 participants, including service providers and service users at a clinic in Khayelitsha in order to explore the feasibility, acceptability and content of a task sharing counselling intervention. The interviews were recorded, translated and transcribed. Themes were identified using the framework analysis approach and were coded and analysed using NVivo v10. After the semi-structured interviews, a workshop was conducted with mental health experts on evidence-based psychological interventions for depression, together with a document review of counselling manuals for community health workers in South Africa. Results: The findings indicate that a task sharing counselling intervention was acceptable and feasible for depressed women in Khayelitsha, under the following conditions: (1) respondents preferred a female counsellor and felt that clinic based individual sessions should be provided at least once a month by an experienced Xhosa speaking counsellor from the community; and (2) the content of a counselling intervention should include psycho-education on cognitive and behavioural effects of depression, how to cope with interpersonal problems, and financial stressors. Based on these conditions, the review of manuals and expert consultation, key components of the counselling intervention were identified as: psycho-education, problem solving, healthy thinking and behaviour activation. These were included in the final counselling manual. Conclusion: The development of task sharing counselling interventions for perinatal depression should be informed by the views and needs of local service users and service providers. The study illustrates the manner in which these views can be incorporated for the development of evidence-based psychological interventions, within a task sharing framework in low and middle-income countries.
dc.identifierhttp://dx.doi.org/10.1186/s12888-016-0873-y
dc.identifier.apacitationNyatsanza, M., Schneider, M., Davies, T., & Lund, C. (2016). Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/20148en_ZA
dc.identifier.chicagocitationNyatsanza, Memory, Marguerite Schneider, Thandi Davies, and Crick Lund "Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa." <i>BMC Psychiatry</i> (2016) http://hdl.handle.net/11427/20148en_ZA
dc.identifier.citationNyatsanza, M., Schneider, M., Davies, T., & Lund, C. (2016). Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa. BMC psychiatry, 16(1), 164.
dc.identifier.issn1471-244X
dc.identifier.ris TY - Journal Article AU - Nyatsanza, Memory AU - Schneider, Marguerite AU - Davies, Thandi AU - Lund, Crick AB - Background: Perinatal depression is a major public health issue especially in low income settings in South Africa, where there is a shortage of mental health professionals. New psychological interventions delivered by non-specialists are needed to fill the treatment gap. This paper describes the process of developing a manual based task sharing counselling intervention for perinatal depression in Khayelitsha, Cape Town. Methods: Qualitative semi-structured interviews were conducted with 26 participants, including service providers and service users at a clinic in Khayelitsha in order to explore the feasibility, acceptability and content of a task sharing counselling intervention. The interviews were recorded, translated and transcribed. Themes were identified using the framework analysis approach and were coded and analysed using NVivo v10. After the semi-structured interviews, a workshop was conducted with mental health experts on evidence-based psychological interventions for depression, together with a document review of counselling manuals for community health workers in South Africa. Results: The findings indicate that a task sharing counselling intervention was acceptable and feasible for depressed women in Khayelitsha, under the following conditions: (1) respondents preferred a female counsellor and felt that clinic based individual sessions should be provided at least once a month by an experienced Xhosa speaking counsellor from the community; and (2) the content of a counselling intervention should include psycho-education on cognitive and behavioural effects of depression, how to cope with interpersonal problems, and financial stressors. Based on these conditions, the review of manuals and expert consultation, key components of the counselling intervention were identified as: psycho-education, problem solving, healthy thinking and behaviour activation. These were included in the final counselling manual. Conclusion: The development of task sharing counselling interventions for perinatal depression should be informed by the views and needs of local service users and service providers. The study illustrates the manner in which these views can be incorporated for the development of evidence-based psychological interventions, within a task sharing framework in low and middle-income countries. DA - 2016-05-26 DB - OpenUCT DP - University of Cape Town J1 - BMC Psychiatry KW - perinatal depression KW - counselling KW - task sharing KW - intervention development LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 1471-244X T1 - Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa TI - Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa UR - http://hdl.handle.net/11427/20148 ER - en_ZA
dc.identifier.urihttp://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0873-y
dc.identifier.urihttp://hdl.handle.net/11427/20148
dc.identifier.vancouvercitationNyatsanza M, Schneider M, Davies T, Lund C. Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa. BMC Psychiatry. 2016; http://hdl.handle.net/11427/20148.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s)
dc.sourceBMC Psychiatry
dc.source.urihttp://bmcpsychiatry.biomedcentral.com/
dc.subjectperinatal depression
dc.subjectcounselling
dc.subjecttask sharing
dc.subjectintervention development
dc.titleFilling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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