The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation
Abstract Background There is a large treatment gap for common mental disorders in rural areas of low-income countries. We tested the Friendship Bench as a brief psychological intervention delivered by village health workers (VHWs) in rural Zimbabwe. Methods Rural women identified with depression in...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425121000327/type/journal_article |
| _version_ | 1811156100349689856 |
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| author | Shamiso Fernando Tim Brown Kavita Datta Dzivaidzo Chidhanguro Naume V. Tavengwa Jaya Chandna Epiphania Munetsi Lloyd Dzapasi Chandiwana Nyachowe Batsirai Mutasa Bernard Chasekwa Robert Ntozini Dixon Chibanda Andrew J. Prendergast |
| author_facet | Shamiso Fernando Tim Brown Kavita Datta Dzivaidzo Chidhanguro Naume V. Tavengwa Jaya Chandna Epiphania Munetsi Lloyd Dzapasi Chandiwana Nyachowe Batsirai Mutasa Bernard Chasekwa Robert Ntozini Dixon Chibanda Andrew J. Prendergast |
| author_sort | Shamiso Fernando |
| collection | DOAJ |
| description | Abstract
Background
There is a large treatment gap for common mental disorders in rural areas of low-income countries. We tested the Friendship Bench as a brief psychological intervention delivered by village health workers (VHWs) in rural Zimbabwe.
Methods
Rural women identified with depression in a previous trial received weekly home-based problem-solving therapy from VHWs for 6 weeks, and joined a peer-support group. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Shona Symptom Questionnaire (SSQ). Acceptability was explored through in-depth interviews and focus group discussions. The proportion of women with depression pre- and post-intervention was compared using McNemar's test.
Results
Ten VHWs delivered problem-solving therapy to 27 women of mean age 33 years; 25 completed six sessions. Women valued an established and trustful relationship with their VHW, which ensured confidentiality and prevented gossip, and reported finding individual problem-solving therapy beneficial. Peer-support meetings provided space to share problems, solutions and skills. The proportion of women with depression or suicidal ideation on the EPDS declined from 68% to 12% [difference 56% (95% confidence interval (CI) 27.0–85.0); p = 0.001], and the proportion scoring high (>7) on the SSQ declined from 52% to 4% [difference 48% (95% CI 24.4–71.6); p < 0.001] after the 6-week intervention.
Conclusion
VHW-delivered problem-solving therapy and peer-support was acceptable and showed promising results in this pilot evaluation, leading to quantitative and qualitative improvements in mental health among rural Zimbabwean women. Scale-up of the Friendship Bench in rural areas would help close the treatment gap for common mental disorders.
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| first_indexed | 2024-04-10T04:44:49Z |
| format | Article |
| id | doaj.art-343b73dfc1274ff9a6fc4b6c7fddc3c0 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-04-10T04:44:49Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-343b73dfc1274ff9a6fc4b6c7fddc3c02023-03-09T12:35:45ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512021-01-01810.1017/gmh.2021.32The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluationShamiso Fernando0Tim Brown1Kavita Datta2Dzivaidzo Chidhanguro3Naume V. Tavengwa4Jaya Chandna5Epiphania Munetsi6Lloyd Dzapasi7Chandiwana Nyachowe8Batsirai Mutasa9Bernard Chasekwa10Robert Ntozini11Dixon Chibanda12Andrew J. Prendergast13https://orcid.org/0000-0001-7904-7992Zvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweQueen Mary University of London, London, UKQueen Mary University of London, London, UKZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweAfrican Mental Health Research Initiative (AMARI), Harare, ZimbabweAfrican Mental Health Research Initiative (AMARI), Harare, ZimbabweMinistry of Health and Child Care, Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, ZimbabweAfrican Mental Health Research Initiative (AMARI), Harare, ZimbabweZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe Queen Mary University of London, London, UKAbstract Background There is a large treatment gap for common mental disorders in rural areas of low-income countries. We tested the Friendship Bench as a brief psychological intervention delivered by village health workers (VHWs) in rural Zimbabwe. Methods Rural women identified with depression in a previous trial received weekly home-based problem-solving therapy from VHWs for 6 weeks, and joined a peer-support group. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Shona Symptom Questionnaire (SSQ). Acceptability was explored through in-depth interviews and focus group discussions. The proportion of women with depression pre- and post-intervention was compared using McNemar's test. Results Ten VHWs delivered problem-solving therapy to 27 women of mean age 33 years; 25 completed six sessions. Women valued an established and trustful relationship with their VHW, which ensured confidentiality and prevented gossip, and reported finding individual problem-solving therapy beneficial. Peer-support meetings provided space to share problems, solutions and skills. The proportion of women with depression or suicidal ideation on the EPDS declined from 68% to 12% [difference 56% (95% confidence interval (CI) 27.0–85.0); p = 0.001], and the proportion scoring high (>7) on the SSQ declined from 52% to 4% [difference 48% (95% CI 24.4–71.6); p < 0.001] after the 6-week intervention. Conclusion VHW-delivered problem-solving therapy and peer-support was acceptable and showed promising results in this pilot evaluation, leading to quantitative and qualitative improvements in mental health among rural Zimbabwean women. Scale-up of the Friendship Bench in rural areas would help close the treatment gap for common mental disorders. https://www.cambridge.org/core/product/identifier/S2054425121000327/type/journal_articleDepressionproblem-solving therapyAfricatask sharingcommunity health workers |
| spellingShingle | Shamiso Fernando Tim Brown Kavita Datta Dzivaidzo Chidhanguro Naume V. Tavengwa Jaya Chandna Epiphania Munetsi Lloyd Dzapasi Chandiwana Nyachowe Batsirai Mutasa Bernard Chasekwa Robert Ntozini Dixon Chibanda Andrew J. Prendergast The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation Cambridge Prisms: Global Mental Health Depression problem-solving therapy Africa task sharing community health workers |
| title | The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation |
| title_full | The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation |
| title_fullStr | The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation |
| title_full_unstemmed | The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation |
| title_short | The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation |
| title_sort | friendship bench as a brief psychological intervention with peer support in rural zimbabwean women a mixed methods pilot evaluation |
| topic | Depression problem-solving therapy Africa task sharing community health workers |
| url | https://www.cambridge.org/core/product/identifier/S2054425121000327/type/journal_article |
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