RecruitingNot ApplicableNCT06456307

Integration of Stepped Care for Perinatal Mood and Anxiety Disorders Among Women Attending MCH Clinics


Sponsor

Kenyatta National Hospital

Enrollment

2,970 participants

Start Date

Feb 17, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

Perinatal mood and anxiety disorders (PMAD), defined as depression and anxiety during pregnancy or up to 1 year postpartum, account for substantial morbidity and mortality among birthing people globally especially in low- and middle-income countries. Several evidence-based interventions are recommended for identification and management of PMAD by non-specialist providers in resource-limited settings. This cluster-randomized trial seeks to evaluate the effect of a stepped-care intervention for screening and treatment of PMAD among perinatal women, on clinical and implementation outcomes.


Eligibility

Sex: FEMALEMin Age: 14 Years

Inclusion Criteria5

  • Pregnant and ≥28 weeks gestation
  • Attending ANC care at the facility
  • ≥14 years old
  • Screen positive for PMAD symptoms (PHQ-2≥3 and/or GAD-2≥3)
  • Willing to return to the MCH and PMTCT clinic for study visits

Exclusion Criteria3

  • Less than 28 weeks gestation
  • Any woman at high risk of self-harm based on a study self-harm assessment protocol,
  • Has cognitive impairments or psychotic symptoms

Interventions

BEHAVIORALIntegrated Perinatal Mental health program (systematic screening for PMAD, PM+ and tele-psychiatry)

The intervention includes systematic screening for PMAD symptoms using PHQ-2 and GAD-2, non-specialist delivery of PM+ for participants with likely depression (PHQ-9≥10) or anxiety (GAD-7≥10) and in-facility tele-linkage to mental health specialist for participants with severe depressive symptoms (PHQ-9≥15), those who endorse suicidality, or non-responders to PM+


Locations(2)

Kenyatta National Hospital

Nairobi, Kenya

HomaBay, Siaya and Kisumu

Western Kenya, Kenya

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NCT06456307


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