Perinatal depression Mental and Behavioural Disorders Perinatal depression
Conditions
Interventions
Current interventions as of 12/08/2020:
The main intervention will be the Mental Health Gap Action Programme (mhGAP) training which will be delivered to frontline primary care providers in maternal ca
Sponsors
University of Ibadan
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 12/08/2020: Trainers of trainers: 1. Psychiatrists experienced (Master Trainers) with experience in the training of providers in the use of mhGAP-IG and perinatal mental health Trainers: 1. Supervisory physicians 2. Senior nurses 3. Senior community health officers Perinatal women: 1. Consecutive women making their first antenatal visit 2. Consent to participate in trial 3. Score 10 or more on the Edinburgh Postnatal Depression Scale (EPDS) 4. Female 5. Adult aged between 18 and 65 years Previous inclusion criteria: Trainers of trainers: 1. Psychiatrists experienced (Master Trainers) with experience in the training of providers in the use of mhGAP-IG and perinatal mental health 2. Male and female 3. Adult aged between 18 and 65 years Trainers: 1. Supervisory physicians 2. Senior nurses 3. Senior community health officers 4. Currently working in maternal clinics where the study is being conducted 5. Male and female 6. Adult aged between 18 and 65 years Perinatal women: 1. Consecutive women making their first antenatal visit 2. Consent to participate in trial 3. Score 10 or more on the Edinburgh Postnatal Depression Scale (EPDS) 4. Female 5. Adult aged between 18 and 65 years
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 12/08/2020: Perinatal women: 1. Suicidality 2. Patient too ill to cope with interview Previous exclusion criteria: Perinatal women: 1. Severe depression (EPDS score 18 or more) 2. Suicidality 3. Patient too ill to cope with interview
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 12/08/2020: Primary implementation outcome: Perinatal depression identified using Edinburgh Postnatal Depression Scale before and after cascade training Primary effectiveness outcome: Remission rates from depression defined as an EPDS score of 5 or less at 6 months postpartum Previous primary outcome measures: Depression measured using the Edinburgh Postnatal Depression Scale at baseline and 3 months | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 12/08/2020: 1. Level of disability assessed with the WHO-DAS at 6 months postpartum 2. Infant growth and development outcomes: 2.1. Gestational age at birth, place of delivery, infant birth weight and head circumference, obtained from enquiry from the perinatal women and from direct measurement of the infants by research assistants at birth 2.2. Infant well-being assessment at 3 months, 6 months and 1 year post-delivery Secondary implementation outcomes: a range of mixed-methods assessments will be conducted as follows: 1. Pre and post-test of providers on knowledge of and attitude to perinatal depression with knowledge of depression scale and depression attitude questionnaire after each training session 2. Assessment of knowledge retention using knowledge of depression scale and depression attitude questionnaire at 6 months after training 3. Supportive supervision of clinics with a structured checklist throughout implementation 4. Assessment of quality of intervention using the Enhancing Assessment of Common Therapeutic factors (ENACT) during implementation 5. Qualitative interviews during and after implementation Previous secondary outcome measures: 1. Patient outcomes: (within 72 hours of being screened and outcome assessments at 3 and 6-month post-delivery) 1.1. Service utilisation, income, accommodation and other cost-related variables measured using the Client Service Receipt Inventory– Postnatal version (CSRI-PND)) 1.2. Disability measured using the World Health Organization Disability Assessment Scale (WHO-DAS) 1.3. Patient care measured using the Patient Assessment of Chronic Illness Care questionnaire 2. Assessment of quality of intervention: Extent to which providers are using the skills acquired during the training measured using the Enhancing Assessment of Common Therapeutic factors (ENACT) rating scale 3. Assessment of contextual factors affecting delivery of intervention: Qualitative interviews will be c | — |
Countries
Nigeria
Outcome results
None listed