Provider- and Facility-Level Characteristics Associated with Lay Provider Competence in Perinatal Mental Health Skills in Primary Care Facilities in Western Kenya

Abstract

This cross-sectional study examined how individual and facility-level factors relate to non-specialist provider competence in delivering the Problem Management Plus (PM+) perinatal mental health intervention within the Integrated Perinatal Mental Health trial set in Western Kenya. Lay providers (HIV testing service [HTS] counselors and mentor mothers) as well as non-specialist healthcare providers (nurses and clinical officers) were trained in PM+ by the study team. Trainee competence was assessed by study staff through observation and scoring by the EQUIP scale. Using GEE analyses, we determined the association of EQUIP score with the individual- and facility-level factors. HTS counselors scored higher EQUIP competence scores than nurses (p = 0.004). Providers with a bachelor’s degree or higher scored higher than those with a diploma or less education (p < 0.001). These findings indicate that lay providers like HTS counselors can deliver mental health interventions with the same competence as other non-specialized providers, and education levels should be considered in PM+ training.