scholarly journals Acceptability and Impact of Group Interpersonal Therapy (IPT-G) on Kenyan Adolescent Mothers Living with HIV: A Qualitative Analysis

2020 ◽  
Author(s):  
Obadia Yator ◽  
Lincoln Khasakhala ◽  
Grace John Stewart ◽  
Manasi Kumar
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Instant Messaging ◽  
Task Shifting ◽  
Wait List ◽  
Wait List Group ◽  
Phone Calls ◽  
Living With Hiv

Abstract Background Task shifting is a well-tested implementation strategy, within low- and middle-income countries (LMICs), that addresses the shortage of trained mental health personnel. Task sharing can increase access to care for patients with mental illnesses. In Kenya, community health workers [CHWs are a combination of community health assistants (CHAs) and community health volunteers (CHVs)], have played a crucial role in this front. In our study, we seek to assess the acceptability and feasibility of IPT-G delivered by CHWs among depressed postpartum adolescents (PPAs) living with HIV.Method Twenty-four PPAs were administered IPT-G by trained CHWs from two health centers. A two-arm study design (IPT-G intervention and treatment as usual) with an intent to treat was used to assess acceptability and feasibility of IPT-G. Participants who scored >10 on Edinburgh postnatal depression scale (EPDS) and who were 6–12 weeks postpartum were eligible for the study using purposeful sampling. Participants were equally distributed into two groups: one group for intervention and another for wait-list group. This was achieved by randomly allocating numerical numbers and separating those with odd numbers (intervention group) and even numbers (wait-list group). Focus group discussions (FGDs) and in-depth interviews ascertained the experience and perceptions of the postpartum adolescents and the CHWs. In addition to weekly face-to-face continuous supportive supervision for CHWs, phone calls, short messages services, and WhatsApp instant messaging services were also utilized.Results The CHWs found the intervention useful for their own knowledge and skill-set. On participation, 21out of the 24 adolescents attended all sessions. Most of the adolescents reported improvement in their interpersonal relationships with reduced distress and lessening of HIV-related stigma. Primary health care workers embraced the intervention by availing space for sessions. Conclusion Our study demonstrates possible benefits of task shifting in addressing mental health problems within low-resource settings in Kenya and group IPT is demonstrated to be both acceptable and feasible by health workers and adolescents receiving care.

scholarly journals Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe

2020 ◽  
Author(s):  
Chiwoneso B. Tinago ◽  
Edward A. Frongillo ◽  
Andrea Warren ◽  
Vivian Chitiyo ◽  
Ashley K. Cifarelli ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Social Isolation ◽  
Peer Support ◽  
Support Groups ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Community Based ◽  
Support Intervention ◽  
Peer Support Intervention

Abstract Background Adolescent mothers in Zimbabwe often experience stigma, isolation and lack coping skills and resources to successfully navigate motherhood. Social isolation and stigma are linked to poor mental health outcomes. No interventions currently address mental health of adolescent mothers in Zimbabwe. Peer support groups in other contexts have been effective at increasing social connectedness, self-esteem, and self-efficacy, providing coping mechanisms to manage stigma experiences, in addition to empowering and improving mental health or adolescents and adolescent mothers. To develop a community-based peer support intervention, we need to understand the unique needs of adolescent mothers and how peer support groups could address those needs. Methods Focus group discussions were conducted with 85 adolescent mothers aged 14-18 years, 24 community health workers, and 25 key community stakeholders in a low-income high-density community in Harare. Data were analyzed thematically using NVivo 12 software.Results Participants described adolescent mother experiences with stigma and social isolation, in addition to challenges including gossip, lack of employment and educational opportunities and gaps in services and programming. Peer support groups for adolescent mothers were welcomed to improve mental health, social support, knowledge sharing and skills building. Participants identified varying preferred frequency and duration of group sessions addressing topics including income generation, mental health, and gossip, facilitated by community health workers at health and community centers. Use of WhatsApp Messenger to support intervention efforts was welcomed as an affordable and user-friendly platform to share information.Conclusions Participants supported peer support groups to empower, meet needs, and improve the health of adolescent mothers.

scholarly journals Development and assessment of feasibility of a community-based peer support intervention to mitigate social isolation and stigma of adolescent motherhood in Harare, Zimbabwe

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chiwoneso B. Tinago ◽  
Edward A. Frongillo ◽  
Andrea M. Warren ◽  
Vivian Chitiyo ◽  
Ashley K. Cifarelli ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Social Isolation ◽  
Community Health Workers ◽  
Peer Support ◽  
Support Groups ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Support Intervention ◽  
Community Stakeholders

Abstract Background Adolescent mothers in Zimbabwe often experience stigma, isolation, and lack coping skills and resources to successfully navigate motherhood. Social isolation and stigma are linked to poor mental health outcomes. No interventions currently address mental health of adolescent mothers in Zimbabwe. Peer support groups in other contexts have been effective at increasing social connectedness, self-esteem, and self-efficacy, providing coping mechanisms to manage stigma experiences, in addition to empowering and improving mental health of adolescents and adolescent mothers. To develop a community-based peer support intervention, we aimed to understand the unique needs of adolescent mothers, how peer support groups could address those needs, and the feasibility of implementing the intervention. Methods Focus group discussions were conducted with 86 adolescent mothers aged 14–18 years, 24 community health workers, and 25 key community stakeholders in a low-income high-density community in Harare. Data were analyzed thematically using NVivo 12 software. Results Participants described adolescent mother experiences with stigma and social isolation, in addition to challenges including gossip, lack of employment and educational opportunities, and gaps in services and programming. Peer support groups for adolescent mothers were welcomed to improve mental health, social support, knowledge sharing, and skills building. Participants identified varying preferred frequency and duration of group sessions addressing topics including income generation, mental health, and gossip, facilitated by community health workers at health and community centers. The use of WhatsApp Messenger to support intervention efforts was welcomed as an affordable and user-friendly platform to share information. Implementation (i.e., training, supervision, frequency, location, and co-facilitation) was feasible. Conclusions Adolescent mothers, community health workers and key community stakeholders welcomed the peer support groups as a feasible way to address the mothers’ needs.

