Global WACh

March 6, 2024

New study aims to promote perinatal mental health screening and reduce the burden of perinatal mood and anxiety disorders in Kenya

Multiple Principal Investigators Drs. John Kinuthia, Amritha Bhat, and Keshet Ronen

Pregnancy and the birth of a child is an exciting and celebratory time for many families. However, for many women and their families, it can be a difficult time if the mother is experiencing symptoms of depression or anxiety. These feelings may get better or go away with time, but if they don’t, it is critical to access care to prevent worsening symptoms and recover. Without appropriate intervention, these feelings can have long term adverse implications for the mental, physical, and emotional health of women, children, and their families.

In Kenya, access to care for perinatal mood and anxiety disorders is limited. Improving access to PMAD treatment among this population requires integration of evidence-based interventions into routine maternal child health (MCH) services. Such efforts have been prioritized in Kenya’s national mental health policy strategy, but their delivery has been limited by lack of provider training and poor linkage across provider cadres (e.g., primary care and mental health providers). There is a need for development and testing of tailored interventions that strengthen workforce capacity and facilitate linkage across provider cadres, as well as implementation strategies to facilitate high- quality intervention delivery.

In a new five-year study funded by the National Institutes of Mental Health, researchers from Kenyatta National Hospital and the University of Washington have identified three interventions to promote perinatal mental health: (1) universal mental health screening, (2) the Problem Management Plus (PM+) counseling intervention for women experiencing PMAD, and (3) telepsychiatry for women with severe symptoms or no response to PM+. They will combine these interventions in a stepped care model, named the Integrated Perinatal Mental Health program, develop implementation strategies to support its integration into routine MCH care in Kenya, and evaluate effectiveness and implementation outcomes of the package in a cluster-randomized trial in 20 healthcare facilities in Western Kenya.

The study is led by Multiple Principal Investigators Dr. John Kinuthia (Obstetrician Gynecologist and Head of Research and Programs, Kenyatta National Hospital), Dr. Amritha Bhat (Perinatal Psychiatrist and Assistant Professor, UW Psychiatry & Behavioral Sciences), and Dr. Keshet Ronen (Assistant Professor, UW Global Health). Dr. Kinuthia is a long-time collaborator and Site Principal Investigator on several Global WACh-affiliated studies, and this study is unique in that it is the first research grant in which Kenyatta National Hospital is the prime funding recipient, with UW as a subcontract. This financial arrangement centers power and decision-making with researchers in Kenya, who best understand the scientific context of the research.