What were you trying to find out with your PhD?
My PhD study sought to evaluate the effectiveness, feasibility and acceptability of integrating depression management into routine care of NCDs on patient and service outcomes in central Malawi. The hospital-based, cross-sectional study was conducted with mixed methods in five districts in central Malawi. The study was conducted in two phases namely an instrument validation study and pilot study. The validation study was conducted in one district and the pilot study was done in four districts. The objective of validation study was to investigate the screening properties of the patient health questionnaire (PHQ-9) in the detection of depression in diabetes care clinic. While the objective for the pilot study was to evaluate the acceptability, feasibility and effectiveness of integrating both screening for depression using PHQ-9 and depression management in diabetes care clinics.
What did you actually find?
The PhD study demonstrated that the Chichewa PHQ-9 is a reasonably accurate screening tool to identify cases of depression in this setting. This was the first time that a validation study of the Patient Health Questionnaire-9 (PHQ-9) to screen for depression in patients with type-2 diabetes mellitus in non-communicable disease clinics in Malawi was done. An investigation of the prevalence and detection rate of depression patients with diabetes showed that depression is common among NCD clinic patients with diabetes in Malawi and is poorly detected by NCD clinicians. Furthermore, a pilot study in which depression screening and management was integrated into routine NCD clinic practice demonstrated its feasibility and acceptability of health workers to screen for depression as part of diabetes care in NCD clinics in Malawi.
What do you think should happen next?
The next step is to transform these findings into actionable strategies to manage the patients with diabetes who have comorbidity with depression. The activities for this include:
Engaging policy makers in planning to integrate depression screening and its management in diabetes care in NCD clinics in Malawi and other low resource settings.
Engaging with advocacy groups and the general public
Developing policy and result briefs
What are your next career steps?
My next career steps include transitioning from early-career researcher (ECR) into mid-career researcher (MCR) then into an independent researcher. As a way of transitioning from being an ECR to a MCR, I have started Postdoctoral training since July 2021 with University of North Carolina at Chapel Hill (UNC-CH) and Kamuzu University of Health Sciences (KUHeS) through the Malawian Program for Mental Health Research Training (WARMHEART) funded by the U.S. National Institutes of Health Fogarty International Center.