Delivering the Thinking Healthy Programme for perinatal depression through volunteer peers: a cluster randomised controlled trial in Pakistan

Publication date: February 2019Source: The Lancet Psychiatry, Volume 6, Issue 2Author(s): Siham Sikander, Ikhlaq Ahmad, Najia Atif, Ahmed Zaidi, Fiona Vanobberghen, Helen A Weiss, Anum Nisar, Hanani Tabana, Qurat Ul Ain, Amina Bibi, Samina Bilal, Tayyiba Bibi, Rakshanda Liaqat, Maria Sharif, Shaffaq Zulfiqar, Daniela C Fuhr, LeShawndra N Price, Vikram Patel, Atif RahmanSummaryBackgroundThe Thinking Healthy Programme (THP), which is endorsed by WHO, is an evidence-based intervention for perinatal depression. We adapted THP for delivery by volunteer peers (laywomen from the community) to address the human resource needs in bridging the treatment gap, and we aimed to assess its effectiveness and cost-effectiveness in Rawalpindi, Pakistan.MethodsIn this cluster randomised controlled trial, we randomly assigned 40 village clusters (1:1) to provide either THP peer-delivered (THPP) and enhanced usual care (EUC; intervention group) or EUC only (control group) to the participants within clusters. These villages were randomly selected from eligible villages by an independent researcher. The participants were pregnant women aged 18 years or older who had scored at least 10 on the Patient Health Questionnaire-9 (PHQ-9), who we recruited from households within communities in Rawalpindi, Pakistan. The research teams who were responsible for recruiting trial participants were masked to treatment allocations. Participants attended follow-up visits at 3 and 6 months after childbirth. The prim...
Source: The Lancet Psychiatry - Category: Psychiatry Source Type: research