Experience of primary healthcare workers in using the mobile app-based WHO mhGAP intervention guide in detection and treatment of people with mental disorders: A qualitative study in Nepal
Open accessAbstract
This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients' data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services.
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A notable challenge in LMICs pertains to the availability of internet access and sufficient bandwidth.
“A notable challenge in LMICs pertains to the availability of internet access and sufficient bandwidth.”
From A Digital Tool (Technology-Assisted Problem Management Plus) for Lay Health Workers to Address Common Mental Health Disorders: Co-production and Usability Study in Pakistan (2025) · cites this paper as [39]
The Results section identifies unavailable or poor internet connectivity as a challenge to using the app in Nepal. The paper does not specifically assess bandwidth or establish how widespread this challenge is across LMICs. (LLM, conf=0.84)
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Flagged first, then by citations
Research works printed but not linked: 4
- WHO mhGAP: Mental Health Gap Action Programme: Scaling up Care for Mental, Neurological and Substance Use Disorders 2008 World Health Organization Geneva 26290926
- WHO mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings: Mental Health Gap Action Programme (mhGAP) – Version 1.0 2010 WHO Geneva, Swizerland 23741783
- WHO mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings: Mental Health Gap Action Programme (mhGAP) – Version 2.0 2016 World Health Organization Geneva 27786430
- WHO mhGAP Intervention Guide - Version 2.0 - for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings 2019 World Health Organization Geneva 27786430
Cited by
Sorted by citations
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“Addressing this barrier in digital health technologies is imperative, as highlighted both in our study and in a concurrent investigation conducted in Nepal [38,39], advocating for the implementation of interventions that XSL • FO RenderX are independent of internet connectivity.”
- Authors
- Luitel, N. P., Neupane, V., Lamichhane, B., Koirala, G. P., Gautam, K., Karki, E., Adhikari, S., Votruba, N., Jordans, M. J., Kohrt, B. A., Carswell, K., Thornicroft, G., & Lempp, H.
- Affiliations
- George Washington University (US)
- The George Institute for Global Health (GB)
- King's College London (GB)
- World Health Organization (CH)
- Corresponding author
- Luitel, Nagendra P.
- ORCID
- Venue
- SSM - Mental Health
- Publisher
- Elsevier BV
- Published
- 2023-12
- Volume
- 4
- Pages
- 100278
- ISSN
- 2666-5603 (ISSN-L)
- PMC
- PMC10751533
- OpenAlex
- W4389152071
- Cited by
- 13
- References
- 32
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 3
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- SSM - Mental Health (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute for Health and Care Research
- National Institute of Mental Health (U19MH113211)
- National Institute for Health Research Applied Research Collaboration South London
- Wellcome Trust
- King's College Hospital NHS Foundation Trust
- UK Research and Innovation (MR/R023697/1)
- Medical Research Council (MR/S001255/1)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- mobile application, primary health care workers, primary care mental health, mobile decision support, technology acceptance, barriers to app use, internet access, technological literacy, psychosocial interventions, follow-up care, mental health service delivery, Nepal
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