The effectiveness of counseling on anxiety and depression by minimally trained counselors: a randomized controlled trial

Objective: To assess if eight counseling sessions conducted by women minimally trained as community counselors could reduce the mean level of anxiety and/or depression in women of their own community.Design: A randomized controlled trial.SETTING: A lower-middle-class, semi-urban community in Karachi, Pakistan.PARTICIPANTS: 366 anxious and/or depressed women providing informed consent.METHOD: Through systematic sampling, 1226 women were screened using an indigenous instrument. Out of these, 366 women were found to have anxiety and/or depression and were randomized to intervention and control groups. Women from the same community were trained in 11 sessions as counselors. Subjects in the intervention group were counseled once weekly for eight weeks by the trained community counselors. After the 8th session, the screening questionnaire was re-administered to both the groups.Results: A significant reduction was found between the mean anxiety and depression scores of the two groups (p value = 0.000).CONCLUSION: Counseling by minimally trained community counselors reduced levels of anxiety and/or depression in women of their own community

Health Needs Assessment for Problem Prioritization in a Primary Healthcare Facility

Background: To determine health needs and potential factors affecting risk behaviors for prioritization of health problems.Methods: In this cross sectional study data was collected through two structured questionnaires using convenience sampling. Questions were asked about the patients and their families. They were evaluated for prevalence of acute and chronic diseases and various risk factors, including hand-washing habits, drinking water, and consumption of staple diet.Results: Each household had an average 10 family members each. The frequency of individuals employed was 60% and self-employed were 25%. The average monthly income was 7000-15000 rupees .Majority (86.7%) individuals owned kacha houses.Water filtration system or boiled water was not a practice in majority (78%).Meat consumption was once a month or less than that in 68% .Conclusion: There is lack of basic hygienic habits among the population of Nurpur Shahan, which is responsible for prevalence of acute infections. The study enables us to identify the actions required to address these health problems that will, in turn, promote wellbeing of the community