An integrated parenting intervention for maternal depression and child development in a low-resource setting: Cluster randomized controlled trial

Nusrat Husain, Tayyeba Kiran, Batool Fatima, Imran B. Chaudhry, Mina Husain, Sadia Shah, Paul Bassett, Nancy Cohen, Farhat Jafri, Shehla Naeem, Zainab Zadeh, Chris Roberts, Atif Rahman, Farooq Naeem, Muhammad Ishrat Husain, Nasim Chaudhry

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: Rates of depression among Pakistani mothers are high, leading to poor developmental outcomes in their children. This study tested the effectiveness of a manualized integrated parenting program; Learning through Play Plus (LTP+) for maternal depression in Karachi, Pakistan. Methods: A cluster randomized control trial conducted from January 2014 to December 2015 across 120 villages in Karachi. A total of 774 depressed mothers aged 18–44 years with children aged 0–30 months old, were included. Villages were randomized to receive LTP+ added to treatment as usual (TAU) or TAU alone. Primary outcomes were severity of maternal depression at 3 and 6 months measured by the Edinburgh Postnatal Depression Scale and child socio-emotional development at 6 months measured by the Ages and Stages Questionnaire (ASQ). Secondary outcomes included maternal anxiety, quality of life, social support, parenting competence, and knowledge about child development. Results: Mothers in the LTP+ group reported significantly lower depression scores compared to those in the TAU group (6.6 vs. 13.8, effect size [ES]: −7.2; 95% confidence interval [CI]: −8.2, −6.1) at 3 and 6 months (7.2 vs. 12.00; ES: −4.6; 95% CI: −5.9, −3.4). Child socio-emotional development at 6 months was significantly better in the LTP+ group on all domains of the ASQ. There were also statistically significant improvements on all secondary outcomes at 3- and 6-month follow-up. Conclusion: In low-resource settings like Pakistan, low-cost integrated parenting interventions delivered by lay health workers can provide effective treatment for depressed mothers, leading to improvements in child development.

Original languageEnglish
Pages (from-to)925-939
Number of pages15
JournalDepression and Anxiety
Volume38
Issue number9
DOIs
Publication statusPublished - Sept 2021
Externally publishedYes

Keywords

  • Pakistan
  • child development
  • low and middle-income countries
  • maternal depression
  • psychosocial development

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