Primary health care workers' knowledge and attitudes towards depression and its management in the MeHPric-P project, Lagos, Nigeria

Objective: This study aimed to evaluate the knowledge, perceived challenges and attitude of primary health care (PHC) workers in Lagos to depression and its management in the PHC.

Methods: Health workers (n=607) from 49 "flagship" PHCs in Lagos were evaluated for their level of knowledge, experience, competence, attitude and perceived challenges to managing depression in the primary care using a case vignette.

Results: More than half (56.2%) of the health workers correctly diagnosed depression. The most endorsed causative factors were "Psycho-social" (77.3%), but "spiritual factors" were endorsed by 36.2%. While only 39.4% agreed that the depressed patient is best managed in a PHC, 86.2% would support treating the patient in their PHC if their capacity is enhanced. Top identified challenges were "heavy work schedule" (68.5%) and "lack of competence of the PHC staff" (67.5%). Over 42% had poor attitude towards depressed patient. Having a mental health training was the major factor that predicted good knowledge (OR 4.52, 95%CI 2.96-7.00) and good attitude (OR 2.17, 95% CI 1.48-3.17).

Conclusions: For successful scale up of mental health services in LMICs, the design of mental health training curriculum for PHC workers should consider their knowledge, experience, competence level, perception and attitudes.