Enablers and barriers for task sharing of mental health care from nurses to community health workers: A scoping review

Abstract

Background: The World Health Organisation (WHO) and other legislative mandates such as South African Mental Health Care Act 17 of 2002, advocate for mental health services to be rendered at the community level closer to the families. This requires task sharing of mental health activities with community health care workers. Objective: To identify the existing literature on enablers and barriers of task sharing of mental health services to community health care workers at the community level. Methods: The scoping review was guided by Arksey and O’Malley (2005) framework. Literature was searched in the following databases: Academic Search Complete, Health Source: Nursing/Academic Edition, Pubmed, APA PsychInfo, and Medline via Ebscohost. Results: 15 articles were eligible for inclusion; however, 6 articles were excluded following full-text screening because they did not have sufficient information on the task sharing of mental health services. Therefore 9 articles met the inclusion criteria. Seven themes were identified of which three are barriers (individual factors (insufficient training, stigma, and family resistance), organisational factors (lack of supervision, lack of equipment, and work overload) and confidentiality and four are enablers (ongoing training, CHWs are known to the community, collaboration of CHWs with the key stakeholders, and feasibility of task sharing of Mental Health Services with CHWs). Conclusion: As evidenced by the results of the reviewed literature, if the barriers can be managed or dealt with it is feasible to implement the task sharing of mental health services to community health care workers at the community level.

Keywords

• Nurses
• Barriers
• Task sharing
• Community health workers
• Enablers