13 results on '"Shital Muke"'
Search Results
2. Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India
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Rahul Shidhaye, Vaibhav Murhar, Shital Muke, Ritu Shrivastava, Azaz Khan, Abhishek Singh, and Erica Breuer
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Primary care ,low and middle income countries ,alcohol disorders ,depressive disorders ,Psychiatry ,RC435-571 - Abstract
BackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo provide quantitative measures of outputs related to implementation processes, describe the role of contextual factors that facilitated and impeded implementation processes, and discuss what has been learned from the MHCP implementation.MethodA convergent parallel mixed-methods design was used. The quantitative strand consisted of process data on mental health indicators whereas the qualitative strand consisted of in-depth interviews and focus group discussions with key stakeholders involved in PRIME implementation.ResultsThe implementation of the MHCP in Sehore district in Madhya Pradesh, India, demonstrated that it is feasible to establish structures (for example Mann-Kaksha) and operationalise processes to integrate mental health services in a ‘real-world’ low-resource primary care setting. The key lessons can be summarised as: (a) clear ‘process maps’ of clinical interventions and implementation steps are helpful in monitoring/tracking the progress; (b) implementation support from an external team, in addition to training of service providers, is essential to provide clinical supervision and address the implementation barriers; (c) the enabling packages of the MHCP play a crucial role in strengthening the health system and improving the context/settings for implementation; and (d) engagement with key community stakeholders and incentives for community health workers are necessary to deliver services at the community-platform level.ConclusionsThe PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.Declaration of interestNone.
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- 2019
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3. Scaling up integrated primary mental health in six low- and middle-income countries: obstacles, synergies and implications for systems reform
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Inge Petersen, André van Rensburg, Fred Kigozi, Maya Semrau, Charlotte Hanlon, Jibril Abdulmalik, Lola Kola, Abebaw Fekadu, Oye Gureje, Dristy Gurung, Mark Jordans, Ntokozo Mntambo, James Mugisha, Shital Muke, Ruwayda Petrus, Rahul Shidhaye, Joshua Ssebunnya, Bethlehem Tekola, Nawaraj Upadhaya, Vikram Patel, Crick Lund, and Graham Thornicroft
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Mental health services ,integrated care ,primary healthcare ,low -and middle-income countries ,global mental health ,Psychiatry ,RC435-571 - Abstract
BackgroundThere is a global drive to improve access to mental healthcare by scaling up integrated mental health into primary healthcare (PHC) systems in low- and middle-income countries (LMICs).AimsTo investigate systems-level implications of efforts to scale-up integrated mental healthcare into PHC in districts in six LMICs.MethodSemi-structured interviews were conducted with 121 managers and service providers. Transcribed interviews were analysed using framework analysis guided by the Consolidated Framework for Implementation Research and World Health Organization basic building blocks.ResultsEnsuring that interventions are synergistic with existing health system features and strengthening of the healthcare system building blocks to support integrated chronic care and task-sharing were identified as aiding integration efforts. The latter includes (a) strengthening governance to include technical support for integration efforts as well as multisectoral collaborations; (b) ring-fencing mental health budgets at district level; (c) a critical mass of mental health specialists to support task-sharing; (d) including key mental health indicators in the health information system; (e) psychotropic medication included on free essential drug lists and (f) enabling collaborative and community- oriented PHC-service delivery platforms and continuous quality improvement to aid service delivery challenges in implementation.ConclusionsScaling up integrated mental healthcare in PHC in LMICs is more complex than training general healthcare providers. Leveraging existing health system processes that are synergistic with chronic care services and strengthening healthcare system building blocks to provide a more enabling context for integration are important.Declaration of interestNone.
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- 2019
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4. Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project
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Dan Chisholm, Sumaiyah Docrat, Jibril Abdulmalik, Atalay Alem, Oye Gureje, Dristy Gurung, Charlotte Hanlon, Mark J. D. Jordans, Sheila Kangere, Fred Kigozi, James Mugisha, Shital Muke, Saheed Olayiwola, Rahul Shidhaye, Graham Thornicroft, and Crick Lund
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Low and middle income countries ,mental health ,mental health systems ,financing ,Psychiatry ,RC435-571 - Abstract
BackgroundCurrent coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.AimsTo identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.MethodIn the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options.ResultsKey challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries.ConclusionsIncluding mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities.Declaration of interestD.C. is a staff member of the World Health Organization.
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- 2019
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5. Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project - CORRIGENDUM
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Sumaiyah Docrat, Dan Chisholm, Graham Thornicroft, Oye Gureje, Atalay Alem, Dristy Gurung, Jibril Abdulmalik, Sheila Kangere, Saheed O. Olayiwola, Crick Lund, Charlotte Hanlon, James Mugisha, Mark J. D. Jordans, Rahul Shidhaye, Fred Kigozi, and Shital Muke
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Finance ,Psychiatry and Mental health ,National Insurance ,Poverty ,business.industry ,Cost effectiveness ,Context (language use) ,Business ,Inclusion (education) ,Mental health ,Psychosocial ,Disease burden - Abstract
Background Current coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment. Aims To identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. Method In the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options. Results Key challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries. Conclusions Including mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities. Declaration of interest D.C. is a staff member of the World Health Organization.
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- 2021
6. 20.3 REMOTE COACHING AND TECHNOLOGY FOR TRAINING COMMUNITY HEALTH WORKERS TO TREAT DEPRESSION IN PRIMARY CARE: CASE EXAMPLE FROM INDIA AND OPPORTUNITIES TO SCALE UP MENTAL HEALTH CARE GLOBALLY
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Vikram Patel, Abhishek Singh, Azaz Khan, Aditya Anand, Shital Muke, Juliana L. Restivo, John A. Naslund, Udita Joshi, Deepak Tugnawat, Ritu Shrivastava, and Anant Bhan
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Medical education ,business.industry ,Context (language use) ,Coaching ,Mental health ,Psychiatry and Mental health ,Global mental health ,Mobile phone ,Blueprint ,Reciprocal teaching ,Workforce ,Developmental and Educational Psychology ,business ,Psychology - Abstract
Objectives: Depression is a leading cause of disability that disproportionately impacts low- and middle-income countries. With greater likelihood of access to a mobile phone than mental health care in most countries, there may be opportunities to leverage these digital tools toward increasing access to depression care. We present a case example from the ESSENCE project in India using digital technology to build capacity of community health workers (CHWs), the essential workforce responsible for frontline maternal and child health services in the country, to deliver a brief evidence-based psychological treatment for depression in primary care. Methods: We discuss key considerations in the design and evaluation of the digital training program, with emphasis on strategies to overcome poor mobile connectivity in rural and underresourced settings, and ensuring participant engagement. We describe the systematic approach to tailor the program to meet the needs of the target user group of CHWs. This involved careful design of the digital program and adapting the training content to the local culture and context. We also describe the use of remote coaching and other support techniques to promote engagement and completion of the training program. Results: We present findings from a pilot study with 42 CHWs that directly informed refinements to the training program and design of a subsequent randomized controlled trial enrolling 340 CHWs. We illustrate the progression from formative research to a larger trial, and the integration of remote coaching support, text messaging, and automated reminders within the digital program to promote engagement. We describe how these efforts are informing the design of a digital platform for training frontline health workers to deliver brief psychological treatments in other settings, including the United States. Conclusions: This example of reciprocal learning in global mental health is particularly timely given the impacts of the COVID-19 pandemic, and renewed efforts to train and support frontline health workers to meet the anticipated surge in mental health challenges globally. This study could yield a blueprint for using widely available digital technology for training and supporting frontline health workers toward scaling up mental health services in India and globally. DDD, TREAT, R
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- 2021
7. Digital training for non-specialist health workers to deliver a brief psychological treatment for depression in India: Protocol for a three-arm randomized controlled trial
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Azaz Khan, Rohit Ramaswamy, Zafra Cooper, Shital Muke, Deepak Tugnawat, Udita Joshi, Juliana L. Restivo, Abhijit Nadkarni, Daisy R. Singla, Vikram Patel, Ritu Shrivastava, Lauren M. Mitchell, Christopher G. Fairburn, Abhishek Singh, John A. Naslund, Steven D. Hollon, Anant Bhan, Sona Dimidjian, Donna Spiegelman, Aditya Anand, and Chunling Lu
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medicine.medical_specialty ,Health Personnel ,education ,India ,Burnout ,Coaching ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Health Workforce ,Competence (human resources) ,Randomized Controlled Trials as Topic ,030505 public health ,Primary Health Care ,business.industry ,Depression ,General Medicine ,Digital health ,Mental health ,Treatment Outcome ,Workforce ,Physical therapy ,Job satisfaction ,0305 other medical science ,business - Abstract
Background Training non-specialist health workers (NSHWs) at scale is a major barrier to increasing the coverage of depression care in India. This trial will test the effectiveness of two forms of digital training compared to conventional face-to-face training in changing the competence of NSHWs to deliver a brief evidence-based psychological treatment for depression. Methods This protocol is for a three-arm, parallel group randomized controlled trial comparing three ways of training NSHWs to deliver the Healthy Activity Program (HAP), a brief manualized psychotherapy for depression, in primary care. The arms are: digital training (DGT); digital training combined with individualized coaching support (DGT+); and conventional face-to-face training (F2F). The target sample comprises N = 336 government contracted NSHWs in Madhya Pradesh, India. The primary outcome is change of competence to deliver HAP; secondary outcomes include cost-effectiveness of the training programs, change in participants' mental health knowledge, attitudes and behavior, and satisfaction with the training. Assessors blind to participant allocation status will collect outcomes pre- (baseline) and post- (endpoint) training to ascertain differences in outcomes between arms. Training program costs will be collected to calculate incremental costs of achieving one additional unit on the competency measure in the digital compared to face-to-face training programs. Health worker motivation, job satisfaction, and burnout will be collected as exploratory outcome variables. Discussion This trial will determine whether digital training is an effective, cost-effective, and scalable approach for building workforce capacity to deliver a brief evidence-based psychological treatment for depression in primary care in a low-resource setting. Trial Registration ClinicalTrials.gov Identifier: NCT04157816
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- 2020
8. Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study
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Anant Bhan, Abhishek Singh, Aditya Anand, Vikram Patel, Ritu Shrivastava, Azaz Khan, Shital Muke, Deepak Tugnawat, John A. Naslund, Udita Joshi, and Juliana L. Restivo
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Adult ,Male ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Health Personnel ,education ,lcsh:Medicine ,Poison control ,India ,Pilot Projects ,Suicide prevention ,Article ,Occupational safety and health ,law.invention ,03 medical and health sciences ,primary care ,0302 clinical medicine ,Randomized controlled trial ,law ,Injury prevention ,Medicine ,Humans ,030212 general & internal medicine ,Health Workforce ,non-specialist health worker ,training ,Primary Health Care ,business.industry ,lcsh:R ,pilot study ,Public Health, Environmental and Occupational Health ,Human factors and ergonomics ,psychological treatment ,Focus group ,Mental health ,task sharing ,Telemedicine ,030227 psychiatry ,Family medicine ,depression ,Female ,digital technology ,business ,mental health - Abstract
