The effectiveness of a home visitor approach to maternal mental health support and infant stimulation activities for Palestinian on mother and child outcomes

Arm 1 - Intervention ttC (as described under the control treatment) has been "enhanced" - (thus Enhanced ttC; or EttC) to include improved skills of CHWs to provide psychosocial support to mothers, early identification of perinatal depression and other potential mental health referral needs. EttC additionally includes Early Childhood Development information and key methods, such as supporting mothers and their families to appropriately offer infant stimulation and optimize parent-child attachment during the infant's first 12 months of life. Materials and resources used for intervention training and delivery: World Vision International Go-Baby-Go Early Childhood Education Project Model WHO, WVI, WTF (2011) Psychological first aid: Guide for field workers World Vision International ttC Home Visitors Toolkit Between 26 and 30 home visits over a 12-18 month period comprises the control (ttC) and intervention (EttC). Visits begin in the third trimester of pregnancy and are timed according to when key messages are needed for the mother and infant. At a minimum, there are 2 home visits per month, with additional visits prior to birth and in the first 3-months post-delivery. Home visits last approximately one-hour. Each home visit has a different task and focus, based on the ttC toolkit or the updated EttC home visitation calendar. Both available on request. Each visit comprises a new and timed topic (e.g., pre-birth about exclusive breastfeeding and early infant stimulation; while post-birth it focuses on mother receiving rest and sleep). visits are also adapted according to mother-infant needs, which will be done depending on the critical issues facing mother-infant health.