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Table 1 Summary of psychological interventions delivered by Lay Health Workers in Africa

From: Cultural adaptation of psychological interventions for people with mental disorders delivered by lay health workers in Africa: scoping review and expert consultation

Authors Country Setting Objective of study Intervention Type of study Sample size Results/outcome
Petersen et al. 2011 South Africa Rural To assess the feasibility of the adapted IPT intervention for women with depressive symptoms that could be delivered by trained lay health workers within a task shifting approach Grouped-based interpersonal therapy Non-randomized, intervention 42 people: 20 intervention; 22 control Decrease of mean beck depression inventory at 12- and 24-weeks post intervention
Bolton et al. 2007 Uganda Rural To assess effect of locally feasible interventions on depression, anxiety, and conduct problem symptoms among adolescent survivors of war and displace- ment in northern Uganda Group interpersonal therapy Randomized clinical trial 314 adolescents: 105 randomized to receive creative play; 105 randomized to receive Group IPT and 104 randomized to control group Substantially and significantly greater decline in the depression symptom scale among the IPT group compared to wait-list control group. Difference in change in adjusted mean score for depression symptoms between group interpersonal psychotherapy and control groups was 9.79 points [95% confidence interval (CI), 1.66–17.93]. This substantial and significant improvement in depression symptoms (12.61 points; 95% CI 2.09–23.14) were found in girls but not in boys receiving group interpersonal psychotherapy
Verena et al. 2011 Uganda Rural To assess the efficacy of a community-based intervention targeting symptoms of posttraumatic stress disorder (PTSD) in formerly abducted individuals Narrative exposure therapy Randomized controlled trial 85 male and female former children soldier (from 12 to 25 years old) with positive screening result for PTSD PTSD symptom severity (range: 0–148) was significantly more improved in the narrative exposure therapy group than in the academic catch-up [mean change difference, − 14.06 (95% confidence interval, − 27.19 to − 0.92)] and waiting-list [mean change difference, − 13.04 (95% confidence interval, − 26.79 to 0.72)] groups. Narrative exposure therapy produced a larger within-treatment effect size (Cohen d = 1.80) than academic catch-up (d = 0.83) and wait-listing (d = 0.81)
Chibanda et al. 2011 Zimbabwe Suburban to gather preliminary data on the effectiveness of this intervention and to see if the intervention would be feasible, and if so to gather ideas about how best to implement it on a larger scale Brief individual talking therapy based on problem-solving therapy Non-randomized, intervention 320 people After receiving between 3 and 6 sessions the mean score of the SSQ (Shona Symptom Questionnaire) dropped by 4.8 points to 6.5 (sd = 2.4) [t = 13.6 (p = 0.0087)]
Murray et al. 2013 Zambia Urban and peri-urban areas to evaluate the feasibility of implementing TF-CBT and the changes in trauma-related symptoms with OVC Trauma focused-cognitive behaviour therapy Cohort study- prospective 58 The average PTSD score after treatment (27.6) was significantly lower than the average pre-treatment score (67.7, p < 0.0001). The effect was similar among males and females. Significant reductions in severity of shame symptoms (p < 0.0001)
Petersen et al. 2014 South Africa peri-urban to evaluate the potential effectiveness of an adapted group-based HIV counsellor delivered intervention for treating depression in people living with HIV/AIDS Group-based counseling intervention for depressed co-morbid HIV patient (adapted from group-based IPT) Randomized controlled pilot study 76 Significantly great improvement on depression scores on the PHQ9 in the intervention group compared to the control group at 3-month follow-up (mean difference score of 8.53 in the intervention group compared to mean difference score of 4.12 in the control group at follow-up) [F (1, 32) = 23.88, p < 0.0001]. at post-test, a significant decline in the mean scores on the HSCL-25 (Hopkins Symptoms Checklist) was found for both groups (1.97 and 2.13 for the two groups), [F(1, 32) = 17.48, p < 0.0001]
Chibanda et al. 2016 Zimbabwe Urban To evaluate the effectiveness of a culturally adapted psychological intervention for common mental disorders delivered by LHWs in primary care Problem solving therapy Randomized clinical trials 573 randomized patients. Woman- 495; 521 completed follow-up at 6 months Intervention group participants had fewer symptoms than control group participants on Shona Symptoms Questionnaire (SSQ-14) (3.81; 95% CI 3.28 to 4.34; 95% CI 8.33 to 9.47; adjusted mean difference, − 4.86; 95% CI − 5.63 to − 4.10; p < 0.001; adjusted risk ratio, 0.21; 95% CI 0.15 to 0.29; p < 0.001).intervention group participants also had lower risk of symptoms of depression (13.7%; ARR, 0.28; 95% CI 0.22 to 0.34; p < 0.001)
Bolton et al. 2003 Uganda Rural To test the efficacy of group interpersonal psychotherapy in alleviating depression and dysfunction and to evaluate the feasibility of conducting controlled trials in Africa Group IPT Randomized controlled trial 248 persons. 108 males and 116 females. Refuse 9, others died decline in depression scores was substantially greater among the intervention groups. Mean changes were 17.47 and 3.55 for the intervention and control groups, respectively (11.59 and 2.38). Within the intervention groups, the mean change among men was 14.43 (95% CI 12.32–16.55) compared with 20.46 (95% CI 18.09–22.84) among women
Bass et al. 2006 Uganda Rural To assess the long-term effectiveness of Interpersonal Psychotherapy this over a subsequent 6-month period Group IPT Randomized controlled trial 216 The overall mean functions impairment score was about 4 points lower in the intervention group compared with control group 2 weeks after the intervention and about 5 points 6 months after the intervention (p < 0.0001)
Munetsi et al. 2018 Zimbabwe Urban To determine whether problem solving therapy delivered by lay health workers can reduce common mental disorder symptoms among people with suicidal ideation, Problem solving therapy for suicide ideation Quasi-experimental study 573 persons At 6-months severity of common mental disorder symptoms were significantly less among participants whom received LHW Friendship Bench care than among control group. The adjusted mean difference in SSQ-14 score participants with suicidal ideation was-5.38 (95% CI − 7.85, − 2.90; p < 0.001) and among those with common mental disorder symptoms but no suicidal ideation the adjusted mean difference was -4.86 (95% CI − 5.86, -4.04; p < 0.001)
  1. IPT, interpersonal therapy; CHW, Community Health Workers; TF-CBT, trauma-focused cognitive behavior therapy; OVC, orphans and vulnerable childrens