A study by Swiss TPH and partners has shown that a new, locally adapted mental health intervention for women with young children in Zambia led to a 50% reduction in mental health symptoms. The intervention also empowered the women, resulting in a positive impact on the relationship with their children and their economic situation.

The findings, published yesterday in The Lancet Psychiatry, represent an important step toward improving maternal mental health in sub-Saharan Africa, where evidence-based interventions, particularly for young mothers, are limited.

Mental health disorders, such as depression and anxiety, are becoming a growing challenge to global health, with women and low-income households being particularly affected. A previous study by Swiss TPH found that 1 out of 4 mothers in Zambia experience high levels of mental health distress.

Challenges affecting their mental health include food insecurity, lack of stable income and housing and gender-based violence. A shortage of trained mental health professionals and a lack of evidence-based and locally adapted psychosocial interventions make it difficult for health systems to provide mental health services to at-risk populations.

Researchers from Swiss TPH and their partners developed a new intervention targeting mothers with children under the age of 5 years and tested the feasibility, acceptability and impact of this intervention.

Locally adapted intervention provided at community level

The intervention was adapted from the World Health Organization’s (WHO) “Problem Management Plus” intervention that has been proven to be feasible and acceptable for treating at-risk populations such as refugees in high-income countries in the past.

The intervention, which integrates psychoeducation, problem-solving skills and relaxation techniques, was specifically tailored to the needs of young mothers in the Zambian socio-cultural context and delivered by trained community health workers with no clinical background. To develop the intervention, the research team worked with community leaders, local policy makers and mental health providers in Zambia.

A total of 265 women participated in the study, receiving 10 sessions either in-person or over the phone. These sessions included practical exercises such as breathing techniques and coping strategies, alongside education on child development, self-care, healthy habits such as healthy sleep and alcohol prevention.

Positive outcomes for mothers and their families

The study’s findings were very encouraging, with 80% of participants completing the intervention and 90% expressing high satisfaction with the program. Importantly, the intervention was associated with a 50% reduction in mental health symptoms at the six-month follow-up.

“The results of our study show that culturally adapted psychosocial interventions delivered by trained community health workers have the potential to significantly reduce the burden of mental health distress in women with young children in low- and middle-income countries,” said Günther Fink, Head of the Household Economics and Health Systems Research unit at Swiss TPH and first author of the study.

The intervention has not only improved the mental well-being of the mothers but has also had a positive impact on their relationships with their children. Some participants also reported economic improvements, such as starting small businesses or selling home-grown vegetables, as a result of the problem-solving skills they acquired.

“The results underscore the broader potential of the intervention to contribute to the well-being of both mothers and their children, fostering resilience within families and communities,” said Irene Falgas-Bague, project leader and senior author of the publication.

This study represents a significant milestone in Swiss TPH’s commitment to advancing global mental health, particularly in LMICs. “The success of this intervention suggests that it could be adapted and implemented in other sub-Saharan African countries, providing a scalable solution to a critical global health challenge,” said Falgas-Bague.

However, further research will be needed to assess the long-term impact on both mothers and their children, and to explore the integration of this intervention into routine health services.

Provided by
Swiss Tropical and Public Health Institute