TY - JOUR
T1 - Task-sharing of psychological treatment for antenatal depression in Khayelitsha, South Africa
T2 - Effects on antenatal and postnatal outcomes in an individual randomised controlled trial
AU - Lund, Crick
AU - Schneider, Marguerite
AU - Garman, Emily
AU - Davies, Thandi
AU - Munodawafa, Memory
AU - Honikman, Simone
AU - Bhana, Arvin
AU - Bass, Judy
AU - Bolton, Paul
AU - Dewey, Michael
AU - Joska, John
AU - Kagee, Ahsraf
AU - Myer, Landon
AU - Petersen, Inge
AU - Prince, Martin
AU - Stein, Dan
AU - Tabana, Hanani
AU - Thornicroft, Graham
AU - Tomlinson, Mark
AU - Hanlon, Charlotte
AU - Alem, Atalay
AU - Susser, Ezra
PY - 2020/7/1
Y1 - 2020/7/1
N2 - The study's objective was to determine the effectiveness of a task-sharing psychological treatment for perinatal depression using non-specialist community health workers. A double-blind individual randomised controlled trial was conducted in two antenatal clinics in the peri-urban settlement of Khayelitsha, Cape Town. Adult pregnant women who scored 13 or above on the Edinburgh Postnatal Depression rating Scale (EPDS) were randomised into the intervention arm (structured six-session psychological treatment) or the control arm (routine antenatal health care and three monthly phone calls). The primary outcome was response on the Hamilton Depression Rating Scale (HDRS) at three months postpartum (minimum 40% score reduction from baseline) among participants who did not experience pregnancy or infant loss (modified intention-to-treat population) (registered on Clinical Trials: NCT01977326). Of 2187 eligible women approached, 425 (19.4%) screened positive on the EPDS and were randomised; 384 were included in the modified intention-to-treat analysis (control: n = 200; intervention: n = 184). There were no significant differences in response on the HDRS at three months postpartum between the intervention and control arm. A task-sharing psychological treatment was not effective in treating depression among women living in Khayelitsha, South Africa. The findings give cause for reflection on the strategy of task-sharing in low-resource settings.
AB - The study's objective was to determine the effectiveness of a task-sharing psychological treatment for perinatal depression using non-specialist community health workers. A double-blind individual randomised controlled trial was conducted in two antenatal clinics in the peri-urban settlement of Khayelitsha, Cape Town. Adult pregnant women who scored 13 or above on the Edinburgh Postnatal Depression rating Scale (EPDS) were randomised into the intervention arm (structured six-session psychological treatment) or the control arm (routine antenatal health care and three monthly phone calls). The primary outcome was response on the Hamilton Depression Rating Scale (HDRS) at three months postpartum (minimum 40% score reduction from baseline) among participants who did not experience pregnancy or infant loss (modified intention-to-treat population) (registered on Clinical Trials: NCT01977326). Of 2187 eligible women approached, 425 (19.4%) screened positive on the EPDS and were randomised; 384 were included in the modified intention-to-treat analysis (control: n = 200; intervention: n = 184). There were no significant differences in response on the HDRS at three months postpartum between the intervention and control arm. A task-sharing psychological treatment was not effective in treating depression among women living in Khayelitsha, South Africa. The findings give cause for reflection on the strategy of task-sharing in low-resource settings.
KW - Community health workers
KW - Counselling
KW - Perinatal depression
KW - Randomised controlled trial
KW - South Africa
KW - Task-sharing
UR - http://www.scopus.com/inward/record.url?scp=85075357294&partnerID=8YFLogxK
U2 - 10.1016/j.brat.2019.103466
DO - 10.1016/j.brat.2019.103466
M3 - Article
SN - 0005-7967
VL - 130
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
IS - 0
M1 - 103466
ER -
