Addition of mental health to the lady health worker curriculum in Pakistan: now or never

Rabbani, Fauziah; Akhtar, Samina; Nafis, Javeria; Khan, Shahid; Siddiqi, Sameen; Merali, Zul

doi:10.1186/s12960-023-00814-8

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…However, the current curriculum of lady health workers is missing the mental health curriculum. A commentary on Pakistani context also suggests upskilling lady health workers and bridge the existing mental health gap (Rabbani, 2023).…”

Section: Discussionmentioning

confidence: 99%

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Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

Sarmad,

Shah,

Javaid

et al. 2023

MHGCJ

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Introduction: Mental health challenges remain a pressing issue, underscored by the glaring gap between the elevated demand and the scarce resources. Research has highlighted the effectiveness of integrating mental health services with primary care services, particularly in low-resource settings. Purpose: The objective of this research was to evaluate the perceived implications and feasibility of integrating basic mental health services into an existing community-based family planning initiative in Pakistan. By adopting a community-driven and co-produced methodology, our study not only ensured a deeper resonance with local needs but also paved the way for a sustainable and transformative uptake of mental health services in low-resource settings. This co-produced strategy, anchored in mutual collaboration and shared expertise with the community, promises a more holistic, enduring, and adaptive integration of essential health services within community frameworks.Methodology: This study utilized a qualitative research approach to obtain a comprehensive understanding of the program's feasibility and potential for expansion. Interview tools and guides, tailored to the regional language, were developed by the Research Associate to gather insights from the lady health workers involved in delivering the intervention, as well as from the clients. Overall, our team conducted 24 interviews, of which 9 were with the lady health workers and 15 with clients. The interviews were facilitated by the Research Associate and a Psychologist.Results: Utilizing the socio-ecological model, we thematically analyzed factors at individual, interpersonal, and community levels that support or hinder the integration of mental health services with existing community-based programmes. We also examined the intervention's impact on its users and the healthcare providers.Our analysis underscores the significant potential of integrating mental health services into existing community-based health programmes, such as family planning, in low-resource settings. Predominant themes highlighted women's willingness to use these services, influenced by strong relationships and trust in the lady health workers, ease of access to services, and community support. Identified barriers to integration included prevailing poverty, a preference for direct financial incentives in addition to counseling, confidentiality concerns in tight-knit communities, and the lingering stigma surrounding mental health.Conclusion: Our findings highlight the value of community collaboration in healthcare, particularly in low-resource settings. The co-production approach blends professional guidance with local insights, fostering community ownership and enhancing program sustainability. As the first to merge mental health with family planning in Pakistan, our research suggests that future health initiatives can greatly benefit from community-driven methods, leading to more sustainable and transformative health outcomes.

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Section: Discussionmentioning

confidence: 99%

“…The World Health Organization's emphasis on upskilling frontline health workers finds validation in our study's results. The glaring omission of a mental health curriculum in current training, as highlighted by Rabbani (2023), underscores a crucial opportunity for systemic enhancements.…”

Section: Issn 2612-2138mentioning

confidence: 99%

Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

Sarmad,

Shah,

Javaid

et al. 2023

MHGCJ

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A qualitative study assessing acceptability and appropriateness of a technology-assisted mental health intervention by community frontline workers: mPareshan implementation research in rural Pakistan

Akhtar,

Rabbani,

Nafis

et al. 2024

Preprint

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Background With a shortage of mental health specialists and a significant rural population in Pakistan, leveraging community-based healthcare workers becomes crucial to address mental health needs. Equipping the healthcare workers with digital tools such as mobile applications have the potential to increase access to mental health support in low-resource areas. This study examines the acceptability, appropriateness, barriers, and facilitators to implementing a technology-assisted mental health intervention (mPareshan) delivered by Lady Health Workers (LHWs) in rural Pakistan. Methods This is a qualitative study embedded within a larger implementation research trial assessing the feasibility of an mHealth intervention aimed at improving anxiety and depression. 8 focus group discussions and 18 in-depth interviews were conducted. Perceptions were sought before and after intervention from stakeholders comprising of policymakers, LHWs, Lady Health Supervisors (LHSs), and community participants. Data underwent thematic analysis using the RE-AIM framework. Results Six main themes emerged from the data. All participants had realization of rising burden of mental illnesses and identified key determinants for mental ill-health. Delivery of mental health counselling by LHWs through a technology-assisted intervention was deemed acceptable and appropriate. LHWs were considered capable and trustworthy by the community to deliver a home-based mHealth intervention, given their easy accessibility as residents of the same community. The technology demonstrated potential for easy adoption as these frontline health workers were already familiar with smartphone technology. Some barriers identified during implementation roll-out included heavy workload of LHWs and difficulty in internet connectivity. Use of videos for counselling, and supportive supervision by LHSs emerged as key facilitators for implementation. Conclusion This study highlights that a technology-focused mental health intervention is feasible, acceptable, and appropriate to be implemented by community frontline workers in resource-constrained rural Pakistani settings. The mPareshan intervention can be easily adopted within the LHW-P. Further research should investigate how implementation barriers can be addressed for successful delivery.

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Addition of mental health to the lady health worker curriculum in Pakistan: now or never

Cited by 2 publications

References 15 publications

Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

Exploring the Feasibility of Integrating Mental Health into a Family Planning Program in low-resource settings

A qualitative study assessing acceptability and appropriateness of a technology-assisted mental health intervention by community frontline workers: mPareshan implementation research in rural Pakistan

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