University of Ibadan: A cluster-randomized controlled trial of the effectiveness and cost- effectiveness of a primary care-based stepped-care management program for depression in adult Nigerians.

The study will utilize a cluster randomized controlled trial design in which a stepped-care management program is compared with care as usual (CAU) for depression in primary care. We expect the intervention program will significantly increase rate of recovery from depression than CAU at the primary end point of 6 months of trial. Among secondary hypotheses to be tested the intervention package will 1) reduce disability; 2) improve quality of life; and 3) be more cost-effective than CAU. The stud y will be conducted in urban and rural primary care clinics around Ibadan, Nigeria, serving predominantly poor people. The intervention program will consist of psychoeducation, problem solving treatment as well as pharmacotherapy to be delivered by non-physician primary health providers. Supervision and support from scarce medical and specialist personnel will be gained by the structured use of mobile telephony. The study is designed to test the effectiveness of an evidence-based intervention p ackage for depression that is contextualized for possible scaling-up in settings with extremely low human resources as is characteristic of much of Sub-Sahara Africa.

Programme: Project Grant

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