Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial.

Journal: Global mental health (Cambridge, England)

Volume: 8

Issue: 

Year of Publication: 

Affiliated Institutions:  University of North Carolina at Chapel Hill, Pittsboro Street, Chapel Hill, NC , USA. Catholic Relief Services Country Office, Tamale, Ghana. Duke Global Health Institute, Duke University, Durham, NC, USA. Navrongo Health Research Centre, Navrongo, Ghana. Catholic Relief Services Head Quarters, Baltimore, MD, USA. Ghana Health Service, Accra, Ghana.

Abstract summary 

Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.

Authors & Co-authors:  Baumgartner Joy Noel JN Ali Mohammed M Gallis John A JA Lillie Margaret M Owusu Raymond R Abubakr-Bibilazu Safiyatu S Adam Haliq H Aborigo Raymond R McEwan Elena E Zhou Yunji Y Kim Eunsoo Timothy ET Mackness Jessica J Williams John Koku Awoonor JKA Hembling John J

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Aboud FE and Yousafzai AK (2015) Global health and development in early childhood. Annual Review of Psychology 66, 433–457.
Authors :  14
Identifiers
Doi : e18
SSN : 2054-4251
Study Population
Mothers
Mesh Terms
Other Terms
Early childhood development;Ghana;infant mental health;maternal depression;socio-emotional health
Study Design
Randomized Control Trial,Cross Sectional Study
Study Approach
Qualitative
Country of Study
Ghana
Publication Country
England