Attitudes to depression among community health workers in Kenya

Njenga, Frank; Shah, Ajit; Okonji, Max; Ayuyo, James; Baraza, Makheti; Parker, Elizabeth M.; Jenkins, Rachel

doi:10.1017/s1121189x00000336

Cited by 9 publications

(10 citation statements)

References 11 publications

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“…This was further buttressed by the observation that less than half of GPs believed that working with depressed individuals was a rewarding experience. A similar scenario was reported among health workers in Kenya 13 and GPs in Brazil. 10 In future, training programs for GPs on depression care in developing countries should place emphasis on the acquisition of basic psychotherapeutic skills such as counselling and cognitive behavioural therapy that have shown proven benefit, especially in mild to moderate depression.…”

Section: Discussionsupporting

confidence: 82%

“…29 GPs held moderately stigmatising attitudes towards depression. This is in contrast with a survey from southwest Nigeria where doctors exhibited a high degree of stigmatising attitudes towards the mentally ill. 13 In addition, over half of GPs believed that depression was a condition amenable to change. Medical practitioners may hold dual views about the behavioural tendencies and prognoses of individuals with psychotic illness on the one hand and depression on the other.…”

Section: Discussionmentioning

confidence: 99%

“…The DAQ was first used in the United Kingdom 18 and has since been used in other developed and developing countries. 8,10,12,13 Research suggests that the DAQ may prove to be a useful instrument to guide educational efforts and measure change over time. The DAQ was slightly modified to adapt it to this environment and improve the clarity of the statements.…”

Section: Instrumentmentioning

confidence: 99%

“…11 In Kenya and Tanzania, the attitudes of primary health workers towards depression was recently surveyed and showed that though they held high levels of knowledge, they perceived working with depressed patients as difficult. 12,13 Abstract Background: Depression contributes significantly to the global burden of disease in developing countries. Poor case detection and inadequate numbers of mental health staff have been associated with increased morbidity among individuals with depression presenting to primary care.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Depression in primary care: the knowledge, attitudes and practice of general practitioners in Benin City, Nigeria

James

Jenkins

Lawani

et al. 2012

South African Family Practice

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Instrumentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Depression in primary care: the knowledge, attitudes and practice of general practitioners in Benin City, Nigeria

James

Jenkins

Lawani

et al. 2012

South African Family Practice

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“…This previous work includes: a detailed situation appraisal of context, needs, resources, provision and outcomes using the mental health country profile [8]; a household survey exploring the conceptual model underlying the views of the general population about mental illness [9]; a focus group study of 60 traditional healers in Maseno District exploring their views of mental illness, aetiology and treatment [10]; a national survey of views of district level staff about mental illness [11]; studies in Tanzania and Kenya of attitudes of primary care staff about mental illness [12,13]; epidemiological surveys of mental disorders in two samples of 1000 people in urban Dar es Salaam, Tanzania [14-16], and in Maseno, a town in a rural district near Kisumu [17,18]; and adaptation of the World Health Organization primary care guidelines for Kenya and Tanzania.…”

Section: Introductionmentioning

confidence: 99%

Perspectives and concerns of clients at primary health care facilities involved in evaluation of a national mental health training programme for primary care in Kenya

Othieno

Jenkins

Okeyo

et al. 2013

Int J Ment Health Syst

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BackgroundA cluster randomised controlled trial (RCT) of a national Kenyan mental health primary care training programme demonstrated a significant impact on the health, disability and quality of life of clients, despite a severe shortage of medicines in the clinics (Jenkins et al. Submitted 2012). As focus group methodology has been found to be a useful method of obtaining a detailed understanding of client and health worker perspectives within health systems (Sharfritz and Roberts. Health Transit Rev 4:81–85, 1994), the experiences of the participating clients were explored through qualitative focus group discussions in order to better understand the potential reasons for the improved outcomes in the intervention group.MethodsTwo ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 10 clients from the intervention group clinics where staff had received the training programme, and 10 clients from the control group where staff had not received the training during the earlier randomised controlled trial.ResultsThese focus group discussions suggest that the clients in the intervention group noticed and appreciated enhanced communication, diagnostic and counselling skills in their respective health workers, whereas clients in the control group were aware of the lack of these skills. Confidentiality emerged from the discussions as a significant client concern in relation to the volunteer cadre of community health workers, whose only training comes from their respective primary care health workers.ConclusionEnhanced health worker skills conferred by the mental health training programme may be responsible for the significant improvement in outcomes for clients in the intervention clinics found in the randomised controlled trial, despite the general shortage of medicines and other health system weaknesses. These findings suggest that strengthening mental health training for primary care staff is worthwhile even where health systems are not strong and where the medicine supply cannot be guaranteed.Trial registrationISRCTN 53515024.

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The State of Readiness of Lagos State Primary Health Care Physicians to Embrace the Care of Depression in Nigeria

Ola

Crabb²,

Adewuya

et al. 2013

Community Ment Health J

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Globally there is a huge treatment gap for common mental disorders such as depression. Key to improving access to treatment will be the attitudes held towards depression by those physicians who work in Primary Care. This study aimed to explore Lagos State's Primary Care Physicians' attitudes towards depression and their views regarding their current working practices. A survey of 41 (82%) Primary Care Physicians in Lagos State who, after written consent, completed the Depression Attitude Questionnaire which assessed their knowledge and attitude towards the causes, consequences and treatment of depression. The largest part of the sample (37.5%) estimated that between 5 and 10% of the patients they saw over a 3 months period would have depression while one in four perceived rates of depression seen to be between 31 and 40%. Close to half (40%) of them felt that fewer than 5% of these depressed patients they saw would need antidepressants and a large part (82.9 %) of them agreed that becoming depressed is a way that people with poor stamina deal with life difficulties. About half (41.6%) of them believed it was not rewarding to look after depressed patients. Our study suggests that the current knowledge, attitudes and practices of most Lagos State primary health care physicians may be a barrier to patients with depression accessing appropriate care.

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Attitudes to depression among community health workers in Kenya

Cited by 9 publications

References 11 publications

Depression in primary care: the knowledge, attitudes and practice of general practitioners in Benin City, Nigeria

Depression in primary care: the knowledge, attitudes and practice of general practitioners in Benin City, Nigeria

Perspectives and concerns of clients at primary health care facilities involved in evaluation of a national mental health training programme for primary care in Kenya

The State of Readiness of Lagos State Primary Health Care Physicians to Embrace the Care of Depression in Nigeria

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