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  1. Article: Reducing the treatment gap for mental, neurological and substance use disorders in Africa: lessons from the Friendship Bench in Zimbabwe.

    Chibanda, D

    Epidemiology and psychiatric sciences

    2017  Volume 26, Issue 4, Page(s) 342–347

    Abstract: Mental, neurological and substance use disorders (MNS) are a leading cause of disability in Africa. In response to the large treatment gap for MNS, a growing body of evidence-based treatments (EBTs) is emerging from Africa; however, there is a dearth of ... ...

    Abstract Mental, neurological and substance use disorders (MNS) are a leading cause of disability in Africa. In response to the large treatment gap for MNS, a growing body of evidence-based treatments (EBTs) is emerging from Africa; however, there is a dearth of knowledge on how to scale up EBT. The Friendship Bench intervention is a brief psychological treatment delivered through the primary health care system in Zimbabwe by trained lay health workers. It has contributed significantly towards narrowing the treatment gap for common mental disorders in Zimbabwe where it has been scaled up to over 70 primary health care facilities. A three-pronged approach consisting of community engagement, use of EBTs and a government endorsed scale-up plan is described as part of the key strategy leading to the scale up of the Friendship Bench.
    MeSH term(s) Community Health Workers ; Delivery of Health Care ; Evidence-Based Practice ; Healthcare Disparities ; Humans ; Mental Disorders/therapy ; Nervous System Diseases/therapy ; Psychotherapy/methods ; Substance-Related Disorders/therapy ; Zimbabwe
    Language English
    Publishing date 2017-04-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2607964-1
    ISSN 2045-7979 ; 2045-7960
    ISSN (online) 2045-7979
    ISSN 2045-7960
    DOI 10.1017/S2045796016001128
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  2. Article ; Online: Programmes that bring mental health services to primary care populations in the international setting.

    Chibanda, Dixon

    International review of psychiatry (Abingdon, England)

    2019  Volume 30, Issue 6, Page(s) 170–181

    Abstract: The last decade has witnessed an exponential growth of evidence-based care packages for mental, neurological, and substance use disorders (MNS) aimed at primary care populations; however, few have been taken to scale. Several barriers to successful ... ...

    Abstract The last decade has witnessed an exponential growth of evidence-based care packages for mental, neurological, and substance use disorders (MNS) aimed at primary care populations; however, few have been taken to scale. Several barriers to successful integration and scale-up, such as low acceptability, poor clinical engagement process, lack of targeted resources, and poor stakeholder and policy support have been cited. This review describes and highlights common features of some of the promising programmes that deliver mental health services through primary health clinics, communities, and digital platforms, with an emphasis on those that show some evidence of complete or partial scale-up. Three distinct overarching themes and initiatives are discussed in relation to the above; primary health facilities, community (outside of primary healthcare), and digital/internet-based platforms, with a focus on how the three may interact synergistically to enhance successful integration and scale-up.
    MeSH term(s) Delivery of Health Care, Integrated/methods ; Health Resources ; Humans ; Internationality ; Mental Disorders/therapy ; Mental Health Services/organization & administration ; Models, Organizational ; Primary Health Care/organization & administration
    Language English
    Publishing date 2019-03-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1018090-4
    ISSN 1369-1627 ; 0954-0261
    ISSN (online) 1369-1627
    ISSN 0954-0261
    DOI 10.1080/09540261.2018.1564648
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    Zs.A 2819: Show issues Location:
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  3. Article ; Online: Effectiveness of single-session therapy for adult common mental disorders: a systematic review.

    Kim, Jongtae / Ryu, Namgil / Chibanda, Dixon

    BMC psychology

    2023  Volume 11, Issue 1, Page(s) 373

    Abstract: Background: Common mental disorders (CMDs) impose significant socioeconomic impacts on the global community. Nevertheless, over 50% of individuals with CMDs do not receive proper treatment, indicating that the current treatment modalities do not ... ...

