부산대학교 도서관

Objectives: There is a huge treatment gap for late‐life depression in sub‐Saharan Africa. Building on prior work to scale‐up mental healthcare with the aid of the WHO Mental Health Gap Action Programme Intervention Guide electronic version (emhGAP‐IG), this study aims to involve older people in the iterative development of innovations to overcome challenges in the detection and clinical management of late‐life depression by frontline non‐specialist primary healthcare workers (PHCW) in Nigeria. Methods: There were 43 participants in the study. We conducted formative qualitative research using 15 in‐depth key informant interviews with persons who were 60 years or older and had a recent experience of depression. We also conducted two focus group discussions comprising 13 of their caregivers. Through a full day stakeholders workshop comprising 15 participants, we drew on the results of our qualitative explorations to identify the pathway to impact of an intervention package (emhGAP‐Age) appropriate for the specific needs of persons with late‐life depression in Nigeria. Results: A Theory of Change (ToC) map was produced. It highlights the expected long‐term outcomes of emhGAP‐Age to include the potential for improvement of the mental health and wellbeing of older people living in Nigeria and the generation of interest among governmental agencies concerned with policy and planning for mental healthcare. Key resources that serve as preconditions were identified to consist of the availability of PHCW who are skilled in the identification and treatment of depression and have interest in and commitment to providing care to older people. Required community resources include support from immediate family, neighbours, and informal groups. Interventions that are appropriate for depression in old age need to incorporate these community resources and address not only the symptoms of the condition but also comorbid physical health problems. Conclusions: A participatory ToC process led to the identification of the key components of an age‐appropriate version of the emhGAP‐IG for delivering care to older persons with depression by PHCW in Nigeria. Key points: There is a large treatment gap for late‐life depression in sub‐Saharan Africa.We used participatory methodology to design an age‐appropriate depression intervention in Nigeria.We identified key resources that may serve as preconditions for depression intervention to drive change.A late life depression intervention has the potential to attract policy interest. [ABSTRACT FROM AUTHOR]