In search of ‘community’: a critical review of community mental health services for women in African settings

Author:

Elias Lauren1,Singh Aneeha2,Burgess Rochelle A13ORCID

Affiliation:

1. Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK

2. International Research and Exchanges Board (South & South East Asia Centre), 1275 K Street, NW, Suite 600 Washington, DC 20005, USA

3. Research Associate, Department of Social Work, University of Johannesburg, South Africa

Abstract

Abstract Community is deemed a central resource for the improvement of health, across disciplines, contexts and conditions. However, what is meant by this term is rarely critically explored. In Global Mental Health, considerable efforts in recent years have been directed towards scaling up ‘community’ approaches, with variable success, creating the need to better understand approaches to its use. Our study contributes to this need, through a critical review of studies engaging with the term ‘community’ in relation to women’s mental health services in African settings. Our review explored 30 peer-reviewed articles from the past 15 years, which were systematically evaluated for quality of evidence. Studies were then analysed using a blend of conventional and directed content analysis to unpack perspectives on the term’s use in intervention and phenomenological studies. We identified four broad categories of community: (1) place (shared geographical location or institutional affiliation), (2) practice (belongingness to a shared activity or profession), (3) symbols (meanings and experiences associated with shared community life) and (4) identity (diagnostic identity around a mental health condition). Analysis identified community of place as the most common primary focus of interest across the sample, with 80% of papers referencing this dimension. We noted that in studies where communities of practice were the focus, this was in relation to leveraging local knowledge to inform or support service delivery of intervention programmes, often designed by outsiders. Implications for future policy and mental health services research are discussed.

Funder

Institute for Global Health Summer internship scheme

Publisher

Oxford University Press (OUP)

Subject

Health Policy

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