Delivering maternal mental health through peer volunteers: a 5-year report
Abstract 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,...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13033-019-0318-3 |
| _version_ | 1818537448761720832 |
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| author | Najia Atif Amina Bibi Anum Nisar Shaffaq Zulfiqar Ikhlaq Ahmed Katherine LeMasters Ashley Hagaman Siham Sikander Joanna Maselko Atif Rahman |
| author_facet | Najia Atif Amina Bibi Anum Nisar Shaffaq Zulfiqar Ikhlaq Ahmed Katherine LeMasters Ashley Hagaman Siham Sikander Joanna Maselko Atif Rahman |
| author_sort | Najia Atif |
| collection | DOAJ |
| description | Abstract 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 peer-delivered version of the World Health Organization’s Thinking Healthy Programme for perinatal depression in Pakistan and India showed clinical, functional and social benefits to women at 3 months postpartum. The programme has been iteratively adapted and continually delivered for 5 years in Pakistan. In this report, we describe the extended intervention and factors contributing to the peers’ continued motivation and retention, and suggest future directions to address scale-up challenges. 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 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 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. |
| first_indexed | 2024-12-11T18:50:52Z |
| format | Article |
| id | doaj.art-c1ec92a4197b446f93e096257586804b |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-12-11T18:50:52Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-c1ec92a4197b446f93e096257586804b2022-12-22T00:54:18ZengBMCInternational Journal of Mental Health Systems1752-44582019-09-011311810.1186/s13033-019-0318-3Delivering maternal mental health through peer volunteers: a 5-year reportNajia Atif0Amina Bibi1Anum Nisar2Shaffaq Zulfiqar3Ikhlaq Ahmed4Katherine LeMasters5Ashley Hagaman6Siham Sikander7Joanna Maselko8Atif Rahman9Human Development Research FoundationHuman Development Research FoundationHuman Development Research FoundationHuman Development Research FoundationHuman Development Research FoundationUniversity of North Carolina at Chapel HillUniversity of North Carolina at Chapel HillHuman Development Research FoundationUniversity of North Carolina at Chapel HillDepartment of Psychological Sciences, Institute of Life and Human Sciences, University of LiverpoolAbstract 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 peer-delivered version of the World Health Organization’s Thinking Healthy Programme for perinatal depression in Pakistan and India showed clinical, functional and social benefits to women at 3 months postpartum. The programme has been iteratively adapted and continually delivered for 5 years in Pakistan. In this report, we describe the extended intervention and factors contributing to the peers’ continued motivation and retention, and suggest future directions to address scale-up challenges. 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 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 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.http://link.springer.com/article/10.1186/s13033-019-0318-3Perinatal depressionMaternal depressionPeer volunteersPsychosocial interventionThinking Healthy ProgrammeLow and middle income countries |
| spellingShingle | Najia Atif Amina Bibi Anum Nisar Shaffaq Zulfiqar Ikhlaq Ahmed Katherine LeMasters Ashley Hagaman Siham Sikander Joanna Maselko Atif Rahman Delivering maternal mental health through peer volunteers: a 5-year report International Journal of Mental Health Systems Perinatal depression Maternal depression Peer volunteers Psychosocial intervention Thinking Healthy Programme Low and middle income countries |
| title | Delivering maternal mental health through peer volunteers: a 5-year report |
| title_full | Delivering maternal mental health through peer volunteers: a 5-year report |
| title_fullStr | Delivering maternal mental health through peer volunteers: a 5-year report |
| title_full_unstemmed | Delivering maternal mental health through peer volunteers: a 5-year report |
| title_short | Delivering maternal mental health through peer volunteers: a 5-year report |
| title_sort | delivering maternal mental health through peer volunteers a 5 year report |
| topic | Perinatal depression Maternal depression Peer volunteers Psychosocial intervention Thinking Healthy Programme Low and middle income countries |
| url | http://link.springer.com/article/10.1186/s13033-019-0318-3 |
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