Elsevier

Journal of Affective Disorders

Volume 292, 1 September 2021, Pages 284-294
Journal of Affective Disorders

Research paper
Effect of a lay counselor delivered integrated maternal mental health and early childhood development group-based intervention in Siaya County, Kenya: A quasi-experimental longitudinal study

https://doi.org/10.1016/j.jad.2021.06.002Get rights and content
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open access

Highlights

  • Integrated maternal mental health & early childhood development program evaluated.

  • 10.3% of enrolled women had probable moderate to severe depression at baseline.

  • No difference in maternal and child outcomes post-intervention by treatment status.

  • Within treatment group, higher program attendance linked to better mental health.

  • More potential program impact for those with less education, higher parity.

Abstract

Background

Maternal mental health is linked to early childhood development; yet there is a gap in evidence-based interventions for low-resource settings. This study estimates the impact of ‘Integrated Mothers and Babies Course and Early Childhood Development’ (iMBC/ECD), a cognitive-behavioral, group-based intervention, on maternal depression and early childhood social-emotional development in Siaya County, Kenya.

Methods

This quasi-experimental study enrolled 417 pregnant women and mothers of children under age 2 across two sub-counties in Siaya County. The intervention area had 193 women in 23 groups implementing iMBC/ECD and the control area had 224 women in 30 groups exposed to ECD only content. Mother/index child dyads were followed for two years. To estimate the causal treatment effect from the non-randomized design, we implemented the propensity score weighting method with inverse probability weights.

Results

At baseline, 10.2% of participants endorsed moderate/severe depressive symptoms. At 14-months post-intervention, 7.4% endorsed moderate/severe depression. Overall, iMBC/ECD intervention did not have a significant impact on reducing maternal depression or improving children's social and emotional development. However, sub-group analyses revealed that iMBC/ECD was associated with lowered depressive symptoms among women with no/low education, four or more children and/or no experience of intimate partner violence in the past year. Women with high program attendance (more than half of 14 sessions) also experienced consistently fewer depressive symptoms compared to those with lower attendance.

Limitations

Non-randomized study, sub-group analyses are exploratory.

Conclusions

The iMBC/ECD program may have the potential to improve maternal mental health and early child development for more targeted vulnerable populations.

Keywords

Mental health
Depression
Early stimulation
Early child development
Cognitive behavior therapy
Lay counselor
Task-shifting
Sub-Saharan Africa

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