Lost in Translation? Cultural Adaptation of Child Mental Health Interventions in Nepal: A Systematic Review

Abstract

This systematic review provides a synthesis of the state of the evidence relating to child and adolescent mental health interventions in Nepal, with particular emphasis on the use and impact of cultural adaptation of these interventions. The review follows the PRISMA and JBI review guidance. Nine papers met the inclusion criteria, studies were characterised by methodological weaknesses impacting on their reliability. Five of the nine studies reported statistically significant improvements, of these, all except one worked with the family and wider community alongside the child. The use of cultural adaptation was implemented in all studies, but varied in terms of the extent of the adaptation processes used. The findings from this review indicate that high quality studies are needed in this area, particularly those which consider the influence on the collectivist nature of Nepali culture on design of the intervention. Interventions need to consider cultural adaptation more closely, as well as the acceptability of the intervention to the wider community.