The feasibility of task-shifting prolonged exposure for Primary Care (PE-PC) for PTSD within a low resource community in the Eastern Cape

Abstract

Although high levels of trauma exposure potentiate an alarming prevalence of PTSD, increasing the need for trauma-focused treatment, the South African health system is unable to care for the population. The South African healthcare system contains a range of systemic and structural inefficiencies, including suboptimal care and shortages of healthcare professionals. PE-PC offers a resource-constrained mental healthcare system solution by integrating an evidence-based intervention (EBI) in primary care settings. Likewise, the present study acknowledges the ratio of mental healthcare professionals to patients in low- and middle-income countries (LMIC). It explores task shifting to expand mental healthcare to primary care settings. The study follows qualitative healthcare design research to explore the experiences and perceptions of the two cohorts of trauma support workers (TSW) from Rhode University and the Joza community in Makhanda. The feasibility of the PE-PC intervention in Makhanda was illustrated through the data obtained from the TSWs' experiences and perceptions of the intervention's utility. The present study presents an essential contribution to the sparse research conducted on treating PTSD in LMIC with shortages in healthcare professionals. The thematic findings look at the trauma support workers (TSWs) role, including some of its challenges, to explore the feasibility of interventions. Some of the themes highlighted unpack the perceived utility of task-shifting in low-resource contexts, the limitations thereof and considerations for future research. Notwithstanding the challenges, the data from the present study indicates that PE-PC can be feasibly task-shifted in low-resource contexts such as Makhanda.