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Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa : study protocol for a randomized controlled trial

dc.contributor.authorLund, Cricken_ZA
dc.contributor.authorSchneider, Margueriteen_ZA
dc.contributor.authorDavies, Thandien_ZA
dc.contributor.authorNyatsanza, Memoryen_ZA
dc.contributor.authorHonikman, Simoneen_ZA
dc.contributor.authorBhana, Arvinen_ZA
dc.contributor.authorBass, Judithen_ZA
dc.contributor.authorBolton, Paulen_ZA
dc.contributor.authorDewey, Michaelen_ZA
dc.contributor.authorJoska, Johnen_ZA
dc.contributor.authorKagee, Ashrafen_ZA
dc.contributor.authorMyer, Landonen_ZA
dc.contributor.authorPetersen, Ingeen_ZA
dc.contributor.authorPrince, Martinen_ZA
dc.contributor.authorStein, Dan J.en_ZA
dc.contributor.authorThornicroft, Grahamen_ZA
dc.contributor.authorTomlinson, Marken_ZA
dc.contributor.authorAlem, Atalayen_ZA
dc.contributor.authorSusser, Ezraen_ZA
dc.date.accessioned2015-07-24T07:00:45Z
dc.date.available2015-07-24T07:00:45Z
dc.date.issued2014-11
dc.identifier.citationLund, C. et al. 2014. Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. Trials, 15:457 doi:10.1186/1745-6215-15-457.en_ZA
dc.identifier.issn1745-6215 (online)
dc.identifier.otherdoi:10.1186/1745-6215-15-457
dc.identifier.urihttp://hdl.handle.net/10019.1/97261
dc.descriptionCITATION: Lund, C. et al. 2014. Task sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa: study protocol for a randomized controlled trial. Trials, 15:457 doi:10.1186/1745-6215-15-457.en_ZA
dc.descriptionThe original article is available at http://www.trialsjournal.com/content/15/1/457en_ZA
dc.description.abstractBackground: Maternal depression carries a major public health burden for mothers and their infants, yet there is a substantial treatment gap for this condition in low-resourced regions such as sub-Saharan Africa. To address this treatment gap, the strategy of “task sharing” has been proposed, involving the delivery of interventions by non-specialist health workers trained and supervised by specialists in routine healthcare delivery systems. Several psychological interventions have shown benefit in treating maternal depression, but few have been rigorously evaluated using a task sharing approach. The proposed trial will be the first randomised controlled trial (RCT) evaluating a task sharing model of delivering care for women with maternal depression in sub-Saharan Africa. The objective of this RCT is to determine the effectiveness and cost-effectiveness of a task sharing counseling intervention for maternal depression in South Africa. Methods/Design: The study is an individual-level two-arm RCT. A total of 420 depressed pregnant women will be recruited from two ante-natal clinics in a low-income township area of Cape Town, using the Edinburgh Postnatal Depression Scale to screen for depression; 210 women will be randomly allocated to each of the intervention and control arms. The intervention group will be given six sessions of basic counseling over a period of 3 to 4 months, provided by trained community health workers (CHW)s. The control group will receive three monthly phone calls from a CHW trained to conduct phone calls but not basic counseling. The primary outcome measure is the 17-Item Hamilton Depression Rating Scale (HDRS-17). The outcome measures will be applied at the baseline assessment, and at three follow-up points: 1 month before delivery, and 3 and 12 months after delivery. The primary analysis will be by intention-to-treat and secondary analyses will be on a per protocol population. The primary outcome measure will be analyzed using linear regression adjusting for baseline symptom severity measured using the HDRS-17. Discussion: The findings of this trial can provide policy makers with evidence regarding the effectiveness and cost-effectiveness of structured psychological interventions for maternal depression delivered by appropriately trained and supervised non-specialist CHWs in sub-Saharan Africa. Trial registration: Clinical Trials: (ClinicalTrials.gov): NCT01977326, registered on 24/10/2013; Pan African Clinical Trials Registry (http://www.pactr.org): PACTR201403000676264, registered on 11/10/2013.en_ZA
dc.publisherBioMed Centralen_ZA
dc.subjectMaternal health services -- Africa, Sub-Saharanen_ZA
dc.subjectDepression in women -- Treatmenten_ZA
dc.subjectHealth care teamsen_ZA
dc.titleTask sharing of a psychological intervention for maternal depression in Khayelitsha, South Africa : study protocol for a randomized controlled trialen_ZA
dc.typeArticleen_ZA
dc.date.updated2014-12-05T16:04:32Z
dc.description.versionPublishers' versionen_ZA
dc.language.rfc3066en
dc.rights.holderCrick Lund et al.; licensee BioMed Central Ltd.


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