Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation
Background: Task-sharing is the redistribution of tasks usually performed by specialists, to staff with less training and fewer qualifications. Despite the established clinical efficacy of task-shared brief psychological interventions in low and middle-income countries, training and supervision mode...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-12-01
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| Series: | SSM - Mental Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666560325001045 |
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| author | Roxanne C Keynejad Adiyam Mulushoa Tesera Bitew Louise M. Howard Charlotte Hanlon Sharon Markless |
| author_facet | Roxanne C Keynejad Adiyam Mulushoa Tesera Bitew Louise M. Howard Charlotte Hanlon Sharon Markless |
| author_sort | Roxanne C Keynejad |
| collection | DOAJ |
| description | Background: Task-sharing is the redistribution of tasks usually performed by specialists, to staff with less training and fewer qualifications. Despite the established clinical efficacy of task-shared brief psychological interventions in low and middle-income countries, training and supervision models are infrequently reported and rarely evaluated. Methods: From the interpretive paradigm, we conducted a developmental evaluation of training, supervision, and task-sharing of antenatal care providers (ANCPs) to deliver problem-solving therapy for antenatal depression in rural Ethiopia. We triangulated 18 qualitative interviews with women intervention recipients, ANCPs, mental health specialist trainer/supervisors and research staff, with documentary data. We employed reflexive thematic analysis before ‘peer review’ of our interpretations by a female Ethiopian research assistant. Findings: Four over-arching themes encompassed the developmental journey, impacts, factors influencing success, and improvements. The complex adaptive healthcare system exerted unforeseen effects on the iterative development of training, supervisory and task-sharing plans. High quality communication skills (‘common elements’) training was most valued by ANCPs, while women especially appreciated psychological intervention ‘specific elements.’ An apprenticeship cascade model could balance the need for frequent, in-person specialist supervision against logistical barriers to travel from the capital. Fostering peer ‘communities of practice’ could support ANCPs' well-being and enhance their continued professional development. Conclusions: This study contributes to sparse literature evaluating task-sharing training and supervisory approaches in resource-restricted settings, from an interpretive paradigm. Developmental evaluation proved a flexible methodological approach for exploring perspectives of stakeholders occupying diverse roles. We demonstrate the importance of embedding in-depth pedagogical consideration and qualitative evaluation into trials which depend on high quality clinical education. |
| format | Article |
| id | doaj-art-d8e8ae6d3b244c9a8eb16a579ff2126e |
| institution | DOAJ |
| issn | 2666-5603 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Mental Health |
| spelling | doaj-art-d8e8ae6d3b244c9a8eb16a579ff2126e2025-08-20T03:13:32ZengElsevierSSM - Mental Health2666-56032025-12-01810049210.1016/j.ssmmh.2025.100492Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluationRoxanne C Keynejad0Adiyam Mulushoa1Tesera Bitew2Louise M. Howard3Charlotte Hanlon4Sharon Markless5King's Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Corresponding author.Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, EthiopiaDepartment of Psychology, Institute of Educational and Behavioural Sciences, Injibara University, Injibara, EthiopiaKing's Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United KingdomCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United KingdomCentre for Education, Faculty of Life Sciences & Medicine, King's College London, London, United KingdomBackground: Task-sharing is the redistribution of tasks usually performed by specialists, to staff with less training and fewer qualifications. Despite the established clinical efficacy of task-shared brief psychological interventions in low and middle-income countries, training and supervision models are infrequently reported and rarely evaluated. Methods: From the interpretive paradigm, we conducted a developmental evaluation of training, supervision, and task-sharing of antenatal care providers (ANCPs) to deliver problem-solving therapy for antenatal depression in rural Ethiopia. We triangulated 18 qualitative interviews with women intervention recipients, ANCPs, mental health specialist trainer/supervisors and research staff, with documentary data. We employed reflexive thematic analysis before ‘peer review’ of our interpretations by a female Ethiopian research assistant. Findings: Four over-arching themes encompassed the developmental journey, impacts, factors influencing success, and improvements. The complex adaptive healthcare system exerted unforeseen effects on the iterative development of training, supervisory and task-sharing plans. High quality communication skills (‘common elements’) training was most valued by ANCPs, while women especially appreciated psychological intervention ‘specific elements.’ An apprenticeship cascade model could balance the need for frequent, in-person specialist supervision against logistical barriers to travel from the capital. Fostering peer ‘communities of practice’ could support ANCPs' well-being and enhance their continued professional development. Conclusions: This study contributes to sparse literature evaluating task-sharing training and supervisory approaches in resource-restricted settings, from an interpretive paradigm. Developmental evaluation proved a flexible methodological approach for exploring perspectives of stakeholders occupying diverse roles. We demonstrate the importance of embedding in-depth pedagogical consideration and qualitative evaluation into trials which depend on high quality clinical education.http://www.sciencedirect.com/science/article/pii/S2666560325001045 |
| spellingShingle | Roxanne C Keynejad Adiyam Mulushoa Tesera Bitew Louise M. Howard Charlotte Hanlon Sharon Markless Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation SSM - Mental Health |
| title | Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation |
| title_full | Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation |
| title_fullStr | Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation |
| title_full_unstemmed | Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation |
| title_short | Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia: a developmental evaluation |
| title_sort | training antenatal care providers to deliver brief problem solving therapy in rural ethiopia a developmental evaluation |
| url | http://www.sciencedirect.com/science/article/pii/S2666560325001045 |
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