scholarly journals Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe

2021 ◽  
Author(s):  
Chiwoneso B. Tinago ◽  
Edward A. Frongillo ◽  
Andrea Warren ◽  
Vivian Chitiyo ◽  
Ashley K. Cifarelli ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Social Isolation ◽  
Peer Support ◽  
Support Groups ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Community Based ◽  
Support Intervention ◽  
Peer Support Intervention

Abstract Background Adolescent mothers in Zimbabwe often experience stigma, isolation and lack coping skills and resources to successfully navigate motherhood. Social isolation and stigma are linked to poor mental health outcomes. No interventions currently address mental health of adolescent mothers in Zimbabwe. Peer support groups in other contexts have been effective at increasing social connectedness, self-esteem, and self-efficacy, providing coping mechanisms to manage stigma experiences, in addition to empowering and improving mental health or adolescents and adolescent mothers. To develop a community-based peer support intervention, we aimed to understand the unique needs of adolescent mothers and how peer support groups could address those needs. Methods Focus group discussions were conducted with 85 adolescent mothers aged 14-18 years, 24 community health workers, and 25 key community stakeholders in a low-income high-density community in Harare. Data were analyzed thematically using NVivo 12 software. Results Participants described adolescent mother experiences with stigma and social isolation, in addition to challenges including gossip, lack of employment and educational opportunities and gaps in services and programming. Peer support groups for adolescent mothers were welcomed to improve mental health, social support, knowledge sharing and skills building. Participants identified varying preferred frequency and duration of group sessions addressing topics including income generation, mental health, and gossip, facilitated by community health workers at health and community centers. Use of WhatsApp Messenger to support intervention efforts was welcomed as an affordable and user-friendly platform to share information. Conclusions Participants supported peer support groups to empower, meet needs, and improve the health of adolescent mothers.

scholarly journals Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

2021 ◽  
Vol 12 ◽  
Author(s):  
Shamaila Mohsin ◽  
Najia Atif ◽  
Waqas Rabbani ◽  
Ahmaren Tariq ◽  
Shahzad Ali Khan ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Maternal Depression ◽  
Community Health ◽  
Community Health Workers ◽  
Cultural Adaptation ◽  
Health Workers ◽  
Primary Care Providers ◽  
Detection Tool ◽  
Health Experts

Background: Evidence indicates that mental health issues like depression, epilepsy, and substance misuse can be detected with reasonable accuracy in resource-poor settings. The Community Informant Detection Tool (CIDT) is one such approach used for detecting mental health problems, including depression. We adapted this community informant approach for detecting maternal depression in Pakistan.Methods: Adaptation of Community Informant Detection Tool for Maternal Depression (CIDT-MD) involved five steps. First, a scoping review of the literature was conducted to select an appropriate tool for adaptation. Second, in-depth interviews were conducted to explore the idioms of depression and distress, perceived causes, and the effects of maternal depression among currently depressed and recovered mothers (n = 11), mothers in law (n = 6), and Primary Care Providers (Primary Care Physicians and Lady Health Supervisors) (n = 6). Third, case vignettes and illustrations were created with input from a panel of mental health experts, incorporating the idioms of depression and distress used, causes, and effects for each symptom described. Fourth, to assess the comprehensibility of the illustrations and level of understanding, Focus Group Discussions (n = 4) were done with purposely selected community health workers (Lady Health Workers and Lay Peers, n = 28) trained in delivering maternal depression intervention. The final step was reflection and inputs by a panel of mental health experts on all steps to finalize the content of the tool.Results: Context-specific cultural adaptation in the presentation and format of CIDT-MD was conducted successfully. Lady Health Workers (LHW) and Lay Peers (LP) were found to be the most appropriate persons to use the tool and function as the informants. The adapted tool with all its vignettes and illustrations was found to be easily understandable, comprehensible, and culturally appropriate, meaningful, and contextually relevant by the community health workers and peers working in the relevant settings. They easily relate to and identify potentially depressed such women lining up with the tool. Lastly, the coding of the tool was found easy to follow as well.Conclusion: The Community Informant Detection Tool for Maternal Depression (CIDT-MD) is a culturally acceptable, easy to use, and comprehensible tool for detecting maternal depression in community settings of Pakistan. The community informants found the content and approach highly relevant to the local needs.

scholarly journals An assessment of mental health programs at community health centers in north Minahasa, Indonesia

2021 ◽  
Vol 8 (12) ◽  
pp. 5707
Author(s):  
Jessica Gloria Mogi ◽  
Gustaaf A. E. Ratag
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Community Health Centers ◽  
Supported Employment ◽  
Health Workers ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Family Approach ◽  
Mental Health Programs

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.

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