Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia
Background The poor detection of depression in primary healthcare (PHC) in low- and middle-income countries continues to threaten the plan to scale up mental healthcare coverage. Aims To describe the process followed to develop an intervention package to improve detection of depression in PHC sett...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-03-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424000012/type/journal_article |
| _version_ | 1797295181006897152 |
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| author | Mekdes Demissie Rahel Birhane Charlotte Hanlon Tigist Eshetu Girmay Medhin Abebaw Minaye Kassahun Habtamu Anthony J. Cleare Barkot Milkias Martin Prince Abebaw Fekadu |
| author_facet | Mekdes Demissie Rahel Birhane Charlotte Hanlon Tigist Eshetu Girmay Medhin Abebaw Minaye Kassahun Habtamu Anthony J. Cleare Barkot Milkias Martin Prince Abebaw Fekadu |
| author_sort | Mekdes Demissie |
| collection | DOAJ |
| description |
Background
The poor detection of depression in primary healthcare (PHC) in low- and middle-income countries continues to threaten the plan to scale up mental healthcare coverage.
Aims
To describe the process followed to develop an intervention package to improve detection of depression in PHC settings in rural Ethiopia.
Method
The study was conducted in Sodo, a rural district in south Ethiopia. The Medical Research Council's framework for the development of complex interventions was followed. Qualitative interviews, observations of provider–patient communication, intervention development workshops and pre-testing of the screening component of the intervention were conducted to develop the intervention.
Results
A multicomponent intervention package was developed, which included (a) manual-based training of PHC workers for 10 days, adapted from the World Health Organization's Mental Health Gap Action Programme Intervention Guide, with emphasis on depression, locally identified depressive symptoms, communication skills, training by people with lived experience and active learning methods; (b) screening for culturally salient manifestations of depression, using a four-item tool; (c) raising awareness among people attending out-patient clinics about depression, using information leaflets and health education; and (d) system-level interventions, such as supportive supervision, use of posters at health facilities and a decision support mobile app.
Conclusions
This contextualised, multicomponent intervention package may lead to meaningful impact on the detection of depression in PHC in rural Ethiopia and similar settings. The intervention will be pilot tested for feasibility, acceptability and effectiveness before its wider implementation.
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| first_indexed | 2024-03-07T21:43:02Z |
| format | Article |
| id | doaj.art-f84ec1c2681a427d95927b5f12f3105b |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-03-07T21:43:02Z |
| publishDate | 2024-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-f84ec1c2681a427d95927b5f12f3105b2024-02-26T06:21:30ZengCambridge University PressBJPsych Open2056-47242024-03-011010.1192/bjo.2024.1Developing interventions to improve detection of depression in primary healthcare settings in rural EthiopiaMekdes Demissie0https://orcid.org/0000-0001-8786-0377Rahel Birhane1Charlotte Hanlon2https://orcid.org/0000-0002-7937-3226Tigist Eshetu3Girmay Medhin4Abebaw Minaye5Kassahun Habtamu6Anthony J. Cleare7Barkot Milkias8Martin Prince9Abebaw Fekadu10https://orcid.org/0000-0003-2219-0952Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Ethiopia; and School Of Nursing and Midwifery, College of Health Sciences and Medicine, Haramaya University, EthiopiaCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, EthiopiaDepartment of Psychiatry, College of Health Sciences, Addis Ababa University, Ethiopia; and Centre for Global Mental Health & Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, EthiopiaSchool of Psychology, College of Education and Behavioral Studies, Addis Ababa University, EthiopiaSchool of Psychology, College of Education and Behavioral Studies, Addis Ababa University, EthiopiaCenter for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKDepartment of Psychiatry, College of Health Sciences, Addis Ababa University, EthiopiaCentre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and King's Global Health Institute, Faculty of Life Sciences and Medicine, King's College London, UKCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Ethiopia; Department of Psychiatry, College of Health Sciences, Addis Ababa University, Ethiopia; Center for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Global Health & Infection, Brighton and Sussex Medical School, UK Background The poor detection of depression in primary healthcare (PHC) in low- and middle-income countries continues to threaten the plan to scale up mental healthcare coverage. Aims To describe the process followed to develop an intervention package to improve detection of depression in PHC settings in rural Ethiopia. Method The study was conducted in Sodo, a rural district in south Ethiopia. The Medical Research Council's framework for the development of complex interventions was followed. Qualitative interviews, observations of provider–patient communication, intervention development workshops and pre-testing of the screening component of the intervention were conducted to develop the intervention. Results A multicomponent intervention package was developed, which included (a) manual-based training of PHC workers for 10 days, adapted from the World Health Organization's Mental Health Gap Action Programme Intervention Guide, with emphasis on depression, locally identified depressive symptoms, communication skills, training by people with lived experience and active learning methods; (b) screening for culturally salient manifestations of depression, using a four-item tool; (c) raising awareness among people attending out-patient clinics about depression, using information leaflets and health education; and (d) system-level interventions, such as supportive supervision, use of posters at health facilities and a decision support mobile app. Conclusions This contextualised, multicomponent intervention package may lead to meaningful impact on the detection of depression in PHC in rural Ethiopia and similar settings. The intervention will be pilot tested for feasibility, acceptability and effectiveness before its wider implementation. https://www.cambridge.org/core/product/identifier/S2056472424000012/type/journal_articleDepressioncase identificationdepression recognitioninterventiondetection of depression |
| spellingShingle | Mekdes Demissie Rahel Birhane Charlotte Hanlon Tigist Eshetu Girmay Medhin Abebaw Minaye Kassahun Habtamu Anthony J. Cleare Barkot Milkias Martin Prince Abebaw Fekadu Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia BJPsych Open Depression case identification depression recognition intervention detection of depression |
| title | Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia |
| title_full | Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia |
| title_fullStr | Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia |
| title_full_unstemmed | Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia |
| title_short | Developing interventions to improve detection of depression in primary healthcare settings in rural Ethiopia |
| title_sort | developing interventions to improve detection of depression in primary healthcare settings in rural ethiopia |
| topic | Depression case identification depression recognition intervention detection of depression |
| url | https://www.cambridge.org/core/product/identifier/S2056472424000012/type/journal_article |
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