Preventing Perinatal Depression: Cultural Adaptation of the Mothers and Babies Course in Kenya and Tanzania

Huynh-Nhu Le; Elena McEwan; Maureen Kapiyo; Fidelis Muthoni; Tobias Opiyo; Kantoniony M Rabemananjara; Shannon Senefeld; John Hembling

doi:10.3390/ijerph20196811

Preventing Perinatal Depression: Cultural Adaptation of the Mothers and Babies Course in Kenya and Tanzania

Int J Environ Res Public Health. 2023 Sep 23;20(19):6811. doi: 10.3390/ijerph20196811.

Authors

Huynh-Nhu Le¹, Elena McEwan², Maureen Kapiyo³, Fidelis Muthoni³, Tobias Opiyo³, Kantoniony M Rabemananjara¹, Shannon Senefeld², John Hembling²

Affiliations

¹ Department of Psychological and Brain Sciences, The George Washington University, Washington, DC 20006, USA.
² Catholic Relief Services Headquarters, Baltimore, MD 21201, USA.
³ Catholic Relief Services, Nairobi 49675, Kenya.

Abstract

Pregnant women and mothers in sub-Saharan Africa are at high risk for perinatal depression, warranting a need to develop culturally tailored interventions to prevent perinatal depression. This paper documents the process of adapting an evidence-based preventive intervention developed in the United States, the Mothers and Babies Course (MBC), to fit the contexts of rural pregnant women and mothers of young children in Kenya and Tanzania using the updated Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Data from informant interviews and field observations from the planning and implementation phases were used to make adaptations and modifications of the MBC for perinatal women through the eight aspects of FRAME. Follow-up field visits and reflection meetings with case managers and intervention participants indicated that the adapted version of the MBC was well accepted, but fidelity was limited due to various implementation barriers. The FRAME provided an optimal structure to outline the key adaptations and modifications of a preventive intervention intended to maximize engagement, delivery, and outcomes for high-risk perinatal women in rural settings.

Keywords: Framework for Reporting Adaptations and Modifications-Enhanced/FRAME; Kenya; Mothers and Babies Course; Tanzania; cultural adaptation; perinatal depression; prevention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Depression* / epidemiology
Depression* / prevention & control
Depressive Disorder*
Female
Humans
Infant
Kenya
Mothers
Pregnancy
Tanzania

Grants and funding

This work was supported by the Catholic Relief Services. The funder was not involved in any part of the conceptualization, writing, and decision to submit this article.