Nonspecialists providing perinatal depression services in China: a qualitative study^†

Abstract Objective To involve stakeholders in Jiangsu Province, China, to identify barriers for nonspecialist-delivered perinatal depression (PND) management to guide management in maternity and child health care institutions. Methods In this qualitative study, semi-structured face-to-face individual interviews were used, guided by the Consolidated Framework for Implementation Research (CFIR). Thematic analysis was done to categorize data using the CFIR framework’s domains. Results There were a total of 20 interviewees. Barriers coded under the CFIR framework included: needs and resources of those served by the organization, cosmopolitanism, available resources, structural characteristics, access to knowledge and information, and knowledge and beliefs. Conclusions Implementing nonspecialist-delivered PND management poses varying obstacles in different situations. Overcoming these barriers can be accomplished by simplifying interventions based on local conditions, changing women’s and families’ attitudes and help-seeking behaviors toward PND, establishing linkages with psychiatry, strengthening policymakers’ capacity and improving mental health care systems, developing detailed intervention manuals, enhancing clinicians’ mental health literacy, and improving the operation of psychologically appropriate approaches to build self-efficacy.