Introduction: Task sharing holds promise for scaling up depression care in countries such as India, yet requires training large numbers of non-specialist health workers. This pilot trial evaluated the feasibility and acceptability of a digital program for training non-specialist health workers to deliver a brief psychological treatment for depression. Methods: Participants were non-specialist health workers recruited from primary care facilities in Sehore, a rural district in Madhya Pradesh, India. A three-arm randomized controlled trial design was used, comparing digital training alone (DGT) to digital training with remote support (DGT+), and conventional face-to-face training. The primary outcome was the feasibility and acceptability of digital training programs. Preliminary effectiveness was explored as changes in competency outcomes, assessed using a self-reported measure covering the specific knowledge and skills required to deliver the brief psychological treatment for depression. Outcomes were collected at pre-training and post-training. Results: Of 42 non-specialist health workers randomized to the training programs, 36 including 10 (72%) in face-to-face, 12 (86%) in DGT, and 14 (100%) in DGT+ arms started the training. Among these participants, 27 (64%) completed the training, with 8 (57%) in face-to-face, 8 (57%) in DGT, and 11 (79%) in DGT+. The addition of remote telephone support appeared to improve completion rates for DGT+ participants. The competency outcome improved across all groups, with no significant between-group differences. However, face-to-face and DGT+ participants showed greater improvement compared to DGT alone. There were numerous technical challenges with the digital training program such as poor connectivity, smartphone app not loading, and difficulty navigating the course content&mdash, issues that were further emphasized in follow-up focus group discussions with participants. Feedback and recommendations collected from participants informed further modifications and refinements to the training programs in preparation for a forthcoming large-scale effectiveness trial. Conclusions: This study adds to mounting efforts aimed at leveraging digital technology to increase the availability of evidence-based mental health services in primary care settings in low-resource settings.
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- 2020
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9. Development and implementation of COVID-19 safety protocols for conducting a randomized trial in global mental health: Field report from Central India
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Shivangi Choubey, Deepak Tugnawat, Udita Joshi, Anant Bhan, Shital Muke, Azaz Khan, and John A. Naslund
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Research Report ,Service (systems architecture) ,India ,Article ,law.invention ,Face-to-face ,Global mental health ,Clinical trials ,Randomized controlled trial ,law ,Pandemic ,Safety protocols ,Humans ,Baseline (configuration management) ,Pandemics ,General Psychology ,Randomized Controlled Trials as Topic ,Medical education ,SARS-CoV-2 ,Research ,COVID-19 ,General Medicine ,Mental health ,Clinical trial ,Standard operating procedures ,Psychiatry and Mental health ,Mental Health ,Research innovation ,Communicable Disease Control ,Psychology ,Compliance - Abstract
The COVID-19 pandemic impacted ongoing clinical trials globally resulting in the suspension, cancellation or transition to entirely remote implementation of studies. In India, the first countrywide lockdown was imposed in phases starting from March 2020 to June 2020, followed by a continued restriction on in-person activities including study procedures, which halted the ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) trial activities such as recruitment, consenting, baseline assessment, digital training orientation, face to face training and end-line assessment evaluation. This situation made it imperative to amend procedures in order to mitigate the risk and address safety requirements for participants and the research team. This paper summarizes the need, development and implementation of the protocols focused on risk reduction and safety enhancement with an objective to resume and continue the research activities while ensuring the safety of study participants and research staff. These protocols are comprised of guidelines and recommendations based on existing literature tailored according to different components in each arm of the trial such as guidelines for supervisors, travellers, training/recruitment venue safety procedures, individual safety procedures; and procedures to implement the study activities. These protocols can be adapted by researchers in other settings to conduct research trials during pandemics such as COVID-19.
