Exploring the cultural appropriateness of a psychosocial intervention, the Thinking Healthy Programme-Peer delivered (THPP), for perinatal depression in Lilongwe, Malawi

  • Mwawi Ng’oma Department of Mental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
  • Najia Atif St John of God Hospitaller Services, Lilongwe, Malawi
  • Samantha Meltzer-Brody Department of Psychiatry, University of North Carolina, United States of America
  • Robert C. Stewart Division of Psychiatry, University of Edinburgh, United Kingdom
  • Ellen Chirwa Department of Reproductive Health, Kamuzu University of Health Sciences, Blantyre, Malawi
Keywords: Perinatal depression, adaptation, the Thinking Healthy Programme-Peer Delivered, Psychosocial intervention, Task sharing, Lay volunteers, Low- and Middle-Income Countries

Abstract

Background
Perinatal depression is a common and disabling mental health problem in Malawi and other Low- and middle-income countries. There is evidence for effective psychosocial interventions for perinatal depression, but no such intervention has been developed for use in Malawi. The broad aim of this study was to explore the cultural appropriateness of a psychosocial intervention for perinatal depression called the Thinking Healthy Programme-Peer delivered for adaptation and use in Lilongwe, Malawi.
Methods
A qualitative exploratory design was used. Data were collected through conducting five Focus Group Discussions, involving thirty-eight purposefully selected participants including pregnant women, community volunteers and their supervisors, the Health Surveillance Assistants and maternal health care workers at implementation and policy level following observations of video recorded role plays of the Thinking Healthy Programme-Peer delivered sessions in theatre testing. A content analysis approach was used to analyse data.
Results
Six main themes were generated regarding the appropriateness of the content and delivery of the Thinking Healthy ProgrammePeer delivered intervention, including: 1) Focus of the intervention; 2) Cultural appropriateness of the content; 3) Language used; 4) Context; 5) Provider of the intervention; and 6) Flexibility in the delivery of the intervention. The Thinking Healthy Programme-Peer delivered intervention was deemed appropriate for the target population, though with recommendations to: review illustrations to enhance clarity, use culturally appropriate stories and idioms, use daily spoken language, and adapt the number and duration of sessions to meet the needs of individual clients.
Conclusions
These findings highlight important areas to inform adaptation of the Thinking Healthy Programme-Peer delivered and add to the growing evidence of cultural adaptation of psychosocial interventions for perinatal depression.

Published
2022-07-01
Section
Original Research

Journal Identifiers


eISSN: 1995-7262
print ISSN: 1995-7262