The content and delivery of psychological interventions for perinatal depression by non-specialist health workers in low and middle income countries: A systematic review

Abstract

Psychological interventions delivered by non-specialist health workers are effective for the treatment of perinatal depression in low- and middle-income countries. In this systematic review, we describe the content and delivery of such interventions. Nine studies were identified. The interventions shared a number of key features, such as delivery provided within the context of routine maternal and child health care beginning in the antenatal period and extending postnatally; focus of the intervention beyond the mother to include the child and involving other family members; and attention to social problems and a focus on empowerment of women. All the interventions were adapted for contextual and cultural relevance; for example, in domains of language, metaphors and content. Although the competence and quality of non-specialist health workers delivered interventions was expected to be achieved through structured training and ongoing supervision, empirical evaluations of these were scarce. Scalability of these interventions also remains a challenge and needs further attention.

Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries

“…The search strategies are available in the Supplemental Appendix. In addition, the bibliographies of systematic reviews of psychological treatments delivered by NSPs in LMICs were also considered (Chowdhary et al 2014, Clarke et al 2013, Rahman et al 2013, van’t Hof et al 2011, van der Waerden et al 2011, van Ginneken et al 2013). …”

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

“…Opportunities for improved co-ordination are offered by using such visits to give advice on nutrition, child health, child development programmes, positive parenting programmes, vaccination programmes, routine childbirth education sessions and community health programmes. 389 Group interventions can seek to achieve improved acceptability and feasibility by being offered in conjunction with individual health-care appointments, as in the CenteringPregnancy model.…”

Postpartum Traditions, Mental Health, and Help-Seeking Considerations Among Vietnamese American Women: a Mixed-Methods Pilot Study

“…In fact, research has demonstrated the effectiveness of this type of intervention in treating perinatal depression and common mental disorders (depressive and anxiety disorders) in other countries, including China and India. 33,34 Future intervention research may consider training lay counselors to reach out to and treat PPD among Vietnamese American mothers. Moreover, practitioners and researchers also need to understand the Vietnamese American mothers' viewpoints about the definition, causes, and symptoms of PPD, as illustrated in this study.…”