IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0143572.html
   My bibliography  Save this article

Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia

Author

Listed:
  • Laura Asher
  • Abebaw Fekadu
  • Charlotte Hanlon
  • Gemechu Mideksa
  • Julian Eaton
  • Vikram Patel
  • Mary J De Silva

Abstract

Background: Community-based rehabilitation (CBR) is a multi-sectoral strategy to improve the functioning and quality of life of people with disabilities. The RISE (Rehabilitation Intervention for people with Schizophrenia in Ethiopia) trial will evaluate the effectiveness of CBR for people with schizophrenia in Ethiopia. Nevertheless, the components of CBR that are both feasible and likely to prove effective in low and middle-income countries such as Ethiopia are unclear. Methods: In this study intervention development work was undertaken to design a CBR intervention that is acceptable and feasible in the local context. The development work consisted of five phases. 1: Identify potential components of CBR for schizophrenia, 2: Situational analysis, 3: Determine feasibility of CBR (Theory of Change workshops with experts and local stakeholders), 4: Determine acceptability of CBR (16 in-depth interviews and five focus group discussions with people with schizophrenia, caregivers, health workers and community leaders) and 5: Synthesise results to finalise intervention. A Theory of Change map was constructed showing the causal pathway for how we expect CBR to achieve its impact. Results: People with schizophrenia in rural Ethiopia experience family conflict, difficulty participating in work and community life, and stigma. Stakeholders perceived CBR to be acceptable and useful to address these problems. The focus of CBR will be on the individual developing the skills and confidence to perform their previous or desired roles and activities. To ensure feasibility, non-health professionals will be trained to deliver CBR and provide supervision, rather than mental health specialists. Novel components of CBR for schizophrenia included family intervention and dealing with distressing symptoms. Microfinance was excluded due to concerns about stress and exploitation. Community mobilisation was viewed as essential to ensure the effectiveness and sustainability of CBR. Conclusion: Extensive formative research using a variety of methods has enabled the design of a culturally appropriate CBR intervention for people with schizophrenia that is acceptable and feasible.

