ABSTRACT
Background: Peripartum common mental disorders (CMD) are highly prevalent in low- and middle-income countries (LMIC) such as South Africa. With limited public mental health resources, task sharing approaches to treatment are showing promise. However, little is known about the feasibility and acceptability of, as well as responses associated with problem-solving therapy (PST) for the treatment of prepartum CMD symptoms in South African public health settings. Aim: To investigate participants' preliminary responses to a task sharing PST intervention, and to evaluate the feasibility and acceptability of the intervention. Setting: A Midwife and Obstetrics Unit attached to a Community Health Centre in a Western Cape district. Methods: Using mixed methods, 38 participants' responses to a PST intervention, and their perceptions of its feasibility and acceptability, were explored. Primary outcomes included psychological distress (Self Reporting Questionnaire; SRQ-20) and depression symptoms (Edinborough Postnatal Depression Scale; EPDS). Semi-structured interviews were conducted three after the last session. Six stakeholders were also interviewed. Results: Significant reductions were seen on EPDS (Cohen's d = 0.61; Hedges g = 0.60) and SRQ-20 (Cohen's d = 0.68; Hedges g = 0.67) scores. The intervention's acceptability lay in the opportunity for confidential disclosure of problems; and in relieving staff of the burden of managing of patients' distress. Barriers included lack of transport and work commitments. Conclusion: Results support task sharing PST to Registered Counsellors to treat antenatal CMDs in perinatal primary health care settings. Research is needed on how such programmes might be integrated into public health settings, incorporating other non-specialists
Subject(s)
Mental Disorders , Mental Health , Patient Acceptance of Health Care , Patient Health Questionnaire , Peripartum Period , Primary Health Care , South Africa , Task Performance and AnalysisABSTRACT
L'etude realisee dans l'arrondissement d'Endom a permis de degager un certain nombre d'elements qui compromettent sans nul doute la supervision des taches des soins de sante primaires effectuee dans les centres de sante de cette circoncription administrative a savoir la categorie professionnelle inadequate pour certains personnels superviseurs; la defaillance dans la perception des taches devant etre realisees dans les centres de sante; la lacune dans la formulation des taches executees et l'insuffisance de couverture des taches de soins de sante primaires par la supervision
Subject(s)
Primary Health Care , Task Performance and AnalysisABSTRACT
La supervision du Programme National de Lutte contre la Tuberculose est une activite indispensable pour s'assurer que les objectifs du programme sont realises selon les criteres de qualite et en respectant les echeances. Elle doit etre reguliere et periodique et n'oublier aucune formation sanitaire. Elle doit employer des indicateurs sensibles; fiables; et toujours les memes pour juger de l'evolution de la qualite du travail. Enfin et surtout; la supervision doit etre concue plus comme un soutien et une aide aux personnels engages dans l'action de sante que comme un controle