    Abstract Background: Common mental disorders (CMDs) impose significant socioeconomic impacts on the global community. Nevertheless, over 50% of individuals with CMDs do not receive proper treatment, indicating that the current treatment modalities do not adequately tackle this issue. Since single-session therapy (SST) is a potential method for reducing the treatment gap, it is crucial to evaluate its effectiveness. Therefore, this systematic review aimed to evaluate the effectiveness of SST on CMD symptoms in adults.
    Methods: This systematic review included randomised and non-randomised studies assessing the clinical effectiveness of SST on CMD symptoms in adults. English-written, peer-reviewed studies or dissertations were included, while grey literature was excluded. MEDLINE, Embase, PsycINFO, and Cochrane's CENTRAL were searched on December 13, 2022, from their inception dates. The risk of bias in the included studies was evaluated using RoB 2 and ROBINS-I. A narrative synthesis was performed. This systematic review was registered in the PROSPERO database on July 6, 2022 (CRD42022343925).
    Results: Six randomised and three non-randomised studies were included after screening 2,130 records. Three non-randomised studies with a "critical" or "serious" risk of bias were excluded from the synthesis. Therefore, six randomised trials involving 298 participants were included in the synthesis. Four out of six studies had a "high" risk of bias. The participants had non-severe symptoms at baseline, and three intervention types (behavioural activation, DBT, and solution-focused psychotherapy) were evaluated. Five of six studies showed positive results for depression, with only one reporting a positive result for anxiety.
    Conclusions: SST may be effective in improving CMD symptoms in adults, particularly depression. However, there is a limit to deriving definite conclusions due to a high risk of bias in included studies, insufficient sample size and research volume. Further research exploring the characteristics of clients who can benefit from SST is required to facilitate its widespread use.
    MeSH term(s) Adult ; Humans ; Mental Disorders/therapy ; Mental Disorders/diagnosis ; Psychotherapy/methods ; Behavior Therapy ; Anxiety Disorders ; Anxiety ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2023-11-07
    Publishing country England
    Document type Systematic Review ; Journal Article
    ZDB-ID 2705921-2
    ISSN 2050-7283 ; 2050-7283
    ISSN (online) 2050-7283
    ISSN 2050-7283
    DOI 10.1186/s40359-023-01410-0
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  4. Article ; Online: Depression and HIV: integrated care towards 90-90-90.

    Chibanda, Dixon

    International health

    2017  Volume 9, Issue 2, Page(s) 77–79

    Abstract: Depression is a global public health problem affecting more than 300 million people. People living with HIV (PLWH) are twice as likely to suffer from depression when compared to matched non-HIV infected persons. Untreated, depression may hasten HIV ... ...

    Abstract Depression is a global public health problem affecting more than 300 million people. People living with HIV (PLWH) are twice as likely to suffer from depression when compared to matched non-HIV infected persons. Untreated, depression may hasten HIV disease progression. A large treatment gap for depression, particularly in low and middle income countries exists. There is, however, emerging evidence suggesting that trained lay health workers (LHW) can deliver evidence-based treatments in the absence of mental health professionals. Evidence-based treatments delivered by LHW can contribute towards reducing the treatment gap for depression and achieving the 90-90-90 objectives.
    MeSH term(s) Antidepressive Agents/therapeutic use ; Depression/epidemiology ; Depression/psychology ; Depression/therapy ; HIV Infections/epidemiology ; HIV Infections/psychology ; HIV Infections/therapy ; Humans ; Maternal Health Services/standards ; Patient Acceptance of Health Care/statistics & numerical data ; Risk Factors
    Chemical Substances Antidepressive Agents
    Language English
    Publishing date 2017-03-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2526175-7
    ISSN 1876-3405 ; 1876-3413
    ISSN (online) 1876-3405
    ISSN 1876-3413
    DOI 10.1093/inthealth/ihw058
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  5. Article ; Online: The future of psychiatry in Africa-thinking outside the box.

    Chibanda, Dixon

    The lancet. Psychiatry

    2017  Volume 4, Issue 10, Page(s) 741–742

    MeSH term(s) Africa ; Forecasting ; Psychiatry ; Thinking
    Language English
    Publishing date 2017-09-25
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2215-0374
    ISSN (online) 2215-0374
    DOI 10.1016/S2215-0366(17)30368-1
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  6. Article ; Online: Common mental health and emotional and behavioural disorders among adolescents and young adults in Harare and Mashonaland East, Zimbabwe: a population-based prevalence study.

    Doyle, Aoife Margaret / Bandason, T / Dauya, E / McHugh, Grace / Grundy, Chris / Simms, Victoria / Chibanda, D / Ferrand, Rashida

    BMJ open

    2023  Volume 13, Issue 3, Page(s) e065276

    Abstract: Objectives: To estimate the prevalence of common mental health disorders (CMDs) and emotional and behavioural disorders among young people and to explore the correlates of CMDs risk.: Setting: Five urban and periurban communities in Harare and ... ...

