Evidence map›Paper›PMID 38329495›Full record

ArticleSocial psychiatry and psychiatric epidemiology2024

Addressing the challenges of integrating care for perinatal depression in primary care in Nigeria.

Bibilola D Oladeji, Olatunde O Ayinde, Toyin Bello, Lola Kola, Neda Faregh, Jibril Abdulmalik, Phyllis Zelkowitz, Soraya Seedat, Oye Gureje

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Article in Social psychiatry and psychiatric epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Bibilola D OladejiDepartment of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria. bibideji@yahoo.com.
Olatunde O AyindeDepartment of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Toyin BelloWHO Collaborating Centre for Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Lola KolaWHO Collaborating Centre for Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Neda FareghDepartment of Psychology, Carleton University, Ottawa, ON, Canada.
Jibril AbdulmalikDepartment of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Phyllis ZelkowitzMcGill University, Montreal, Canada.
Soraya SeedatDepartment of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Oye GurejeDepartment of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Funding

Global Affairs Canada (GAC), the Canadian Institutes of Health Research (CIHR) and Canada's International Development Research Centre (IDRC) Grant number 108552-001
6 · The paper itself

Abstract

purposeThis report provides the results of a task-shared approach for integrating care for perinatal depression (PND) within primary maternal and child healthcare (PMCH), including the factors that may facilitate or impede the process.

methodsThis hybrid implementation-effectiveness study guided by the Replicating Effective Programmes framework was conducted in 27 PMCH clinics in Ibadan, Nigeria. The primary implementation outcome was change in the identification rates of PND by primary health care workers (PHCW) while the primary effectiveness outcome was the difference in symptom remission (EPDS score ≤ 5) 6 months postpartum. Outcome measures were compared between two cohorts of pregnant women, one recruited before and the other after training PHCW to identify and treat PND. Barriers and facilitators were explored in qualitative interviews.

resultsIdentification of PND improved from 1.4% before to 17.4% after training; post-training rate was significantly higher in clinics where PHCW routinely screened using the 2-item patient health questionnaire (24.8%) compared to non-screening clinics (5.6%). At 6-months postpartum, 60% of cohort one experienced remission from depression, compared to 56.5% cohort two [OR-0.9 (95%CI-0.6, 1.3) p = 0.58]. Identified facilitators for successful integration included existence of policy specifying mental health as a component of PHC, use of screening to aid identification and supportive supervision, while barriers included language and cultural attitudes towards mental health and human resource constraints. PHCW were able to make adaptations to address these barriers.

conclusionsSuccessful implementation of task-shared care for perinatal depression requires addressing staff shortages and adopting strategies that can improve identification by non-specialist providers.

trial registrationThis study was retrospectively registered 03 Dec 2019. https://doi.org/10.1186/ISRCTN94230307 .

Indexed as

Delivery of Health Care, IntegratedPrimary Health CareAdultDepressionDepression, PostpartumFemaleHealth PersonnelHumansNigeriaPerinatal CarePregnancyPregnancy ComplicationsImplementation researchLow- and middle-income countryPerinatal depressionPrimary healthcareReplicating effective programs (REP) frameworkTask-sharing

Identifiers

PMID38329495

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.