Acceptability of a role for community health workers in integrated mental health care for perinatal depression: a qualitative study from Surabaya, Indonesia

<jats:title>Abstract</jats:title> <jats:p>Background: Integrated antenatal care in Indonesia has the potential to extend the role of community health workers (CHWs) to include the identification of perinatal depression in the community and referral to primary health care (PHC) centres, which is an example of task-sharing. This study aimed to examine the acceptability of this type of task-sharing in perinatal depression in Surabaya.Methods: Semi-structured interviews were conducted with participants from four PHC stakeholder groups. 62 participants were recruited from PHC centres, villages and integrated health service posts, the district health office, and one hospital. Data were analysed using framework analysis.Results: More than ninety percent of participants accepted or conditionally accepted task-sharing in perinatal depression. Acceptability was influenced by the perceived benefits of task-sharing, the convenience of the service delivery, the existence of cases of perinatal depression perceived by stakeholders, personal characteristics of CHWs, and the scope of their responsibility within existing tasks. Acceptability was limited by stigma of mental health problems, confidentiality, CHWs’ perceived self-capacity, lack of confidence in CHWs’ competencies, and the objectives of task-sharing in depression identification.Conclusion: Results indicate the need to enhance CHWs’ knowledge about perinatal depression and the needs of users, and CHWs’ competencies in identifying depression. Stigma influences potential health service users’ attitudes to mental health services and help-seeking and help-providing behaviours among service providers, and can reduce motivation to use and to provide services.</jats:p>