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ARTICLE
Year : 2021  |  Volume : 19  |  Issue : 1  |  Page : 58-66

Adapting Problem Management Plus for Implementation: Lessons Learned from Public Sector Settings Across Rwanda, Peru, Mexico and Malawi


1 Partners In Health, Boston, USA
2 Partners In Health/Inshuti Mu Buzima, Rwanda
3 Department of Psychology, University of Maryland, College Park, USA
4 MSW, School of Social Work and College of Public Health, University of South Florida, Tampa, ; Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
5 Partners In Health/Socios En Salud, Peru, Harvard Global Health Institute, Boston, USA
6 Partners In Health/Compañeros En Salud; London School of Hygiene & Tropical Medicine, Mexico
7 Partners In Health/Compañeros En Salud, Mexico
8 Partners In Health/Abwenzi Pa Za Umoyo, Malawi
9 Partners In Health/Abwenzi Pa Za Umoyo, Malawi; Division of Pediatrics and Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
10 Icahn School of Medicine at Mount Sinai, New York, USA
11 Partners In Health, Boston; Partners In Health, Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA; The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, USA
12 Partners In Health, Boston, MA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, ; Department of Psychiatry, Brigham and Women’s Hospital, Boston, USA

Correspondence Address:
Sarah F Coleman
Partners In Health, 800 Boylston Street, Suite 300, Boston MA 02199
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INTV.INTV_41_20

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Problem Management Plus (PM+) is a low-intensity psychological intervention developed by the World Health Organization that can be delivered by nonspecialists to address common mental health conditions in people affected by adversity. Emerging evidence demonstrates the efficacy of PM+ across a range of settings. However, the published literature rarely documents the adaptation processes for psychological interventions to context or culture, including curriculum or implementation adaptations. Practical guidance for adapting PM+ to context while maintaining fidelity to core psychological elements is essential for mental health implementers to enable replication and scale. This paper describes the process of contextually adapting PM+ for implementation in Rwanda, Peru, Mexico and Malawi undertaken by the international nongovernmental organisation Partners In Health. To our knowledge, this initiative is among the first to adapt PM+ for routine delivery across multiple public sector primary care and community settings in partnership with Ministries of Health. Lessons learned contribute to a broader understanding of effective processes for adapting low-intensity psychological interventions to real-world contexts. Key implications for practice
  • PM+ can be contextualised based on cultural and implementation considerations while maintaining core psychological elements across different settings.
  • The adaptation of PM+ for local health systems and articulation of practical guidance on implementation for routine care is essential.
  • Partnerships across implementing sites are fundamental for iterative PM+ adaptation and provide opportunities for sharing lessons learned.


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