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
| dc.contributor.author | Boisits, Sonet | |
| dc.contributor.author | Abrahams, Zulfa | |
| dc.contributor.author | Schneider, Marguerite | |
| dc.contributor.author | Honikman, Simone | |
| dc.contributor.author | Kaminer, Debra | |
| dc.contributor.author | Lund, Crick | |
| dc.date.accessioned | 2021-10-11T17:02:04Z | |
| dc.date.available | 2021-10-11T17:02:04Z | |
| dc.date.issued | 2021-03-15 | |
| dc.date.updated | 2021-03-21T04:23:35Z | |
| dc.description.abstract | Background 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 delivery 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 intervention 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 intervention with community-based health workers resulted in minor adaptations of the counselling assessment method. Conclusion Input from health workers and pregnant women is a critical component of adapting existing maternal mental health protocols to the context of routine care in South Africa, providing valuable data to align therapeutic content with contextual needs. Multisector stakeholder engagements is vital to align the intervention design to health system requirements and guidelines. | en_US |
| dc.identifier.apacitation | Boisits, S., Abrahams, Z., Schneider, M., Honikman, S., Kaminer, D., & Lund, C. (2021). 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. <i>International Journal of Mental Health Systems</i>, 15(Article number: 23), http://hdl.handle.net/11427/35166 | en_ZA |
| dc.identifier.chicagocitation | Boisits, Sonet, Zulfa Abrahams, Marguerite Schneider, Simone Honikman, Debra Kaminer, and Crick Lund "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." <i>International Journal of Mental Health Systems</i> 15, Article number: 23. (2021) http://hdl.handle.net/11427/35166 | en_ZA |
| dc.identifier.citation | Boisits, S., Abrahams, Z., Schneider, M., Honikman, S., Kaminer, D. & Lund, C. 2021. 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. <i>International Journal of Mental Health Systems.</i> 15(Article number: 23) http://hdl.handle.net/11427/35166 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Boisits, Sonet AU - Abrahams, Zulfa AU - Schneider, Marguerite AU - Honikman, Simone AU - Kaminer, Debra AU - Lund, Crick AB - Background 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 delivery 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 intervention 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 intervention with community-based health workers resulted in minor adaptations of the counselling assessment method. Conclusion Input from health workers and pregnant women is a critical component of adapting existing maternal mental health protocols to the context of routine care in South Africa, providing valuable data to align therapeutic content with contextual needs. Multisector stakeholder engagements is vital to align the intervention design to health system requirements and guidelines. DA - 2021-03-15 DB - OpenUCT DP - University of Cape Town IS - Article number: 23 J1 - International Journal of Mental Health Systems KW - Perinatal KW - Depression KW - Anxiety KW - Task-sharing KW - Psychological intervention KW - Primary health care KW - Low- and middle-income countries LK - https://open.uct.ac.za PY - 2021 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/35166 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13033-021-00443-5 | |
| dc.identifier.uri | http://hdl.handle.net/11427/35166 | |
| dc.identifier.vancouvercitation | Boisits S, Abrahams Z, Schneider M, Honikman S, Kaminer D, Lund C. 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. International Journal of Mental Health Systems. 2021;15(Article number: 23) http://hdl.handle.net/11427/35166. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Department of Psychiatry and Mental Health | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | International Journal of Mental Health Systems | en_US |
| dc.source.journalissue | Article number: 23 | en_US |
| dc.source.journalvolume | 15 | en_US |
| dc.source.uri | ||
| dc.source.uri | https://ijmhs.biomedcentral.com/ | |
| dc.subject | Perinatal | en_US |
| dc.subject | Depression | en_US |
| dc.subject | Anxiety | en_US |
| dc.subject | Task-sharing | en_US |
| dc.subject | Psychological intervention | en_US |
| dc.subject | Primary health care | en_US |
| dc.subject | Low- and middle-income countries | en_US |
| dc.title | 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 | en_US |
| dc.type | Journal Article | en_US |