Improving access to psychosocial interventions for perinatal depression in low- and middle-income countries: lessons from the field

Abstract

Over 90% women with perinatal depression in low and middle-income countries do not receive treatment. Scale-up of evidence-based psychosocial interventions is a key challenge. We developed the Thinking Healthy Programme (THP), a psychosocial intervention that can be delivered by non-specialist providers such as community health workers in primary and secondary care settings. Our research showed that three out of 4 women with perinatal depression who received the programme recovered, and there were beneficial effects on infant outcomes. In over a decade since the original research, policy and practice uptake of the programme globally has been promising. We describe factors contributing to this: the programme is relatively inexpensive and culturally transferable; the intervention can be integrated with existing maternal and child health programmes; the programme is amenable to ‘task-sharing’ via peers, nurses, community health-workers and other frontline workers; cascaded models of training and supervision, and the use of technology for training and delivery provide exciting future avenues for scaled-up implementation. These innovations are relevant to the neglected field of public mental health, especially in the post COVID19 era when rates of anxiety and depression are likely to rise globally.

Keywords:

• Perinatal depression
• global mental health
• Thinking Healthy Programme
• psychosocial interventions
• low- and middle-income countries

Disclosure statement

None declared.

Additional information

Funding

The study received no funding. Atif Rahman had full access to all the data in the study and had final responsibility for the decision to submit for publication.