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Comrie-Thomson, Liz, Webb, Karen, Patel, Diana, Wata, Precious, Kapamurandu, Zivanai, Mushavi, Angela, Nicholas, Mary-Ann, Agius, Paul A, Davis, Jessica and Luchters, Stanley (2022) 'Engaging women and men in the gender-synchronised, community-based Mbereko+Men intervention to improve maternal mental health and perinatal care-seeking in Manicaland, Zimbabwe: A cluster-randomised controlled pragmatic trial'. Journal of Global Health, Vol 12, 04042.
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Abstract
Background
Maternal mental morbidity and low perinatal health service utilisation in resource-constrained settings contribute substantially to the global burden of poor maternal, newborn, and child health. The community-based Mbereko+Men program in rural Zimbabwe engaged women and men in complementary activities to improve men’s support for women and babies, coparents’ equitable, informed health decision-making, and ultimately, maternal mental health and care-seeking for maternal and newborn health services. The study aimed to test the effectiveness of the Mbereko+Men program on maternal mental health at 0-6 months after childbirth.
Methods
We conducted a cluster-randomised controlled pragmatic trial using a two-arm parallel design with four clusters per arm. Data was data collected through cross-sectional surveys before and after the implementation of the intervention or standard care. Rural health facility catchments in Mutasa District, Zimbabwe, were randomised using a true random number sequence. Survey participants were women who had given birth within 0-6 months and their male coparents. The primary outcome was women’s mean Edinburgh Postnatal Depression Scale (EPDS) score. Secondary outcomes captured care-seeking, men’s supportive behaviours, and gender dynamics in coparent relationships. Masking was not used. All clusters were included in the analysis. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001014943) in October 2020.
Results
Between April 13 and May 20, 2016, 457 women and 242 men participated in the pre-intervention survey; between October 19 and November 30, 2017, 433 women and 273 men participated in the post-intervention survey. Women’s mean EPDS scores declined in both arms. The decline was 34% greater in the intervention arm (adjusted risk ratio = 0.66; 95% confidence interval = 0.48, 0.90, P = 0.008). Improvements in care-seeking, men’s support, and coparents’ relationships were detected.
Conclusions
A low-intensity gender-synchronised intervention engaged women and men to improve maternal mental health and care-seeking in a setting characterised by gender inequality and demand-side barriers to care.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WQ Obstetrics > WQ 20 Research (General) WQ Obstetrics > WQ 500 Postnatal care |
| Faculty: Department: | Clinical Sciences & International Health > International Public Health Department |
| Digital Object Identifer (DOI): | https://doi.org/10.7189/jogh.12.04042 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 08 Sep 2022 13:35 |
| Last Modified: | 14 Jun 2023 11:00 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/20500 |
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