Psychological interventions delivered by non-specialist health workers are effective for the treatment of perinatal depression in low- and middle-income countries. In this systematic review, the content and delivery of such interventions are described. Nine studies were identified. The interventions shared a number of key features, such as delivery provided within the context of routine maternal and child health care beginning in the antenatal period and extending postnatally; focus of the intervention beyond the mother to include the child and involving other family members; and attention to social problems and a focus on empowerment of women. All the interventions were adapted for contextual and cultural relevance; for example, in domains of language, metaphors and content. Although the competence and quality of non-specialist health workers delivered interventions was expected to be achieved through structured training and ongoing supervision, empirical evaluations of these were scarce. Scalability of these interventions also remains a challenge and needs further attention.
Chowdhary N, Sikander S, Atif N, Singh N, Fuhr D, Rahman A, et al. The content and delivery of psychological interventions for perinatal depression by non-specialist health workers in low and middle-income countries: A systematic review. Best Practice & Research Clinical Obstetrics and Gynaecology 2014; 28: 113–133. DOI: 10.1016/j.bpobgyn.2013.08.013