The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation.

Journal: Global mental health (Cambridge, England)

Volume: 8

Issue: 

Year of Publication: 

Affiliated Institutions:  Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe. Queen Mary University of London, London, UK. African Mental Health Research Initiative (AMARI), Harare, Zimbabwe. Ministry of Health and Child Care, Harare, Zimbabwe.

Abstract summary 

There is a large treatment gap for common mental disorders in rural areas of low-income countries. We tested the Friendship Bench as a brief psychological intervention delivered by village health workers (VHWs) in rural Zimbabwe.Rural women identified with depression in a previous trial received weekly home-based problem-solving therapy from VHWs for 6 weeks, and joined a peer-support group. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Shona Symptom Questionnaire (SSQ). Acceptability was explored through in-depth interviews and focus group discussions. The proportion of women with depression pre- and post-intervention was compared using McNemar's test.Ten VHWs delivered problem-solving therapy to 27 women of mean age 33 years; 25 completed six sessions. Women valued an established and trustful relationship with their VHW, which ensured confidentiality and prevented gossip, and reported finding individual problem-solving therapy beneficial. Peer-support meetings provided space to share problems, solutions and skills. The proportion of women with depression or suicidal ideation on the EPDS declined from 68% to 12% [difference 56% (95% confidence interval (CI) 27.0-85.0); = 0.001], and the proportion scoring high (>7) on the SSQ declined from 52% to 4% [difference 48% (95% CI 24.4-71.6); < 0.001] after the 6-week intervention.VHW-delivered problem-solving therapy and peer-support was acceptable and showed promising results in this pilot evaluation, leading to quantitative and qualitative improvements in mental health among rural Zimbabwean women. Scale-up of the Friendship Bench in rural areas would help close the treatment gap for common mental disorders.

Authors & Co-authors:  Fernando Shamiso S Brown Tim T Datta Kavita K Chidhanguro Dzivaidzo D Tavengwa Naume V NV Chandna Jaya J Munetsi Epiphania E Dzapasi Lloyd L Nyachowe Chandiwana C Mutasa Batsirai B Chasekwa Bernard B Ntozini Robert R Chibanda Dixon D Prendergast Andrew J AJ

Study Outcome 

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Citations :  Barnhart DA, Farrar J, Murray SM, et al. (2020) Lay-worker delivered home visiting promotes early childhood development and reduces violence in Rwanda: a randomized pilot. Journal of Child and Family Studies 29, 1804–1817.
Authors :  14
Identifiers
Doi : e31
SSN : 2054-4251
Study Population
Female,Women
Mesh Terms
Other Terms
Africa;Depression;community health workers;problem-solving therapy;task sharing
Study Design
Study Approach
,Quantitative,Qualitative,Mixed Methods
Country of Study
Zimbabwe
Publication Country
England