    Abstract Objectives: To estimate the prevalence of common mental health disorders (CMDs) and emotional and behavioural disorders among young people and to explore the correlates of CMDs risk.
    Setting: Five urban and periurban communities in Harare and Mashonaland East, Zimbabwe DESIGN: Population-based cross-sectional study PARTICIPANTS: Young people aged 13-24 years living in households in the study areas.
    Outcome measures: The primary outcome was the proportion of participants screening positive for probable CMDs defined as a Shona Symptoms Questionnaire (SSQ) score ≥8. Secondary outcomes were emotional and behavioural disorders measured using the Strength and Difficulties Questionnaire (SDQ), and adjusted ORs for factors associated with CMD.
    Results: Out of 634 young people, 37.4% (95% CI 33.0% to 42.0%) screened positive for probable CMDs, 9.8% (95% CI 7.5% to 12.7%) reported perceptual symptoms and 11.2% (95% CI 9.0% to 13.8%) reported suicidal ideation. Using UK norms to define normal, borderline and abnormal scores for each of the SDQ domains, a high proportion (15.8%) of Zimbabwean young people had abnormal scores for emotional symptoms and a low proportion had abnormal scores for hyperactivity/inattention scores (2.8%) and prosocial scores (7.1%). We created local cut-offs for the emotional symptoms, hyperactivity/attention and prosocial SDQ domains. The odds of probable CMDs increased with each year of age (OR 1.09, p<0.001) and was higher among those who were out of school and not working compared with those in school or working (adj. OR 1.67 (1.07, 2.62), p=0.04). One in five participants (22.1%) were referred immediately for further clinical assessment but uptake of referral services was low.
    Conclusions: We observed a high prevalence of symptoms of CMDs among general population urban and peri-urban young people especially among those with no employment. There is a need for more accessible and acceptable youth-friendly mental health services.
    MeSH term(s) Humans ; Adolescent ; Young Adult ; Mental Health ; Zimbabwe/epidemiology ; Cross-Sectional Studies ; Prevalence ; Mental Disorders/psychology
    Language English
    Publishing date 2023-03-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-065276
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  7. Article: Reprioritising global mental health: psychoses in sub-Saharan Africa.

    Omigbodun, O O / Ryan, G K / Fasoranti, B / Chibanda, D / Esliker, R / Sefasi, A / Kakuma, R / Shakespeare, T / Eaton, J

    International journal of mental health systems

    2023  Volume 17, Issue 1, Page(s) 6

    Abstract: Arthur Kleinman's 2009 Lancet commentary described global mental health as a "moral failure of humanity", asserting that priorities should be based not on the epidemiological and utilitarian economic arguments that tend to favour common mental health ... ...

    Abstract Arthur Kleinman's 2009 Lancet commentary described global mental health as a "moral failure of humanity", asserting that priorities should be based not on the epidemiological and utilitarian economic arguments that tend to favour common mental health conditions like mild to moderate depression and anxiety, but rather on the human rights of those in the most vulnerable situations and the suffering that they experience. Yet more than a decade later, people with severe mental health conditions like psychoses are still being left behind. Here, we add to Kleinman's appeal a critical review of the literature on psychoses in sub-Saharan Africa, highlighting contradictions between local evidence and global narratives surrounding the burden of disease, the outcomes of schizophrenia, and the economic costs of mental health conditions. We identify numerous instances where the lack of regionally representative data and other methodological shortcomings undermine the conclusions of international research carried out to inform decision-making. Our findings point to the need not only for more research on psychoses in sub-Saharan Africa, but also for more representation and leadership in the conduct of research and in international priority-setting more broadly-especially by people with lived experience from diverse backgrounds. This paper aims to encourage debate about how this chronically under-resourced field, as part of wider conversations in global mental health, can be reprioritised.
    Language English
    Publishing date 2023-03-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2382266-1
    ISSN 1752-4458
    ISSN 1752-4458
    DOI 10.1186/s13033-023-00574-x
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  8. Article ; Online: Rural Friendship Bench: A qualitative study in Zaka district, Zimbabwe.

    Kidia, K / Machando, D / Dzoro, V / Chibanda, D / Abas, M / Manda, E / Mutengerere, A / Nyandoro, T / Chawarika, M / Majichi, D / van Dijk, J H / Jack, H

    Social science & medicine (1982)

    2024  Volume 348, Page(s) 116791

    Abstract: Background: We piloted the Friendship Bench-an evidence-based, urban-area task sharing intervention for common mental disorders-in rural Zimbabwe. The intervention combines problem solving therapy with income generating activities. This study sought to ... ...

