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Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis
Open accessAbstract
OBJECTIVE: To assess the effectiveness of interventions to improve the mental health of women in the perinatal period and to evaluate any effect on the health, growth and development of their offspring, in low- and middle-income (LAMI) countries. METHODS: Seven electronic bibliographic databases were systematically searched for papers published up to May 2012 describing controlled trials of interventions designed to improve mental health outcomes in women who were pregnant or had recently given birth. The main outcomes of interest were rates of common perinatal mental disorders (CPMDs), primarily postpartum depression or anxiety; measures of the quality of the mother-infant relationship; and measures of infant or child health, growth and cognitive development. Meta-analysis was conducted to obtain a summary measure of the clinical effectiveness of the interventions. FINDINGS: Thirteen trials representing 20 092 participants were identified. In all studies, supervised, non-specialist health and community workers delivered the interventions, which proved more beneficial than routine care for both mothers and children. The pooled effect size for maternal depression was -0.38 (95% confidence interval: -0.56 to -0.21; I (2) = 79.9%). Where assessed, benefits to the child included improved mother-infant interaction, better cognitive development and growth, reduced diarrhoeal episodes and increased immunization rates. CONCLUSION: In LAMI countries, the burden of CPMDs can be reduced through mental health interventions delivered by supervised non-specialists. Such interventions benefit both women and their children, but further studies are needed to understand how they can be scaled up in the highly diverse settings that exist in LAMI countries.
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“Presently, meager resources within public health frameworks are allocated toward addressing perinatal depression; nonetheless, recent investigations underscore the efficacy of psychosocial interventions dispensed by lay women (Rahman et al., 2013).”
From Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach (2025) · cites this paper as Rahman et al., 2013
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“Recent systematic reviews have indicated effective use of task-shifting for the delivery of psychosocial interventions for the prevention and treatment of perinatal depression through community health workers [18, 19].”
From Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study (2016) · cites this paper as [18]
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Metadata
- Authors
- Rahman, A., Fisher, J., Bower, P., Luchters, S., Tran, T., Yasamy, M. T., Saxena, S., & Waheed, W.
- Affiliations
- Institute of Psychology, Health and Society, University of Liverpool, Alder Hey Children’s Hospital, Mulberry House, Eaton Road, Liverpool, L12 2AP, England.
- Jean Hailes (AU)
- University of Manchester (GB)
- Burnet Institute (AU)
- Research and Training Centre for Community Development, Hanoi, Viet Nam.
- World Health Organization (CH)
- ORCID
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2013-04-18
- Volume
- 91
- Issue
- 8
- Pages
- 593-601I
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC3738304
- OpenAlex
- W2124280624
- Cited by
- 403
- References
- 54
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 35 · 2023: 35 · 2022: 49 · 2021: 47 · 2020: 40 · 2019: 36 · 2018: 27 · 2017: 25 · 2016: 32 · 2015: 15 · 2014: 16 · 2013: 5
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- perinatal mental disorders, postpartum depression, postpartum anxiety, maternal mental health interventions, community-based intervention, mother-infant relationship, child cognitive development, child growth, diarrhea, immunization, low- and middle-income countries
- MeSH terms
- Anxiety, Mental Disorders, Child Development, Developing Countries, Female, Humans, Infant, Mother-Child Relations, Mothers, Pregnancy, Puerperal Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Perinatal Care, Depression, Postpartum
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