Training and supervision of lay mental health workers in community-based interventions in East Africa: a scoping review.

Lay mental health workers play a central role in implementing and sustaining mental health interventions across East Africa. However, limited research exists on how these workers are trained and supervised, an important gap given their role in addressing the region's severe treatment shortage, where up to 85% of individuals with mental disorders receive little or no evidence-based care. Task-sharing, which involves training non-specialist workers to deliver psychological interventions under supervision, has become a key strategy over the past two decades. Yet, the processes that ensure LMHW competence, fidelity, and wellbeing, particularly training and supervision, remain underexplored. Guided by Arksey and O'Malley's five-stage framework, this scoping review maps and synthesizes literature on training and supervision practices for LMHWs delivering community-based mental health interventions in East Africa. Systematic searches of five databases (Web of Science, Embase, Scopus, PubMed, and ProQuest) yielded records that, after screening and eligibility assessment, resulted in 18 included studies from five of the seven East African countries. Data were charted and thematically analyzed to describe training methods, supervision strategies, outcomes, and implementation challenges. Findings revealed wide variations in training duration and pedagogy, from brief workshops to multi-module or apprenticeship models, and diverse supervision formats, including hierarchical, peer, hybrid, and digital approaches. Evidence showed improvements in client outcomes, provider competence, and service delivery, but highlighted persistent gaps in standardized supervision, sustainability, and workforce support. This review informs policy and implementation efforts to strengthen LMHW training and supervision systems, contributing to narrowing the mental health treatment gap in East Africa.