Developing mental health curricula and a service provision model for clinical associates in South Africa: a Delphi survey of family physicians and psychiatrists.

Journal: BMC medical education

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. saiendhra.moodley@up.ac.za. School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.

Abstract summary 

Clinical associates are a health professional cadre that could be utilised in mental health task sharing in South Africa but this is training dependent. The objectives of the study were to identify the potential curricula content, training sites, and teaching modalities for undergraduate and potential postgraduate clinical associate mental health training and to identify the tasks that they should perform based on these curricula.We utilised the Delphi method to reach consensus on items with the panel comprising psychiatrists and family physicians. The first round questionnaire of the Delphi survey was developed based on a literature review and the results from earlier phases of the overall study. The survey was administered electronically and consisted of three rounds. Following both the first and second rounds, an updated questionnaire was constructed omitting the items on which consensus was reached. The questionnaire consisted primarily of nine-point scales with consensus based on 70% of participants rating 1,2,3 or 7,8,9.There were 26 participants in the first round with this number falling to 23 in later rounds. There was strong consensus on a training attachment to a mental health clinic at a community health centre (CHC) at undergraduate (96.2%) and postgraduate level (100%). Consensus was reached on the importance of training on the management of six categories of disorders at the undergraduate level and nine categories of disorders at the postgraduate level. Clerking patients as a teaching modality reached 100% consensus at both undergraduate and postgraduate levels. PHC clinics, CHCs and district hospitals reached consensus as appropriate settings for clinical associates to provide mental health services. In addition, GP practices and secondary hospitals reached consensus for those with postgraduate training. Consensus was reached on ten of the 21 listed tasks that could be performed based on undergraduate training and 20 of the 21 tasks based on a postgraduate qualification in mental health.The Delphi panel's recommendations provide a clear roadmap for enhancing mental health curricula for clinical associates, enabling their utilisation in mental health service provision. A future postgraduate mental health qualification for clinical associates would allow for expanded task sharing.

Authors & Co-authors:  Moodley Saiendhra Vasudevan SV Wolvaardt Jacqueline J Grobler Christoffel C

Study Outcome 

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Statistics
Citations :  Malakoane B, Heunis J, Chikobvu P, Kigozi N, Kruger W. Public health system challenges in the Free State, South Africa: a situation appraisal to inform health system strengthening. BMC Health Serv Res. 2020;20:1–14. doi: 10.1186/s12913-019-4862-y.
Authors :  3
Identifiers
Doi : 669
SSN : 1472-6920
Study Population
Male,Female
Mesh Terms
South Africa
Other Terms
Clinical associates;Curriculum;Delphi method;Delphi panel;Mental health;Mental illness;Task sharing;Training
Study Design
Study Approach
Country of Study
South Africa
Publication Country
England