Suggested Citation

  • Laura Asher & Abebaw Fekadu & Charlotte Hanlon & Gemechu Mideksa & Julian Eaton & Vikram Patel & Mary J De Silva, 2015. "Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
  • Handle: RePEc:plo:pone00:0143572
    DOI: 10.1371/journal.pone.0143572
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0143572
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0143572&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0143572?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Padmanathan, Prianka & De Silva, Mary J., 2013. "The acceptability and feasibility of task-sharing for mental healthcare in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 97(C), pages 82-86.
    2. Medhin Selamu & Laura Asher & Charlotte Hanlon & Girmay Medhin & Maji Hailemariam & Vikram Patel & Graham Thornicroft & Abebaw Fekadu, 2015. "Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
    3. Anahita Khodabakhshi Koolaee & Ahmad Etemadi, 2010. "The Outcome of Family Interventions for the Mothers of Schizophrenia Patients in Iran," International Journal of Social Psychiatry, , vol. 56(6), pages 634-646, November.
    4. Mendenhall, Emily & De Silva, Mary J. & Hanlon, Charlotte & Petersen, Inge & Shidhaye, Rahul & Jordans, Mark & Luitel, Nagendra & Ssebunnya, Joshua & Fekadu, Abebaw & Patel, Vikram & Tomlinson, Mark &, 2014. "Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and U," Social Science & Medicine, Elsevier, vol. 118(C), pages 33-42.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jane Wilbur & Tess Bright & Thérèse Mahon & Shaffa Hameed & Belen Torondel & Wakisa Mulwafu & Hannah Kuper & Sarah Polack, 2018. "Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi," IJERPH, MDPI, vol. 15(12), pages 1-21, December.
    2. Sean A Kidd & Athena Madan & Susmitha Rallabandi & Donald C Cole & Elisha Muskat & Shoba Raja & David Wiljer & David Aylward & Kwame McKenzie, 2016. "A Multiple Case Study of Mental Health Interventions in Middle Income Countries: Considering the Science of Delivery," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-17, March.
    3. Xanthe Hunt & Melissa Bradshaw & Steyn Lodewyk Vogel & Alberto Vasquez Encalada & Shanice Eksteen & Marguerite Schneider & Kelly Chunga & Leslie Swartz, 2022. "Community Support for Persons with Disabilities in Low- and Middle-Income Countries: A Scoping Review," IJERPH, MDPI, vol. 19(14), pages 1-17, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Woollett, Nataly & Brahmbhatt, Heena & Dodd, Kate & Booth, Michelle & Berman, Hayley & Cluver, Lucie, 2017. "Revealing the impact of loss: Exploring mental health through the use of drawing/writing with HIV positive adolescents in Johannesburg," Children and Youth Services Review, Elsevier, vol. 77(C), pages 197-207.
    2. 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., 2024. "Rural Friendship Bench: A qualitative study in Zaka district, Zimbabwe," Social Science & Medicine, Elsevier, vol. 348(C).
    3. Shital S. Muke & Deepak Tugnawat & Udita Joshi & Aditya Anand & Azaz Khan & Ritu Shrivastava & Abhishek Singh & Juliana L. Restivo & Anant Bhan & Vikram Patel & John A. Naslund, 2020. "Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study," IJERPH, MDPI, vol. 17(17), pages 1-22, September.
    4. Medhin Selamu & Laura Asher & Charlotte Hanlon & Girmay Medhin & Maji Hailemariam & Vikram Patel & Graham Thornicroft & Abebaw Fekadu, 2015. "Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
    5. Jinvo Nam & Nicola Dempsey, 2018. "Community Food Growing in Parks? Assessing the Acceptability and Feasibility in Sheffield, UK," Sustainability, MDPI, vol. 10(8), pages 1-21, August.
    6. Sarkar, Nandini D.P. & Baingana, Florence & Criel, Bart, 2022. "Integration of perinatal mental health care into district health services in Uganda: Why is it not happening? The Four Domain Integrated Health (4DIH) explanatory framework," Social Science & Medicine, Elsevier, vol. 296(C).
    7. Sabrina Gabrielle Anjara & Chiara Bonetto & Poushali Ganguli & Diana Setiyawati & Yodi Mahendradhata & Bambang Hastha Yoga & Laksono Trisnantoro & Carol Brayne & Tine Van Bortel, 2019. "Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-26, November.
    8. Eddy Eustache & Margaret E Gerbasi & Jennifer Severe & J Reginald Fils-Aimé & Mary C Smith Fawzi & Giuseppe J Raviola & Sarah Darghouth & Kate Boyd & Tatiana Thérosmé & Rupinder Legha & Ermaze L Pi, 2017. "Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings," International Journal of Social Psychiatry, , vol. 63(4), pages 314-324, June.
    9. Nadja van Ginneken & Meera S Maheedhariah & Sarah Ghani & Jayashree Ramakrishna & Anusha Raja & Vikram Patel, 2017. "Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-25, June.
    10. Mayssa Rekhis & Abir Ben Hamouda & Sami Ouanes & Rym Rafrafi, 2017. "Rights of people with mental disorders: Realities in healthcare facilities in Tunisia," International Journal of Social Psychiatry, , vol. 63(5), pages 439-447, August.
    11. Mendenhall, Emily & De Silva, Mary J. & Hanlon, Charlotte & Petersen, Inge & Shidhaye, Rahul & Jordans, Mark & Luitel, Nagendra & Ssebunnya, Joshua & Fekadu, Abebaw & Patel, Vikram & Tomlinson, Mark &, 2014. "Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and U," Social Science & Medicine, Elsevier, vol. 118(C), pages 33-42.
    12. Martin Agrest & PhuongThao D Le & Lawrence H Yang & Franco Mascayano & Silvia Alves-Nishioka & Saloni Dev & Tanvi Kankan & Thamara Tapia-Muñoz & Samantha Sawyer & Josefina Toso-Salman & Gabriella A D, 2019. "Implementing a community-based task-shifting psychosocial intervention for individuals with psychosis in Chile: Perspectives from users," International Journal of Social Psychiatry, , vol. 65(1), pages 38-45, February.
    13. Marziyeh Khoshgoftar & Anahita Khodabakhshi-Koolaee & Mohammad Reza Sheikhi, 2022. "Analysis of the early mother-child relationship in schizophrenic patients," International Journal of Social Psychiatry, , vol. 68(3), pages 548-554, May.
    14. Anahita Khodabakhshi-Koolaee & Mina Manoochehri, 2023. "Improving resilience in mothers with schizophrenic sons: A group movie analysis," International Journal of Social Psychiatry, , vol. 69(1), pages 63-69, February.
    15. Trang Nguyen & Tuan Tran & Sally Green & Arthur Hsueh & Thach Tran & Ha Tran & Jane Fisher, 2020. "Proof of concept of participant informed, psycho-educational, community-based intervention for people with severe mental illness in rural Vietnam," International Journal of Social Psychiatry, , vol. 66(3), pages 232-239, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0143572. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.