scholarly journals Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne
Keyword(s):  
Mental Health ◽  
Postpartum Depression ◽  
Focus Groups ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Academic Community ◽  
Barriers And Facilitators ◽  
Postpartum Women

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

scholarly journals Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Acute Malnutrition ◽  
Control Group ◽  
Supportive Supervision ◽  
Supervision Group ◽  
Different Levels

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

scholarly journals Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan

2021 ◽  
Vol 12 ◽  
Author(s):  
Shamaila Mohsin ◽  
Najia Atif ◽  
Waqas Rabbani ◽  
Ahmaren Tariq ◽  
Shahzad Ali Khan ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Maternal Depression ◽  
Community Health ◽  
Community Health Workers ◽  
Cultural Adaptation ◽  
Health Workers ◽  
Primary Care Providers ◽  
Detection Tool ◽  
Health Experts

Background: Evidence indicates that mental health issues like depression, epilepsy, and substance misuse can be detected with reasonable accuracy in resource-poor settings. The Community Informant Detection Tool (CIDT) is one such approach used for detecting mental health problems, including depression. We adapted this community informant approach for detecting maternal depression in Pakistan.Methods: Adaptation of Community Informant Detection Tool for Maternal Depression (CIDT-MD) involved five steps. First, a scoping review of the literature was conducted to select an appropriate tool for adaptation. Second, in-depth interviews were conducted to explore the idioms of depression and distress, perceived causes, and the effects of maternal depression among currently depressed and recovered mothers (n = 11), mothers in law (n = 6), and Primary Care Providers (Primary Care Physicians and Lady Health Supervisors) (n = 6). Third, case vignettes and illustrations were created with input from a panel of mental health experts, incorporating the idioms of depression and distress used, causes, and effects for each symptom described. Fourth, to assess the comprehensibility of the illustrations and level of understanding, Focus Group Discussions (n = 4) were done with purposely selected community health workers (Lady Health Workers and Lay Peers, n = 28) trained in delivering maternal depression intervention. The final step was reflection and inputs by a panel of mental health experts on all steps to finalize the content of the tool.Results: Context-specific cultural adaptation in the presentation and format of CIDT-MD was conducted successfully. Lady Health Workers (LHW) and Lay Peers (LP) were found to be the most appropriate persons to use the tool and function as the informants. The adapted tool with all its vignettes and illustrations was found to be easily understandable, comprehensible, and culturally appropriate, meaningful, and contextually relevant by the community health workers and peers working in the relevant settings. They easily relate to and identify potentially depressed such women lining up with the tool. Lastly, the coding of the tool was found easy to follow as well.Conclusion: The Community Informant Detection Tool for Maternal Depression (CIDT-MD) is a culturally acceptable, easy to use, and comprehensible tool for detecting maternal depression in community settings of Pakistan. The community informants found the content and approach highly relevant to the local needs.

scholarly journals Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e021467 ◽  
Author(s):  
James O’Donovan ◽  
Charles O’Donovan ◽  
Isla Kuhn ◽  
Sonia Ehrlich Sachs ◽  
Niall Winters
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Review Of The Literature ◽  
Ongoing Training

scholarly journals Postpartum Depression: Prevention strategies in South East Asia and its possibility of replication in Nepal

2019 ◽  
Vol 14 (1) ◽  
pp. 6-18
Author(s):  
Manisha Singh ◽  
Ishwar Tiwari ◽  
Dinesh Bhandari ◽  
Basanta Katwal
Keyword(s):  
Postpartum Depression ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Positive Impact ◽  
Maternal Mental Health ◽  
Post Partum ◽  
East Asian ◽  
Asian Countries ◽  
Depression Prevention

Aims: To identify existing interventions in South East Asian countries implemented to prevent postpartum depression (PPD) and explore the possibility of replication of such interventions in Nepal to reduce it. Methods: The paper reviewed the risk factors and preventive strategies implemented in South East Asian countries to prevent PPD. Results: Enough actions have not been taken to address PPD despite of high prevalence in the reviewed countries (Bangladesh, India, Pakistan, Srilanka and Nepal). However, some of the interventions used such as cognitive behavior therapy, education for girls, poverty alleviation program, participatory approach for empowerment and involvement of community health workers have shown positive impact on reducing PPD. Conclusions: The interventions used in South East Asian countries were simple in design intervention and mostly conducted through community health workers; it showed a possibility of replication in Nepal as it already has sufficient community workforces working in maternal and child health.   Keywords: interventions, maternal depression, maternal mental health, post–partum depression, prevention, south asia, strategies

scholarly journals Strategies Used By Community Health Workers to Influence Adoption of Maternal Nutrition Behaviors in Rural Bangladesh: A Focused Ethnographic Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1359-1359
Author(s):  
Gargi Wable Grandner ◽  
Katherine Dickin ◽  
Purnima Menon ◽  
Tiffany Yeh ◽  
John Hoddinott
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Ethnographic Study ◽  
Low Income Countries ◽  
Cultural Congruence ◽  
Healthy Tree ◽  
Diet Diversity

Abstract Objectives Efforts to integrate nutrition into antenatal health promotion in low income countries have led to increased involvement of community health workers (CHWs) in counseling on maternal nutrition. Little is known about how CHWs “package” messages in resource-poor communities to increase adoption of recommended maternal nutrition behaviors. We developed focused ethnographic techniques to explore this. Methods We interviewed 35 randomly selected CHWs providing monthly counseling to pregnant women and their families in 7 ‘Alive & Thrive’ intervention sites in Bangladesh. Two sorting exercises explored CHW strategies for promoting and perceptions of adoption of messages on micronutrient supplements, maternal dietary adequacy, and rest during pregnancy. In-depth probing on messages identified as “difficult” to deliver or adopt revealed how CHWs addressed barriers. Analysis of quantitative sorting data complemented thematic coding of qualitative textual data using grounded theory. Results CHW communication strategies involved 3 themes: feasibility (attitudes, norms, agency, poverty), audience (influence, motivators, support), and linguistic choice (emotional appeals, metaphors, logic, sellable but inaccurate arguments). CHWs viewed micronutrient messages as least difficult to adopt, requiring minimal “packaging”. Dietary messages were moderately difficult to adopt, prompting CHWs to leverage cultural congruence to target family members with different strategies. For example, messaging on diet diversity targeted husbands—the primary food-buyers—with logical arguments highlighting costs of inaction. When mothers-in-law held beliefs restricting gestational food intake, CHWs used metaphors (‘healthy tree, healthy fruit’) or faith-based appeals. Some CHWs used inaccurate messages (‘mother rests, baby rests’) to promote rest during pregnancy because it was seen as the least feasible behavior to adopt. Conclusions Where behavior change is viewed as feasible, CHWs use culturally resonant strategies to enhance adoption of maternal nutrition behaviors. Cultural congruence, or shared beliefs, language and cultural identity, is key to CHW effectiveness, but unhelpful for contextually infeasible behaviors. BCC programs co-designed with CHWs could improve messaging and effectiveness. Funding Sources Cornell AWARE Travel Grant.

Assessing community health workers’ conditions for delivering care to patients in low-income communities

2020 ◽  
Vol 82 ◽  
pp. 102944 ◽  
Author(s):  
Alessandro Jatobá ◽  
Hugo Cesar Bellas ◽  
Bárbara Bulhões ◽  
Isabella Koster ◽  
Rodrigo Arcuri ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers
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