Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis

dc.contributor.authorMunodawafa, Memory
dc.contributor.authorMall, Sumaya
dc.contributor.authorLund, Crick
dc.contributor.authorSchneider, Marguerite
dc.date.accessioned2018-05-04T09:20:51Z
dc.date.available2018-05-04T09:20:51Z
dc.date.issued2018-03-23
dc.date.updated2018-04-09T15:13:07Z
dc.description.abstractBackground Perinatal depression is common in low and middle income countries (LAMICs). Task sharing interventions have been implemented to treat perinatal depression in these settings, as a way of dealing with staff shortages. Task sharing allows lay health workers to provide services for less complex cases while being trained and supervised by specialists. Randomized controlled trials suggest that these interventions can be effective but there is limited qualitative information exploring barriers and facilitators to their implementation. This systematic review aims to systematically review current qualitative evidence of process evaluations of task sharing interventions for perinatal depression in LAMICs in relation to the United Kingdom (UK) Medical Research Council (MRC) framework for conducting process evaluations. Methods We searched Medline/ PubMed, PsycINFO, Scopus, Cochrane Library and Web of science for studies from LAMICS using search terms under the broad categories of: (a) “maternal depression’” (b) “intervention” (c) “lay counsellor” OR “community health worker” OR “non-specialist” and (d) “LAMICs”. Abstracts were independently reviewed for inclusion by two authors. Full text articles were screened and data for included articles were extracted using a standard data extraction sheet. Qualitative synthesis of qualitative evidence was conducted. Results 8420 articles were identified from initial searches. Of these, 26 full text articles were screened for eligibility with only three studies meeting the inclusion criteria. Main findings revealed that participants identified the following crucial factors: contextual factors included physical location, accessibility and cultural norms. Implementation factors included acceptability of the intervention and characteristics of the personnel. Mechanisms included counsellor factors such as motivating and facilitating trust; intervention factors such as use of stories and visual aids, and understandability of the content; and participant factors such as shared experience, meeting learning needs, and meeting expectations. Conclusions While task sharing has been suggested as an effective way of filling the treatment gap for perinatal depression, there is a paucity of qualitative research exploring barriers and facilitators to implementing these interventions. Qualitative process evaluations are crucial for the development of culturally relevant interventions.
dc.identifier.apacitationMunodawafa, M., Mall, S., Lund, C., & Schneider, M. (2018). Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/27933en_ZA
dc.identifier.chicagocitationMunodawafa, Memory, Sumaya Mall, Crick Lund, and Marguerite Schneider "Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis." <i>BMC Health Services Research</i> (2018) http://hdl.handle.net/11427/27933en_ZA
dc.identifier.citationMunodawafa, M., Mall, S., Lund, C., & Schneider, M. (2018). Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis. BMC health services research, 18(1), 205.
dc.identifier.ris TY - Journal Article AU - Munodawafa, Memory AU - Mall, Sumaya AU - Lund, Crick AU - Schneider, Marguerite AB - Background Perinatal depression is common in low and middle income countries (LAMICs). Task sharing interventions have been implemented to treat perinatal depression in these settings, as a way of dealing with staff shortages. Task sharing allows lay health workers to provide services for less complex cases while being trained and supervised by specialists. Randomized controlled trials suggest that these interventions can be effective but there is limited qualitative information exploring barriers and facilitators to their implementation. This systematic review aims to systematically review current qualitative evidence of process evaluations of task sharing interventions for perinatal depression in LAMICs in relation to the United Kingdom (UK) Medical Research Council (MRC) framework for conducting process evaluations. Methods We searched Medline/ PubMed, PsycINFO, Scopus, Cochrane Library and Web of science for studies from LAMICS using search terms under the broad categories of: (a) “maternal depression’” (b) “intervention” (c) “lay counsellor” OR “community health worker” OR “non-specialist” and (d) “LAMICs”. Abstracts were independently reviewed for inclusion by two authors. Full text articles were screened and data for included articles were extracted using a standard data extraction sheet. Qualitative synthesis of qualitative evidence was conducted. Results 8420 articles were identified from initial searches. Of these, 26 full text articles were screened for eligibility with only three studies meeting the inclusion criteria. Main findings revealed that participants identified the following crucial factors: contextual factors included physical location, accessibility and cultural norms. Implementation factors included acceptability of the intervention and characteristics of the personnel. Mechanisms included counsellor factors such as motivating and facilitating trust; intervention factors such as use of stories and visual aids, and understandability of the content; and participant factors such as shared experience, meeting learning needs, and meeting expectations. Conclusions While task sharing has been suggested as an effective way of filling the treatment gap for perinatal depression, there is a paucity of qualitative research exploring barriers and facilitators to implementing these interventions. Qualitative process evaluations are crucial for the development of culturally relevant interventions. DA - 2018-03-23 DB - OpenUCT DO - 10.1186/s12913-018-3030-0 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis TI - Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis UR - http://hdl.handle.net/11427/27933 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-018-3030-0
dc.identifier.urihttp://hdl.handle.net/11427/27933
dc.identifier.vancouvercitationMunodawafa M, Mall S, Lund C, Schneider M. Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis. BMC Health Services Research. 2018; http://hdl.handle.net/11427/27933.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Health Services Research
dc.source.urihttps://bmchealthservres.biomedcentral.com/
dc.subject.otherMRC process evaluation guidelines
dc.subject.otherPerinatal depression
dc.subject.otherTask shared intervention
dc.subject.otherLay health worker
dc.subject.otherLow and middle income country
dc.titleProcess evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis
dc.typeJournal Article
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