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Cited by 36Mental Health Treatment and AccessHealth Policy Implementation ScienceGlobal Health and Surgery

Scaling up interventions for depression in sub-Saharan Africa: lessons from Zimbabwe

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Chibanda, D., Verhey, R., Munetsi, E., Rusakaniko, S., Cowan, F., Lund, C.·2016·Global Mental Health
DOI 10.1017/gmh.2016.8PMC PMC5314736
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Abstract

Background: There is a dearth of information on how to scale-up evidence-based psychological interventions, particularly within the context of existing HIV programs. This paper describes a strategy for the scale-up of an intervention delivered by lay health workers (LHWs) to 60 primary health care facilities in Zimbabwe. Methods: A mixed methods approach was utilized as follows: (1) needs assessment using a semi-structured questionnaire to obtain information from nurses (n = 48) and focus group discussions with District Health Promoters (n = 12) to identify key priority areas; (2) skills assessment to identify core competencies and current gaps of LHWs (n = 300) employed in the 60 clinics; (3) consultation workshops (n = 2) with key stakeholders to determine referral pathways; and (4) in-depth interviews and consultations to determine funding mechanisms for the scale-up. Results: Five cross-cutting issues were identified as critical and needing to be addressed for a successful scale-up. These included: the lack of training in mental health, unavailability of psychiatric drugs, depleted clinical staff levels, unavailability of time for counseling, and poor and unreliable referral systems for people suffering with depression. Consensus was reached by stakeholders on supervision and support structure to address the cross-cutting issues described above and funding was successfully secured for the scale-up. Conclusion: Key requirements for success included early buy-in from key stakeholders, extensive consultation at each point of the scale-up journey, financial support both locally and externally, and a coherent sustainability plan endorsed by both government and private sectors.

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  • Several non-pharmacological interventions such as Friendship Bench, Problem Management Plus, and Self Help Plus have been readily included in WHO packages and are often employed in emergency settings.

    “Several of these, such as those known as 'Friendship Bench' (Chibanda et al. 2016), 'Problem Management Plus (PM+)' (Dawson et al. 2015), and 'Self Help Plus (SH+)' (Tol et al. 2020), have been readily included in WHO packages and are often employed in emergency settings (see Chapter 5).”

    From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Chibanda et al. 2016

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Cited by

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Authors
Chibanda, D., Verhey, R., Munetsi, E., Rusakaniko, S., Cowan, F., & Lund, C.
Affiliations
  • University of Zimbabwe (ZW)
  • Centre for Sexual Health and HIV AIDS Research (ZW)
  • University of Cape Town (ZA)
Corresponding author
Chibanda, D.
ORCID
Venue
Global Mental Health
Publisher
Cambridge University Press (CUP)
Published
2016
Volume
3
Pages
e13-e13
ISSN
2054-4251 (ISSN-L)
DOI
10.1017/gmh.2016.8
PMC
PMC5314736
OpenAlex
W2324252594
Cited by
36
References
5
Citations by year
2026: 3 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 8 · 2020: 3 · 2019: 6 · 2018: 4 · 2017: 3 · 2016: 1
FWCI
7.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • University of Cambridge
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
  • Grand Challenges Canada (0087-04, GMH0087-04)
  • University of Cape Town
  • Medical Research Council
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
Keywords
depression, scaling up interventions, lay health workers, HIV/AIDS programs, primary care, mental health training, referral systems, stakeholder buy-in, financial mechanisms, sustainability planning, supervision and support, Zimbabwe

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