An Adapted Collaborative Care Model to Manage Co-morbidities of Depression and Chronic Non-Communicable Diseases in Rwanda.

Background: The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda. Purpose: The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context. Methods: The larger study used the Action Research design with mixed method -sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data. Results: Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable. Conclusions: Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.