Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa
Open accessAbstract
BACKGROUND: Perinatal depression is a major public health issue especially in low income settings in South Africa, where there is a shortage of mental health professionals. New psychological interventions delivered by non-specialists are needed to fill the treatment gap. This paper describes the process of developing a manual based task sharing counselling intervention for perinatal depression in Khayelitsha, Cape Town. METHODS: Qualitative semi-structured interviews were conducted with 26 participants, including service providers and service users at a clinic in Khayelitsha in order to explore the feasibility, acceptability and content of a task sharing counselling intervention. The interviews were recorded, translated and transcribed. Themes were identified using the framework analysis approach and were coded and analysed using NVivo v10. After the semi-structured interviews, a workshop was conducted with mental health experts on evidence-based psychological interventions for depression, together with a document review of counselling manuals for community health workers in South Africa. RESULTS: The findings indicate that a task sharing counselling intervention was acceptable and feasible for depressed women in Khayelitsha, under the following conditions: (1) respondents preferred a female counsellor and felt that clinic based individual sessions should be provided at least once a month by an experienced Xhosa speaking counsellor from the community; and (2) the content of a counselling intervention should include psycho-education on cognitive and behavioural effects of depression, how to cope with interpersonal problems, and financial stressors. Based on these conditions, the review of manuals and expert consultation, key components of the counselling intervention were identified as: psycho-education, problem solving, healthy thinking and behaviour activation. These were included in the final counselling manual. CONCLUSION: The development of task sharing counselling interventions for perinatal depression should be informed by the views and needs of local service users and service providers. The study illustrates the manner in which these views can be incorporated for the development of evidence-based psychological interventions, within a task sharing framework in low and middle-income countries.
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Clients' minimization of the extent of their problems or doubt in the efficacy of an intervention presented barriers to widespread uptake.
“Clients’ minimization of the extent of their problems or doubt in the efficacy of an intervention also presented barriers to widespread uptake [74].”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [74]
The Discussion (page not available) says that some individuals could minimize their problems and refuse counselling, supporting that part of the claim. It does not identify doubt about the intervention’s efficacy as a barrier; the Results instead say all 12 interviewed service users considered counselling acceptable. (LLM, conf=0.86)
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Cognitive-behavioral interventions for mental health conditions among women in sub-Saharan Africa
Le, H., Rabemananjara, K. M., & Goyal, D. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85726-0.00015-6 · Cited by 1 · see citing works
Global Epidemiology, Etiology, and Treatment
Wittenborn, A. K., Lachmar, E. M., Huerta, P. L., Mitchell, E. A., & Tseng, C. (2020) · Wiley eBooks · doi:10.1002/9781119788409.ch10
(2023) · International Journal of Biology Pharmacy and Allied Sciences · doi:10.31032/ijbpas/2023/12.6.6982
(2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2025.10010.pr5
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An intersectional exploration of experiences of Registered Counsellors in primary health care
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Self-citation
- Authors
- Nyatsanza, M., Schneider, M., Davies, T., & Lund, C.
- Affiliations
- University of Cape Town (ZA)
- Corresponding author
- Nyatsanza, Memory
- Venue
- BMC Psychiatry
- Published
- 2016-05-26
- Volume
- 16
- Issue
- 1
- Pages
- 164-164
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC4881204
- OpenAlex
- W2406487705
- Cited by
- 49
- References
- 58
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 12 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 3 · 2017: 4 · 2016: 1
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open University of Cape Town (University of Cape Town) (submittedVersion)
- Funders
- National Institute of Mental Health (5U19MH095699)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- perinatal depression, task sharing, counseling intervention, community health workers, treatment gap, intervention development, feasibility and acceptability, psychoeducation, problem solving, Khayelitsha, low- and middle-income countries
- MeSH terms
- Adult, Community Health Workers, Counseling, Depression, Female, Humans, Poverty, Pregnancy, Pregnancy Complications, South Africa, Depression, Postpartum
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