Cultural adaptation of psychological interventions for people with mental disorders delivered by lay health workers in Africa: scoping review and expert consultation

Authors: Dirceu Mabunda, Déborah Oliveira, Mohsin Sidat, Maria Tavares Cavalcanti, Vasco Cumbe, Flávio Mandlate, Milton Wainberg, Francine Cournos & Jair de Jesus Mari

This literature review sought to explore the cultural appropriateness and sustainability of psychological services provided by Lay Health Workers in Africa. Authors reviewed ten peer-reviewed articles from Zimbabwe, Uganda, South Africa, and Zambia. Of the interventions, five described group-based therapy, three described problem solving therapy, and two others explored narrative exposure and cognitive behavior therapies. Authors found that psychological interventions were adapted to meet the cultural competency of LHWs. While symptom improvement was observed in all ten interventions, the magnitude of improvement and the quality of evidence varied widely by study. The authors concluded that there is a promising potential for LHW-delivered psychological interventions to be effective in meeting mental health needs, but more research is needed on the topic.