Delivering maternal mental health through peer volunteers: a 5-year report.
Cognitive behaviour strategies
Low and middle income countries
Maternal depression
Peer volunteers
Perinatal depression
Psychosocial intervention
Task-shifting
Thinking Healthy Programme
Journal
International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224
Informations de publication
Date de publication:
2019
2019
Historique:
received:
31
07
2019
accepted:
11
09
2019
entrez:
20
9
2019
pubmed:
20
9
2019
medline:
20
9
2019
Statut:
epublish
Résumé
Maternal depression affects one in five women in low-and middle income countries (LMIC) and has significant economic and social impacts. Evidence-based psychosocial interventions delivered by non-specialist health workers are recommended as first-line management of the condition, and recent studies on such interventions from LMIC show promising results. However, lack of human resource to deliver the interventions is a major bottle-neck to scale-up, and much research attention has been devoted to 'task-sharing' initiatives. A The study was conducted in rural Rawalpindi. We used mixed methods to evaluate the programme 5 years since its initiation. The competency of the peers in delivering the intervention was evaluated using a specially developed Quality and Competency Checklist, an observational tool used by trainers to rate a group session on key areas of competencies. In-depth interviews explored factors contributing to the peer volunteers' continued motivation and retention, as well as the key challenges faced. Our key findings are that about 70% of the peer volunteers inducted 5 years ago continued to be part of the programme, retaining their competency in delivering the intervention, with only token financial incentives. Factors contributing to sustained motivation included altruistic aspirations, enhanced social standing in the community, personal benefits to their own mental health, and the possibility for other avenues of employment. Long-term challenges included demotivation due to lack of certainty about the programme's future, increased requirement for financial incentivisation, the logistics of organising groups in the community, and resistance from some families to the need for ongoing care. The programme, given the sustained motivation and competence of peer volunteers in delivering the intervention, has the potential for long-term sustainability in under-resourced settings and a candidate for scale-up.
Sections du résumé
BACKGROUND
BACKGROUND
Maternal depression affects one in five women in low-and middle income countries (LMIC) and has significant economic and social impacts. Evidence-based psychosocial interventions delivered by non-specialist health workers are recommended as first-line management of the condition, and recent studies on such interventions from LMIC show promising results. However, lack of human resource to deliver the interventions is a major bottle-neck to scale-up, and much research attention has been devoted to 'task-sharing' initiatives. A
METHODS
METHODS
The study was conducted in rural Rawalpindi. We used mixed methods to evaluate the programme 5 years since its initiation. The competency of the peers in delivering the intervention was evaluated using a specially developed Quality and Competency Checklist, an observational tool used by trainers to rate a group session on key areas of competencies. In-depth interviews explored factors contributing to the peer volunteers' continued motivation and retention, as well as the key challenges faced.
RESULTS
RESULTS
Our key findings are that about 70% of the peer volunteers inducted 5 years ago continued to be part of the programme, retaining their competency in delivering the intervention, with only token financial incentives. Factors contributing to sustained motivation included altruistic aspirations, enhanced social standing in the community, personal benefits to their own mental health, and the possibility for other avenues of employment. Long-term challenges included demotivation due to lack of certainty about the programme's future, increased requirement for financial incentivisation, the logistics of organising groups in the community, and resistance from some families to the need for ongoing care.
CONCLUSIONS
CONCLUSIONS
The programme, given the sustained motivation and competence of peer volunteers in delivering the intervention, has the potential for long-term sustainability in under-resourced settings and a candidate for scale-up.
Identifiants
pubmed: 31534475
doi: 10.1186/s13033-019-0318-3
pii: 318
pmc: PMC6747744
doi:
Types de publication
Journal Article
Langues
eng
Pagination
62Subventions
Organisme : FIC NIH HHS
ID : K43 TW010399
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD075875
Pays : United States
Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
Références
Lancet. 2008 Sep 13;372(9642):902-9
pubmed: 18790313
Bull World Health Organ. 2011 Aug 1;89(8):608-15
pubmed: 21836759
J Adv Nurs. 2013 Nov;69(11):2423-31
pubmed: 23517523
J Affect Disord. 2016 Mar 1;192:83-90
pubmed: 26707352
Int J Ment Health Syst. 2016 Mar 15;10:24
pubmed: 26985235
Trials. 2017 Feb 16;18(1):74
pubmed: 28209167
Lancet Psychiatry. 2019 Feb;6(2):115-127
pubmed: 30686385
Lancet Psychiatry. 2019 Feb;6(2):128-139
pubmed: 30686386
Glob Ment Health (Camb). 2019 Apr 26;6:e4
pubmed: 31143465
Glob Ment Health (Camb). 2019 May 16;6:e8
pubmed: 31157115