# Strengthening the identification and treatment of depression in primary care in Mozambique

> **NIH NIH K01** · UNIVERSITY OF WASHINGTON · 2020 · $153,105

## Abstract

ABSTRACT
Mozambique was recently estimated to have the highest suicide rate in Africa.
Global modeling exercises
estimate that depression is one of the leading causes of disability nationally, yet our pilot studies suggest
depression is not often identified or treated.
Given limited specialist human resources and reach of the current
mental health system, the Ministry of Health has targeted mental health service integration with primary care as
a high priority. However, there is currently no primary care integration, with all mental healthcare occurring at
district-level specialized psychiatric services. The goal of this award is to broaden the candidate’s expertise to
conduct independent mental health systems research focused on the integration of mental health in global
primary care settings. Through research, coursework, structured mentorship, and conference attendance, the
candidate will develop new competencies in mental health systems research, including: (1) content knowledge
on the evidence-base for integrating mental healthcare in primary care; (2)
mixed-methods
techniques for
pragmatic randomized trials in low- and middle-income country (LMIC) health systems; (3) ethical conduct of
clinical research in LMICs; and (4) professional development to become an independent NIH-funded investigator.
Drs. Deepa Rao, Kenneth Sherr, Jürgen Unützer, Inge Petersen, Palmira dos Santos, and Vasco Cumbe will
mentor and advise the candidate in these four objectives. The research will be conducted in Sofala, Mozambique
in partnership with the Mozambican Ministry of Health. The candidate will determine the optimal screening cut-
off for the Patient Health Questionnaire-9 and conduct the first-ever study of prevalence, associated factors, and
care-seeking for depressive symptoms (including suicidal ideation) among primary care patients in Sofala,
Mozambique (Aim 1).
These data, combined with semi-structured key-informant interviews of existing practices
and perceptions of supply/demand side barriers (Aim 2), will be used to inform the design and implementation
of mental health integration guidelines and decision-support tools.
Last, the candidate will implement and pilot-
test the feasibility of depression care integration within public clinics in Sofala, Mozambique.
The candidate will
collect mixed-methods pilot data of input variables, implementation outcomes, and patient outcomes, paired with
the Consolidated Framework for Implementation Research (CFIR) to systematically assess intervention
characteristics, outer/inner setting, and processes (Aim 3). Pilot effectiveness data, along with analyses of CFIR
constructs affecting implementation, will help identify factors distinguishing between facilities achieving high and
low implementation success, and inform implementation strategies for a follow-on NIH grant testing impact and
implementation strategies in an adequately-powered cluster randomized trial. In Mozambique, this research will
contribute to scala...

## Key facts

- **NIH application ID:** 9994373
- **Project number:** 5K01MH110599-04
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Bradley Wagenaar
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $153,105
- **Award type:** 5
- **Project period:** 2017-08-01 → 2021-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994373

## Citation

> US National Institutes of Health, RePORTER application 9994373, Strengthening the identification and treatment of depression in primary care in Mozambique (5K01MH110599-04). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/9994373. Licensed CC0.

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