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- 2021
10. Scaling up integrated primary mental health in six low- and middle-income countries: obstacles, synergies and implications for systems reform
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Dristy Gurung, André Janse van Rensburg, Bethlehem Tekola, Graham Thornicroft, Crick Lund, Lola Kola, Ruwayda Petrus, James Mugisha, Maya Semrau, Shital Muke, Oye Gureje, Fred Kigozi, Jibril Abdulmalik, Rahul Shidhaye, Mark J. D. Jordans, Joshua Ssebunnya, Nawaraj Upadhaya, Charlotte Hanlon, Inge Petersen, Abebaw Fekadu, Vikram Patel, Ntokozo Mntambo, RS: CAPHRI - R4 - Health Inequities and Societal Participation, Metamedica, and Promovendi PHPC
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Knowledge management ,Service delivery framework ,Psychological intervention ,Context (language use) ,Health informatics ,03 medical and health sciences ,primary healthcare ,0302 clinical medicine ,Global mental health ,global mental health ,030212 general & internal medicine ,Emerald Series ,integrated care ,business.industry ,CARE ,Mental health ,030227 psychiatry ,3. Good health ,Integrated care ,low-and middle-income countries ,Psychiatry and Mental health ,Mental health services ,low -and middle-income countries ,Implementation research ,business - Abstract
Background There is a global drive to improve access to mental healthcare by scaling up integrated mental health into primary healthcare (PHC) systems in low- and middle-income countries (LMICs). Aims To investigate systems-level implications of efforts to scale-up integrated mental healthcare into PHC in districts in six LMICs. Method Semi-structured interviews were conducted with 121 managers and service providers. Transcribed interviews were analysed using framework analysis guided by the Consolidated Framework for Implementation Research and World Health Organization basic building blocks. Results Ensuring that interventions are synergistic with existing health system features and strengthening of the healthcare system building blocks to support integrated chronic care and task-sharing were identified as aiding integration efforts. The latter includes (a) strengthening governance to include technical support for integration efforts as well as multisectoral collaborations; (b) ring-fencing mental health budgets at district level; (c) a critical mass of mental health specialists to support task-sharing; (d) including key mental health indicators in the health information system; (e) psychotropic medication included on free essential drug lists and (f) enabling collaborative and community- oriented PHC-service delivery platforms and continuous quality improvement to aid service delivery challenges in implementation. Conclusions Scaling up integrated mental healthcare in PHC in LMICs is more complex than training general healthcare providers. Leveraging existing health system processes that are synergistic with chronic care services and strengthening healthcare system building blocks to provide a more enabling context for integration are important. Declaration of interest None.
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- 2019
11. Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India
- Author
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Azaz Khan, Abhishek Singh, Ritu Shrivastava, Vaibhav Murhar, Rahul Shidhaye, Erica Breuer, and Shital Muke
- Subjects
Medical education ,low and middle income countries ,Process (engineering) ,Psychological intervention ,Clinical supervision ,Context (language use) ,Service provider ,Primary care ,Focus group ,Mental health ,030227 psychiatry ,alcohol disorders ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Incentive ,Papers ,030212 general & internal medicine ,Business ,depressive disorders - Abstract
BackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo provide quantitative measures of outputs related to implementation processes, describe the role of contextual factors that facilitated and impeded implementation processes, and discuss what has been learned from the MHCP implementation.MethodA convergent parallel mixed-methods design was used. The quantitative strand consisted of process data on mental health indicators whereas the qualitative strand consisted of in-depth interviews and focus group discussions with key stakeholders involved in PRIME implementation.ResultsThe implementation of the MHCP in Sehore district in Madhya Pradesh, India, demonstrated that it is feasible to establish structures (for example Mann-Kaksha) and operationalise processes to integrate mental health services in a ‘real-world’ low-resource primary care setting. The key lessons can be summarised as: (a) clear ‘process maps’ of clinical interventions and implementation steps are helpful in monitoring/tracking the progress; (b) implementation support from an external team, in addition to training of service providers, is essential to provide clinical supervision and address the implementation barriers; (c) the enabling packages of the MHCP play a crucial role in strengthening the health system and improving the context/settings for implementation; and (d) engagement with key community stakeholders and incentives for community health workers are necessary to deliver services at the community-platform level.ConclusionsThe PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.Declaration of interestNone.
