Effectiveness of community-based and community-led interventions to improve the psychosocial well-being of those affected by skin-NTDs: A systematic review

Abstract

Introduction Skin-related neglected tropical diseases (skin-NTDs) are a subgroup of neglected tropical diseases (NTDs) that present with manifestations of the skin, often leading to stigmatization and discrimination of those affected. Community models may be a promising feature in improving the mental health of those affected by skin-NTDs by providing mental health care or resources in areas without formal mental health services. This review aimed to identify existing community-based interventions for improving the psychosocial well-being of individuals affected by skin-NTDs, as well as to evaluate their effectiveness. Sub-questions focused on identifying which interventions are also community-led and evaluating cost-effectiveness. Methodology/Principle findings This study is a systematic review, and the protocol was registered with PROSPERO (CRD420251015152). The interventions were evaluated according to an integrated framework and if provided, the cost-effectiveness of the interventions was also assessed. 16 papers were included in this review, and interventions were grouped as either: (I) Group-based, (II) Counselling, (III) Basic Psychological Support, (IV) Management Programs, or (V) Mixed interventions. Results indicated that community-based interventions were effective in reducing internalized stigma and improving the well-being of persons affected by skin-NTDs. Results emphasized how community leadership of interventions is a foundation for its sustainability. There was sparse information on the cost of interventions. Conclusions/Significance The findings emphasize that community leadership and participatory methods are a promising method for research in this field and future research should aim to follow this. While only a few interventions addressed multiple skin-NTDs, there is potential for integration of these interventions, both in addressing multiple diseases and for integration within local health structures. The findings highlight that effective interventions exist to support communities without formal mental health resources to improve the psychosocial well-being of those affected by skin-NTDs.