    Abstract Background: We piloted the Friendship Bench-an evidence-based, urban-area task sharing intervention for common mental disorders-in rural Zimbabwe. The intervention combines problem solving therapy with income generating activities. This study sought to understand the intervention's implementation in terms of acceptability, feasibility, and sustainability as well as local attitudes towards mental wellbeing in rural Zimbabwe.
    Methods: Using four separate semi-structured interview guides, we conducted in-depth interviews (N = 32) with patients (n = 9), village health workers (n = 12), nurses (n = 6), and community leaders (n = 5). We analyzed our data using thematic analysis with a diverse coding team using an integrative deductive-inductive approach.
    Results: Five themes emerged: 1) explanatory models for mental illness, 2) clinical workflow and emphasis on documentation, 3) positive feedback about the Friendship Bench, 4) accessibility, and 5) feasibility.
    Conclusion: In its current format, our intervention was acceptable but neither feasible nor sustainable. Sociocultural context is critical in the development of rural task sharing interventions for mental health. We thus recommend a robust pilot and adaptation phase when scaling task sharing interventions in rural sub-Saharan Africa to elevate community voices, leverage existing social structures, and embed interventions as deeply into communities as possible.
    MeSH term(s) Humans ; Zimbabwe ; Qualitative Research ; Female ; Male ; Rural Population ; Adult ; Mental Disorders/therapy ; Mental Disorders/psychology ; Middle Aged
    Language English
    Publishing date 2024-03-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 4766-1
    ISSN 1873-5347 ; 0037-7856 ; 0277-9536
    ISSN (online) 1873-5347
    ISSN 0037-7856 ; 0277-9536
    DOI 10.1016/j.socscimed.2024.116791
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    Zs.A 625: Show issues Location:
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  9. Article: Erratum: A community health volunteer delivered problem-solving therapy mobile application based on the Friendship Bench 'Inuka Coaching' in Kenya: A pilot cohort study - CORRIGENDUM.

    Doukani, Asmae / van Dalen, Robin / Valev, Hristo / Njenga, Annie / Sera, Francesco / Chibanda, Dixon

    Global mental health (Cambridge, England)

    2023  Volume 10, Page(s) e54

    Abstract: This corrects the article DOI: 10.1017/gmh.2021.3.]. ...

    Abstract [This corrects the article DOI: 10.1017/gmh.2021.3.].
    Language English
    Publishing date 2023-09-15
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2806466-5
    ISSN 2054-4251
    ISSN 2054-4251
    DOI 10.1017/gmh.2023.54
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  10. Article: Reliability and validity of the Shona version of the Exercise Benefits and Barriers Scale in Zimbabwean adult people living with HIV/AIDS.

    Dambi, Jermaine M / Domingue, Ben / Abas, Melanie / Chibanda, Dixon / Esterhuizen, Tonya M

    Frontiers in psychiatry

    2023  Volume 14, Page(s) 1188689

    Abstract: Introduction: Despite the widely known benefits of physical activity (PA), only 25% of people living with HIV (PLHIV) meet the WHO-recommended minimum PA levels. Consequently, it is essential to understand PA barriers and facilitators using objective ... ...

    Abstract Introduction: Despite the widely known benefits of physical activity (PA), only 25% of people living with HIV (PLHIV) meet the WHO-recommended minimum PA levels. Consequently, it is essential to understand PA barriers and facilitators using objective measures. Although the Exercise Benefits and Barriers Scale (EBBS) is extensively used, its psychometric evidence is fragmented and has not been previously validated in PLHIV. This study aimed to translate and validate the EBBS Shona version in Zimbabwean PLHIV.
    Methods: A cross-sectional study was used to recruit 567 PLHIV from four (4/9) randomly selected polyclinics (primary healthcare facilities) in urban Harare, Zimbabwe. We recruited adult patients (aged ≥18 years) with a confirmed diagnosis of HIV. Participants had to be willing to provide informed consent, not acutely unwell, and proficient in the Shona language. We used a forward-backwards translation method to translate the EBBS from English to Shona, a native Zimbabwean language. After cross-cultural adaptation, we pretested the draft version in 10 PLHIV to assess the face validity, understandability and cultural appropriateness using semi-structured interviews. Thereafter, the EBBS was administered to 567 consecutively-selected PLHIV. Factor analyses were performed for construct validity evaluation.
    Results: Most participants were female (72.5%) and reached secondary/high school (78.8%), with a mean age of 39.9 (SD 12.1) years. The EBBS-Shona version yielded a four-factor solution consisting of three benefits factors and one barrier factor against the originally postulated six-factor structure. The EBBS-Shona yielded α = 0.85 and intraclass correlation coefficient = 0.86, demonstrating excellent reliability. Increased perception of exercise benefits was positively correlated with increased reports of physical activity, higher health-related quality of life and lower psychiatric morbidity; evidence for construct validity.
    Discussion: This study demonstrates the validity and reliability of the EBBS-Shona version in Zimbabwean PLHIV. The EBBS-Shona version can be used for research and clinical purposes to glean data to inform the development, implementation, and evaluation of bespoke PA interventions for PLHIV.
    Language English
    Publishing date 2023-08-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2023.1188689
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