TY - JOUR
T1 - Evaluation of a Depression Intervention in People With HIV and/or TB in Eswatini Primary Care Facilities
T2 - Implications for Southern Africa
AU - Putnis, Nina
AU - Riches, Nick
AU - Nyamayaro, Archibald
AU - Boucher, Darah
AU - King, Rebecca
AU - Walker, Ian F.
AU - Burger, Alett
AU - Southworth, Paul
AU - Mwanjali, Violet
AU - Walley, John
N1 - Publisher Copyright:
© Putnis et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0)
PY - 2023/4
Y1 - 2023/4
N2 - Introduction: Depression associated with chronic illnesses is common in Southern Africa, yet there are major treatment gaps. This study assesses the feasibility and acceptability of the Healthy Activity Program intervention for depression among people with HIV and/or TB. The intervention involves training nonspecialist nurses in depression, including identification, counseling based on behavioral activation theory, and structured referral. Methods: This is a mixed methods evaluation of a pilot counseling service integrated within routine HIV and TB care from 2018 to 2019. Participants included people living with HIV and/or patients with TB in rural Eswatini. Results: A total of 324 people living with HIV and/or TB were screened for depression, with 19% (62/324) screening positive. The median number of sessions attended was 3 (interquartile range: 1-5), with 16/60 (26%) attending the minimum 5 sessions. Qualitative results indicated acceptability, but there were concerns about feasibility. Conclusions: The Healthy Activity Program is a promising option to manage the treatment gap for depression in people with HIV and/or TB. However, task-shifting to nonspecialist health care professionals without increasing staff capacity is a barrier to implementation. Realistic and pragmatic assessments of capacity and workforce are essential.
AB - Introduction: Depression associated with chronic illnesses is common in Southern Africa, yet there are major treatment gaps. This study assesses the feasibility and acceptability of the Healthy Activity Program intervention for depression among people with HIV and/or TB. The intervention involves training nonspecialist nurses in depression, including identification, counseling based on behavioral activation theory, and structured referral. Methods: This is a mixed methods evaluation of a pilot counseling service integrated within routine HIV and TB care from 2018 to 2019. Participants included people living with HIV and/or patients with TB in rural Eswatini. Results: A total of 324 people living with HIV and/or TB were screened for depression, with 19% (62/324) screening positive. The median number of sessions attended was 3 (interquartile range: 1-5), with 16/60 (26%) attending the minimum 5 sessions. Qualitative results indicated acceptability, but there were concerns about feasibility. Conclusions: The Healthy Activity Program is a promising option to manage the treatment gap for depression in people with HIV and/or TB. However, task-shifting to nonspecialist health care professionals without increasing staff capacity is a barrier to implementation. Realistic and pragmatic assessments of capacity and workforce are essential.
UR - https://www.scopus.com/pages/publications/85159237017
U2 - 10.9745/GHSP-D-22-00016
DO - 10.9745/GHSP-D-22-00016
M3 - Article
C2 - 37116919
AN - SCOPUS:85159237017
SN - 2169-575X
VL - 11
JO - Global Health Science and Practice
JF - Global Health Science and Practice
IS - 2
M1 - e2200016
ER -
