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2. Use of the WHO's Perceived Well-Being Index (WHO-5) as an Efficient and Potentially Valid Screen for Depression in a Low Income Country

Author

Garland, Ann F., Desta, Menelik, Zerihun, Tigist, Deyessa, Negussie, Alem, Atalay, Hall, Kristopher G., Goren, Nicole, and Fish, Irving

Subjects
Depression (Mood disorder) -- Analysis, Childhood mental disorders -- Analysis, Family -- Analysis, Evidence-based medicine -- Analysis, Family relations -- Analysis, Family and marriage, Health, Psychology and mental health, World Health Organization
Abstract

Introduction: Depression is associated with negative social, economic, and family outcomes and the majority of individuals with depression in low and middle income countries (LMICs) are untreated. A critical first step in bridging the treatment gap is accurate, feasible, and culturally appropriate screening to identify those who need treatment. The WHO's Perceived Well-Being Index (WHO-5) well-being instrument can potentially meet the screening needs of LMICs in primary care and community-based settings. This study tested the feasibility and validity of this tool to identify depression among adult parents of young children in Addis Ababa, Ethiopia. Successful identification and treatment of depression in parents extends benefits to children and families. Method: The WHO-5 was translated to Amharic and administered to 849 adults and compared with simultaneous administration of the well-established PHQ-9 instrument. Feasibility was assessed and analyses evaluated frequency of positive screens for depression, internal consistency, sensitivity and specificity of the WHO-5, and sociodemographic correlates of depression. Results: The prevalence of probable depression was similar as assessed by the PHQ-9 (17.3%) and the WHO-5 (18.5%). The internal consistency of the WHO-5 was strong (Cronbach's alpha = .83). WHO-5 agreement with the PHQ-9 was moderate; sensitivity and specificity were strong. Correlates of depression included unemployment and financial status. Discussion: The study provides promising evidence to support use of the WHO-5 to identify depression in Ethiopia. Feasibility was good, and it was culturally and linguistically acceptable. The results suggest that minimally trained community health and education workers in countries like Ethiopia could use the WHO-5 effectively in primary health and education settings. Keywords: depression screening, WHO-5, Ethiopia, According to the World Health Organization, depression is the leading cause of disability around the world (Friedrich, 2017). As the number of people suffering from depression increases, the economic, social, [...]

Published
2018
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3. Non-specialist delivery of the WHO Caregiver Skills Training Programme for children with developmental disabilities:stakeholder perspectives about acceptability and feasibility in rural Ethiopia

Author

Zerihun, Tigist, Kinfe, Mersha, Koly, Kamrun Nahar, Abdurahman, Rehana, Girma, Fikirte, WHO CST Team, Hanlon, Charlotte, de Vries, Petrus J., and Hoekstra, Rosa

Abstract

Autism and other developmental disabilities (DD) are common in low- and middle-income countries. The World Health Organization (WHO) developed the Caregiver Skills Training (CST) programme to address the needs of families with children with DD globally. This study explored the acceptability and feasibility of the CST facilitated by non-specialists in rural Ethiopia, where contextual factors such as poverty, stigma and low literacy may affect CST delivery. In-depth interviews were conducted with caregivers (n=19) and four focus groups with non-specialist facilitators (n=8) in two rural pilot tests of the CST programme. Results suggested that participants experienced the CST programme as acceptable and relevant for their context but suggested some modifications to improve the programme. Caregivers’ accounts showed that facilitation by non-specialists was acceptable; facilitators emphasised the importance of supervision throughout the programme. Participants indicated that the home visit and group training modalities were acceptable and feasible. Facilitators indicated that some CST topics were difficult to explain to caregivers; the concept of formalised play between caregiver and child was particularly foreign to caregivers. Lack of available toys made it difficult to practise some of the CST exercises. These findings may have relevance to non-specialist delivery of the CST and other parent-mediated interventions in low-resource contexts.

Published
2023
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