A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya

E. van 't Hof, K.D. Dawson, Alison Schafer, Anna Chiumento, Melissa Harper Shehadeh, Marit Sijbrandij, Richard A. Bryant, Dorothy Anjuri, Lincoln Ndogoni, Phiona Koyiet, Jeannette Ulate, Mark van Ommeren

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background:
Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials in
Kenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya.
Methods:
Qualitative interviews were conducted with 27 key informants from peri-urban Nairobi, Kenya, where PM+ was tested. Interview participants included six women who completed PM+, six community health volunteers (CHVs) who delivered the intervention, seven people with local decision making power, and eight project staff involved in the PM+ trial.
Results:
Key informants generally noted positive experiences with PM+. Participants and CHVs reported the positive impact PM+ had made on their lives. Nonetheless, potential structural and psychological barriers to scale up were identified. The sustainability of CHVs as unsalaried, volunteer providers was mentioned by most interviewees as the main barrier to scaling up the intervention.
Conclusions:
The findings across diverse stakeholders show that PM+ is largely acceptable in this Kenyan setting. The results indicated that when further implemented, PM+ could be of great value to people in communities exposed to adversities such as interpersonal violence and chronic poverty. Barriers to large-scale implementation were identified, of which the sustainability of the non-specialist health workforce was the most important one.
Original languageEnglish
Article numbere6
Number of pages12
JournalGlobal Mental Health
Volume5
DOIs
Publication statusPublished - 6 Feb 2018

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Kenya
Women's Health
Volunteers
Health
Interviews
Health Manpower
Pakistan
Poverty
Violence
Decision Making
Randomized Controlled Trials
Psychology

Cite this

van 't Hof, E. ; Dawson, K.D. ; Schafer, Alison ; Chiumento, Anna ; Harper Shehadeh, Melissa ; Sijbrandij, Marit ; Bryant, Richard A. ; Anjuri, Dorothy ; Ndogoni, Lincoln ; Koyiet, Phiona ; Ulate, Jeannette ; van Ommeren, Mark. / A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya. In: Global Mental Health. 2018 ; Vol. 5.
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title = "A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya",
abstract = "Background:Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials inKenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya.Methods:Qualitative interviews were conducted with 27 key informants from peri-urban Nairobi, Kenya, where PM+ was tested. Interview participants included six women who completed PM+, six community health volunteers (CHVs) who delivered the intervention, seven people with local decision making power, and eight project staff involved in the PM+ trial.Results:Key informants generally noted positive experiences with PM+. Participants and CHVs reported the positive impact PM+ had made on their lives. Nonetheless, potential structural and psychological barriers to scale up were identified. The sustainability of CHVs as unsalaried, volunteer providers was mentioned by most interviewees as the main barrier to scaling up the intervention.Conclusions:The findings across diverse stakeholders show that PM+ is largely acceptable in this Kenyan setting. The results indicated that when further implemented, PM+ could be of great value to people in communities exposed to adversities such as interpersonal violence and chronic poverty. Barriers to large-scale implementation were identified, of which the sustainability of the non-specialist health workforce was the most important one.",
author = "{van 't Hof}, E. and K.D. Dawson and Alison Schafer and Anna Chiumento and {Harper Shehadeh}, Melissa and Marit Sijbrandij and Bryant, {Richard A.} and Dorothy Anjuri and Lincoln Ndogoni and Phiona Koyiet and Jeannette Ulate and {van Ommeren}, Mark",
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van 't Hof, E, Dawson, KD, Schafer, A, Chiumento, A, Harper Shehadeh, M, Sijbrandij, M, Bryant, RA, Anjuri, D, Ndogoni, L, Koyiet, P, Ulate, J & van Ommeren, M 2018, 'A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya' Global Mental Health, vol. 5, e6. https://doi.org/10.1017/gmh.2017.26

A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya. / van 't Hof, E.; Dawson, K.D.; Schafer, Alison; Chiumento, Anna; Harper Shehadeh, Melissa; Sijbrandij, Marit; Bryant, Richard A.; Anjuri, Dorothy; Ndogoni, Lincoln; Koyiet, Phiona; Ulate, Jeannette; van Ommeren, Mark.

In: Global Mental Health, Vol. 5, e6, 06.02.2018.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya

AU - van 't Hof, E.

AU - Dawson, K.D.

AU - Schafer, Alison

AU - Chiumento, Anna

AU - Harper Shehadeh, Melissa

AU - Sijbrandij, Marit

AU - Bryant, Richard A.

AU - Anjuri, Dorothy

AU - Ndogoni, Lincoln

AU - Koyiet, Phiona

AU - Ulate, Jeannette

AU - van Ommeren, Mark

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N2 - Background:Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials inKenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya.Methods:Qualitative interviews were conducted with 27 key informants from peri-urban Nairobi, Kenya, where PM+ was tested. Interview participants included six women who completed PM+, six community health volunteers (CHVs) who delivered the intervention, seven people with local decision making power, and eight project staff involved in the PM+ trial.Results:Key informants generally noted positive experiences with PM+. Participants and CHVs reported the positive impact PM+ had made on their lives. Nonetheless, potential structural and psychological barriers to scale up were identified. The sustainability of CHVs as unsalaried, volunteer providers was mentioned by most interviewees as the main barrier to scaling up the intervention.Conclusions:The findings across diverse stakeholders show that PM+ is largely acceptable in this Kenyan setting. The results indicated that when further implemented, PM+ could be of great value to people in communities exposed to adversities such as interpersonal violence and chronic poverty. Barriers to large-scale implementation were identified, of which the sustainability of the non-specialist health workforce was the most important one.

AB - Background:Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials inKenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya.Methods:Qualitative interviews were conducted with 27 key informants from peri-urban Nairobi, Kenya, where PM+ was tested. Interview participants included six women who completed PM+, six community health volunteers (CHVs) who delivered the intervention, seven people with local decision making power, and eight project staff involved in the PM+ trial.Results:Key informants generally noted positive experiences with PM+. Participants and CHVs reported the positive impact PM+ had made on their lives. Nonetheless, potential structural and psychological barriers to scale up were identified. The sustainability of CHVs as unsalaried, volunteer providers was mentioned by most interviewees as the main barrier to scaling up the intervention.Conclusions:The findings across diverse stakeholders show that PM+ is largely acceptable in this Kenyan setting. The results indicated that when further implemented, PM+ could be of great value to people in communities exposed to adversities such as interpersonal violence and chronic poverty. Barriers to large-scale implementation were identified, of which the sustainability of the non-specialist health workforce was the most important one.

U2 - 10.1017/gmh.2017.26

DO - 10.1017/gmh.2017.26

M3 - Article

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JO - Global Mental Health

JF - Global Mental Health

M1 - e6

ER -