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- 2019
12. Community, facility and individual level impact of integrating mental health screening and treatment into the primary healthcare system in Sehore district, Madhya Pradesh, India
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Shital Muke, Ritu Shrivastava, Vaibhav Murhar, Rahul Shidhaye, Abhishek Singh, Azaz Khan, Sanjay Shrivastava, Vikram Patel, Emily Baron, Crick Lund, and Sujit D Rathod
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medicine.medical_specialty ,Impact evaluation ,programme evaluation ,India ,Treatment and control groups ,03 medical and health sciences ,primary healthcare ,0302 clinical medicine ,Health care ,Medicine ,030212 general & internal medicine ,Social determinants of health ,Prospective cohort study ,Depression (differential diagnoses) ,business.industry ,Research ,Health Policy ,Public Health, Environmental and Occupational Health ,Health services research ,Mental health ,health services research ,030227 psychiatry ,mental disorders ,Family medicine ,business - Abstract
IntroductionProgramme for Improving Mental Health Care (PRIME) designed a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India. The objective of this paper is to describe the findings of the district-level impact evaluation of the MHCP.MethodsRepeat community-based CS were conducted to measure change in population-level contact coverage for depression and alcohol use disorders (AUD), repeat FDS were conducted to assess change in detection and initiation of treatment for depression and AUD, and the effect of treatment on patient outcomes was assessed using disorder-specific prospective cohort studies.ResultsPRIME MHCP did not have any impact on contact coverage/treatment seeking for depression (14.8% at the baseline and 10.5% at the follow-up) and AUD (7.7% at the baseline and 7.3% at the follow-up) and had a small impact on detection and initiation of treatment for depression and AUD (9.7% for depression and 17.8% for AUD compared with 0% for both at the baseline) in the health facilities. Patients with depression who received care as part of the MHCP had higher rates of response (52.2% in the treatment group vs 26.9% in the comparison/usual care group), early remission (70.2% in the treatment group vs 44.8% in the comparison/usual care group) and recovery (56.1% in the treatment group vs 28.5% in the comparison/usual care group), but there was no impact of treatment on their functioning.ConclusionsWhile dedicated human resources (eg, Case Managers) and dedicated space for mental health clinics (eg, Mann-Kaksha) strengthen the ‘formal’ healthcare platform, without substantial additional investments in staff, such as Community Health Workers/Accredited Social Health Activists to improve community level processes and provision of community-based continuing care to patients, we are unlikely to see major changes in coverage or clinical outcomes.
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- 2019
13. Acceptability and feasibility of digital technology for training community health workers to deliver brief psychological treatment for depression in rural India
- Author
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Deepak Tugnawat, Vikram Patel, Ritu Shrivastava, Vaibhav Murhar, Shital Muke, John A. Naslund, Azaz Khan, Rahul Shidhaye, and Lauren M. Mitchell
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Adult ,Rural Population ,Process (engineering) ,Attitude of Health Personnel ,India ,Qualitative property ,Training (civil) ,Article ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Community health workers ,Humans ,General Psychology ,Depression (differential diagnoses) ,Community Health Workers ,Medical education ,Depression ,General Medicine ,Middle Aged ,Focus group ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,Community health ,Feasibility Studies ,Psychotherapy, Brief ,Female ,Psychology ,030217 neurology & neurosurgery ,Computer-Assisted Instruction - Abstract
Introduction Digital technology offers opportunities to train community health workers to deliver psychological treatments towards closing the gap in existing mental health services in low-resource settings. This study explored the acceptability and feasibility of using digital technology for training community health workers to deliver evidence-based brief psychological treatment for depression in rural India. Methods This study consisted of two sequential evaluations of digital training prototypes using focus group discussions to explore community health worker perspectives about the digital training platform and the program content. Through an iterative design process, feedback was collected about the first prototype to inform modifications to the second prototype. Qualitative data was analyzed using a framework analysis approach. Results Thirty-two community health workers participated in three separate focus group discussions. Five overarching themes related to acceptability and feasibility of digital training revealed that training on detection and treatment of depression was considered important by study participants for addressing ‘stress’ and ‘tension’ within their communities, while the digital platform was viewed as useful and convenient despite limited familiarity with using digital technology. Moreover, participants suggested simple language for the program and use of interactive content and images to increase interest and improve engagement. Discussion Digital technology appears acceptable and feasible for supporting training of community health workers to deliver evidence-based depression care in rural India. These findings can inform use of technology as a tool for developing the clinical skills of community health workers for treating depression in low-resource settings.
- Published
- 2019
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