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Cascade training for scaling up care for perinatal depression in primary care in Nigeria

BACKGROUND: Task-shared care is a demonstrated approach for integrating mental health into maternal and child healthcare (MCH) services. Training and continued support for frontline providers is key to the success of task sharing initiatives. In most settings this is provided by mental health specia...

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Autores principales: Oladeji, Bibilola D., Ayinde, Olatunde O., Bello, Toyin, Kola, Lola, Faregh, Neda, Abdulmalik, Jibril, Zelkowitz, Phyllis, Seedat, Soraya, Gureje, Oye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658820/
https://www.ncbi.nlm.nih.gov/pubmed/37986025
http://dx.doi.org/10.1186/s13033-023-00607-5
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author Oladeji, Bibilola D.
Ayinde, Olatunde O.
Bello, Toyin
Kola, Lola
Faregh, Neda
Abdulmalik, Jibril
Zelkowitz, Phyllis
Seedat, Soraya
Gureje, Oye
author_facet Oladeji, Bibilola D.
Ayinde, Olatunde O.
Bello, Toyin
Kola, Lola
Faregh, Neda
Abdulmalik, Jibril
Zelkowitz, Phyllis
Seedat, Soraya
Gureje, Oye
author_sort Oladeji, Bibilola D.
collection PubMed
description BACKGROUND: Task-shared care is a demonstrated approach for integrating mental health into maternal and child healthcare (MCH) services. Training and continued support for frontline providers is key to the success of task sharing initiatives. In most settings this is provided by mental health specialists. However, in resource constrained settings where specialists are in short supply, there is a need to explore alternative models for providing training and supportive supervision to frontline maternal care providers. This paper reports on the impact of a cascade training (train-the-trainers) approach in improving the knowledge and attitudes of primary healthcare workers (PHCW) to perinatal depression. METHODS: Senior primary health care providers selected from across participating local government areas were trained to provide training to other PHCWs. The training sessions facilitated by these trainers were observed and rated for fidelity by specialist trainers, while the trainees provided their impression of and satisfaction with the training sessions using predesigned assessment forms. Training outcomes assessed included knowledge of depression (using mhGAP training questions and knowledge of depression questionnaire) and attitude towards providing care for depression (revised depression attitude questionnaire (R-DAQ)) measured pre and post training as well as six months after training. RESULTS: Trainees were 198 PHCWs (94.4% female), who routinely provide MCH services in 28 selected primary care clinics and had between 6- and 34-years’ experience. Training was provided by 11 trained trainers who were general physicians or senior nurses. Training sessions were rated high in fidelity and on training style. Sessions were rated excellent by 77.8% of the trainees with the trainers described as knowledgeable, effective and engaging. Knowledge of depression mean score improved from a pre-training level of 12.3 ± 3.5 to 15.4 ± 3.7, immediately post-training and 14.7 ± 3.2, six months post-training (both comparisons: p < 0.001). The proportion of PHCW workers endorsing statements indicative of positive attitudes on the professional confidence and the generalist perspective modules of the R-DAQ also increased with training. CONCLUSION: Our findings suggest that cascade training can be an effective model for rapidly providing training and upskilling frontline PHCWs to deliver care for women with perinatal depression in resource limited settings. TRIAL REGISTRATION: This study was retrospectively registered 03 December 2019. 10.1186/ISRCTN 94,230,307.
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spelling pubmed-106588202023-11-20 Cascade training for scaling up care for perinatal depression in primary care in Nigeria Oladeji, Bibilola D. Ayinde, Olatunde O. Bello, Toyin Kola, Lola Faregh, Neda Abdulmalik, Jibril Zelkowitz, Phyllis Seedat, Soraya Gureje, Oye Int J Ment Health Syst Research BACKGROUND: Task-shared care is a demonstrated approach for integrating mental health into maternal and child healthcare (MCH) services. Training and continued support for frontline providers is key to the success of task sharing initiatives. In most settings this is provided by mental health specialists. However, in resource constrained settings where specialists are in short supply, there is a need to explore alternative models for providing training and supportive supervision to frontline maternal care providers. This paper reports on the impact of a cascade training (train-the-trainers) approach in improving the knowledge and attitudes of primary healthcare workers (PHCW) to perinatal depression. METHODS: Senior primary health care providers selected from across participating local government areas were trained to provide training to other PHCWs. The training sessions facilitated by these trainers were observed and rated for fidelity by specialist trainers, while the trainees provided their impression of and satisfaction with the training sessions using predesigned assessment forms. Training outcomes assessed included knowledge of depression (using mhGAP training questions and knowledge of depression questionnaire) and attitude towards providing care for depression (revised depression attitude questionnaire (R-DAQ)) measured pre and post training as well as six months after training. RESULTS: Trainees were 198 PHCWs (94.4% female), who routinely provide MCH services in 28 selected primary care clinics and had between 6- and 34-years’ experience. Training was provided by 11 trained trainers who were general physicians or senior nurses. Training sessions were rated high in fidelity and on training style. Sessions were rated excellent by 77.8% of the trainees with the trainers described as knowledgeable, effective and engaging. Knowledge of depression mean score improved from a pre-training level of 12.3 ± 3.5 to 15.4 ± 3.7, immediately post-training and 14.7 ± 3.2, six months post-training (both comparisons: p < 0.001). The proportion of PHCW workers endorsing statements indicative of positive attitudes on the professional confidence and the generalist perspective modules of the R-DAQ also increased with training. CONCLUSION: Our findings suggest that cascade training can be an effective model for rapidly providing training and upskilling frontline PHCWs to deliver care for women with perinatal depression in resource limited settings. TRIAL REGISTRATION: This study was retrospectively registered 03 December 2019. 10.1186/ISRCTN 94,230,307. BioMed Central 2023-11-20 /pmc/articles/PMC10658820/ /pubmed/37986025 http://dx.doi.org/10.1186/s13033-023-00607-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Oladeji, Bibilola D.
Ayinde, Olatunde O.
Bello, Toyin
Kola, Lola
Faregh, Neda
Abdulmalik, Jibril
Zelkowitz, Phyllis
Seedat, Soraya
Gureje, Oye
Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title_full Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title_fullStr Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title_full_unstemmed Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title_short Cascade training for scaling up care for perinatal depression in primary care in Nigeria
title_sort cascade training for scaling up care for perinatal depression in primary care in nigeria
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658820/
https://www.ncbi.nlm.nih.gov/pubmed/37986025
http://dx.doi.org/10.1186/s13033-023-00607-5
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