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 OF AFFECTIVE DISORDERS

卷:292

Article

Kim, Eunsoo Timothy¹  Opiyo, Tobias²  Acayo, Pauline S.²  Lillie, Margaret¹  Gallis, John^1,3  Zhou, Yunji^1,3  Ochieng, Michael⁴  Okuro, Samwel⁴  Hembling, John⁵  McEwan, Elena⁵  Baumgartner, Joy Noel^1,6 

[1] Duke Global Hlth Inst, Durham, NC USA

[2] Catholic Relief Serv, Nairobi, Kenya

[3] Duke Univ, Dept Biostat & Bioinformat, Durham, NC USA

[4] B&M Consult, Nairobi, Kenya

[5] Catholic Relief Serv, Baltimore, MD USA

[6] Univ N Carolina, Sch Social Work, 325 Pittsboro St, Chapel Hill, NC 27599 USA

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

DOI  :  10.1016/j.jad.2021.06.002

来源: Elsevier

【 摘 要 】

Background: Maternal mental health is linked to early childhood development; yet there is a gap in evidencebased 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 postintervention, 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.

【 授权许可】

Free