Family-based youth mental health interventions delivered by nonspecialist providers in low- and middle-income countries: A systematic review

30 September, 2018

With thanks to McMaster Health Systems Evidence:

Citation, abstract and comment below.

CITATION: Healy EA, Kaiser BN, Puffer ES. Family-based youth mental health interventions delivered by nonspecialist providers in low- and middle-income countries: A systematic review. Families, Systems & Health. 2018;36(2):182-197.

DOI 10.1037/fsh0000334

Countries in which studies (included in the synthesis) were conducted

Burundi(1)China(1)Congo (Democratic Republic of)(1)India(1)Kenya(1)Liberia(1)Pakistan(1)South Africa(3)Thailand(1)


INTRODUCTION: Youth in low- and middle-income countries (LMICs) are at increased risk for poor mental health due to economic and social disadvantage. Interventions that strengthen families may equip children and adolescents with the supports and resources to fulfill their potential and buffer them from future stressors and adversity. Due to human resource constraints, task-sharing-delivery of interventions by nonspecialists-may be an effective strategy to facilitate the dissemination of mental health interventions in low resource contexts. To this end, we conducted a systematic review of the literature on family-based interventions delivered in LMICs by nonspecialist providers (NSPs) targeting youth mental health and family related outcomes. METHOD: Cochrane and PRISMA procedures guided this review. Searches were conducted in PsychInfo, PubMed, and Web of Science, with additional articles pulled from reference lists. RESULTS: This search yielded 10 studies. Four studies were developed specifically for the delivery context using formative qualitative research; the remaining interventions underwent adaptation for use in the context. All interventions employed a period of structured training; nine studies additionally provided ongoing supervision to counselors. Interventions noted widespread acceptance of program material and delivery by NSPs. They also noted the need for ongoing supervision of NSPs to increase treatment fidelity. DISCUSSION: Usage of NSPs is quite consistently proving feasible, acceptable, and efficacious and is almost certainly a valuable component within approaches to scaling up mental health programs. A clear next step is to establish and evaluate sustainable models of training and supervision to further inform scalability.

Comment (Neil PW): What is unclear here is the lack of an authors' working definition of 'non-specialist providers'. Does this refer to community health workers and/or generalist medical and nursing personnel? The full-text is restricted, so we are unable to learn much from this.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (, which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: