Treatment of maternal depression in low-income women: A feasibility
study from Kilifi, Kenya
Aims of the study: To test the feasibility of a group psychosocial
intervention called Learning Through Play (LTP) plus Culturally adapted
Cognitive Behaviour Therapy (CaCBT) for depressed Kenyan mothers with
children aged 0-36 months. Methods used to conduct the study: This study
was a single-arm mixed methods feasibility study to test an integrated
parenting intervention for maternal depression in a low-income rural
area of Fumbini village in Kilifi District of Kenya. Women between the
ages of 18 and 45 years with children up to three years were screened
for depression using PHQ-9 (Patient Health Questionnaire). Those scoring
above 10 on PHQ-9 were interviewed using the Revised Clinical Interview
Schedule (CIS-R) to confirm the diagnosis of depression. Assessments
were carried out at baseline and the end of the intervention (3 months),
followed by qualitative interviews with 12 women. Qualitative interviews
were analysed using thematic analysis from a social-constructionist
theoretical lens. Results of the study: The LTP Plus was both feasible
and acceptable with high satisfaction among the participants.
Qualitative results showed that the women perceived the intervention as
beneficial in reducing the symptoms of depression, coping with stress
and negative emotions. The results also indicated that there was a
reduction in scores on PHQ-9, GAD-7 with an increase in perceived social
support, health-related quality of life and an improvement in mothers’
knowledge about child development at the end of the intervention.
Conclusions drawn from the study and clinical implications: This study
represents the first feasibility research on integrated parenting
intervention in Kenya. The results indicated that culturally adapted LTP
plus CaCBT is feasible and acceptable in a low-income setting of Kenya.
There is now a need to study the clinical and cost-effectiveness of LTP
plus CaCBT in an appropriately powered larger randomised control trial,
with a longer follow-up period.