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.

Journal: Journal of affective disorders

Volume: 292

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Duke Global Health Institute, Durham, NC, USA. Catholic Relief Services, Nairobi, Kenya. Duke Global Health Institute, Durham, NC, USA; Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA. B&M Consult, Nairobi, Kenya. Catholic Relief Services, Baltimore, MD, USA. Duke Global Health Institute, Durham, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: joy.baumgartner@unc.edu.

Abstract summary 

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.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.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.Non-randomized study, sub-group analyses are exploratory.The iMBC/ECD program may have the potential to improve maternal mental health and early child development for more targeted vulnerable populations.

Authors & Co-authors:  Kim Opiyo Acayo Lillie Gallis Zhou Ochieng Okuro Hembling McEwan Baumgartner

Study Outcome 

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Citations :  Asrat B, Schneider M, Ambaw F, Lund C, 2020. Effectiveness of psychological treatments for depressive symptoms among people living with HIV/AIDS in low- and middle-income countries: a systematic review and meta-analysis. J. Affect. Disord 270, 174–187. 10.1016/j.jad.2020.03.068.
Authors :  11
Identifiers
Doi : 10.1016/j.jad.2021.06.002
SSN : 1573-2517
Study Population
Women,Mothers
Mesh Terms
Child Development
Other Terms
Cognitive behavior therapy;Depression;Early child development;Early stimulation;Lay counselor;Mental health;Sub-Saharan Africa;Task-shifting
Study Design
Longitudinal Study,Quasi Experimental Study
Study Approach
Country of Study
Kenya
Publication Country
Netherlands