Gender Transformative Interventions for Perinatal Mental Health in Low and Middle Income Countries—A Scoping Review
Abstract
:1. Introduction
2. Method
2.1. Identifying the Research Question
2.2. Identifying Relevant Studies
2.3. Study Selection (Inclusion and Exclusion)
- Published in English
- Programs designed and implemented in LMIC countries.
- Studies having any one of the three mental health outcomes in the perinatal period which include
- a.
- Improvement in social support or better relationship with partner;
- b.
- Decrease in depression, anxiety or any Common Mental Disorder;
- c.
- Decrease in Domestic violence or Intimate Partner Violence.
- Any study design—RCTs, Non Randomised Controlled studies, Case Control studies, pre post intervention studies.
- Publication years 2007–2022.
- Study location not in LMIC.
- Studies not relating to perinatal period.
- Studies not relating to mental health or risk.
- Studies not relating to maternal mental health.
2.4. Charting the Data
2.5. Reporting the Results
3. Results
3.1. Article Characteristics
3.2. Program Evaluation
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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S/No | Author, Year and Country | Target Population and Sample Size | Gender-Transformative Components | Aspect of Male Engagement | Primary Outcomes (With Data if Possible) |
---|---|---|---|---|---|
1 | Santhya et al., 2008 [41] West Bengal and Gujarat, India | Women (pregnant and post-partum first time mothers), husbands and family members 2115 women | The First Time Parent project targeted young married women and their husbands as well as family members to modify gender norms and support prenatal as well as maternal healthcare behaviours. | Outreach workers interacted with husbands about pregnancy and delivery plans. Husbands received home visits from male outreach workers. |
|
2 | Comrie-Thomson, L. et al. (2015) [42] Bangladesh, Tanzania and Zimbabwe | Married men and their wives 237 males and females | Education and outreach were conducted with men’s groups and individual men through designated gender equality champions, peer educators or role models. Dialogue, education and mobilisation were conducted with traditional and religious leaders, who have influence over community beliefs and behaviours. Integrated gender equality and male engagement messages delivered through a wide range of activities including community Theatre for Development (T4D), community radio (in Barguna), and community meetings. | Education and outreach were conducted with men’s groups and individual men through designated gender equality champions, peer educators or role models. |
|
3 | Raj et al., 2016 [23] Yore et al., 2016 [43] Maharashtra, India | Married men and their wives 1081 Rural young husbands and their wives | The intervention involved three gender, culture and contextually-tailored family planning and gender equity (FP + GE) counseling sessions. A desk-sized CHARM flipchart was used by village health providers to provide men and couples with pictorial information on family planning options, barriers to family planning use including gender equity-related issues (e.g., son preference), the importance of healthy and shared family planning decision-making, and how to engage in respectful marital communication and interactions (inclusive of no spousal violence in the men’s sessions). | Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) intervention, a multi-session intervention delivered to males alone, but included a session with their wives. |
|
4 | Doyle et al., 2018 [44] Rwanda | Expectant/current fathers and their partners (pregnant women) 575 couples and 1123 men | The Bandebereho couples’ intervention engaged men and their partners in participatory, small group sessions of critical reflection and dialogue. In Rwanda, the MenCare+ program was known as Bandebereho, or “role model”, as it aimed to transform norms around masculinity by demonstrating positive models of fatherhood. | Transform norms around masculinity by demonstrating positive models of fatherhood. Sessions addressed: gender and power; fatherhood; couple communication and decision-making; IPV; caregiving; child development; and male engagement in reproductive and maternal health. |
|
5 | Bapolisi et al., 2020 [45] Democratic Republic of Congo | Husbands and wives 800 men and women | The “Mawe tatu” program, links Village Savings and Loans Associations (VSLA) for women with men-to-men sensitisation to transform gender-inequitable norms and behaviours for the empowerment of women. Comprehensive sexuality education for young people, which includes gender and rights themes, is offered as well. | Developing “positive masculinity” by engaging men, if possible spouses of VSLA’s members, towards women’s rights using a peer-to-peer approach. |
|
6 | Comrie-Thomson et al., 2022 [46] Manicaland, Zimbabwe | Women and male co-parents 433 women (Pregnant and post-partum mothers up to 2 years post-pregnancy) and 273 men | Women participated in Participatory learning action (PLA) cycles conducted through monthly one-hour group discussions. Discussions explored MNCH services and home care practices recommended during pregnancy and between zero and two years of age, including services for the prevention of mother-to-child transmission of HIV (PMTCT). The +Men component was delivered by a trained male OPHID staff member who was also a nurse and midwife with substantial community development experience, targeting men. Men participated in monthly one-hour group discussions. Discussions explored similar health topics to those addressed in women’s groups and the same flip chart was used to present information. | Men participated in monthly one-hour group discussions, facilitated by the male project staff member in men’s workplaces or a central community location. |
|
S/No | Study Design (Format) | Male Engagement Intervention | Individual/Couple/Group Intervention | Facilitators | Inclusion of Other Family Members |
---|---|---|---|---|---|
1 | Randomised controlled trial | MenCare+ program | Couple based intervention. Men along with their current partners (pregnant wonen) were included. Men alone were invited for 15 sessions and with their partners were invited for 8 sessions. | Sex-matched interviewers from Laterite, who had no involvement in the intervention, conducted the interviews. Community volunteers (local fathers) met with the same group of 12 men/couples on a weekly basis. The volunteers received a two-week training, material support, and refresher training. Local nurses and police officers co-facilitated the sessions on pregnancy, family planning, and local laws, respectively. | No |
2 | Cluster randomised controlled trial | CHARM gender-equity (GE) counselling in family planning (FP) services. The intervention involved three gender, culture and contextually-tailored family planning and gender equity (FP + GE) counselling sessions delivered by trained male village health care providers to married men (sessions 1 and 2) and couples (session 3) in a clinical setting. | Couple-based intervention | CHARM providers were allopathic (n = 9) and non-allopathic (n = 13) village health care providers trained over three days on FP counselling, GE and IPV issues, and CHARM implementation. All VHPs in the study villages were male; 22 VHPs were trained for delivery. | No |
3 | Qualitative study | Focus-group discussions and in-depth interviews | Men-only counselling Couples counselling | Male community workers engaged in men-only education group sessions. | No |
4 | Cluster-randomised, longitudinal intervention study | Positive masculinity groups | Only men peer-to-peer discussion groups | Information not given | No |
5 | A cluster-randomised controlled pragmatic trial | +Men component | Only men discussion groups Men and women were assessed separately for baseline scores. | Trained male Public Health Interventions and Development (OPHID) staff members. | No |
6 | A quasi-experimental research design | First-time Parents Project | Women-only sessions from female outreach workers. Husbands received home-visits from male outreach workers. | Same-sex facilitators conducted interventions. | Yes. Mothers and mother-in-law were included for home-visit based interventions (family sessions). |
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Raghavan, A.; Satyanarayana, V.A.; Fisher, J.; Ganjekar, S.; Shrivastav, M.; Anand, S.; Sethi, V.; Chandra, P.S. Gender Transformative Interventions for Perinatal Mental Health in Low and Middle Income Countries—A Scoping Review. Int. J. Environ. Res. Public Health 2022, 19, 12357. https://doi.org/10.3390/ijerph191912357
Raghavan A, Satyanarayana VA, Fisher J, Ganjekar S, Shrivastav M, Anand S, Sethi V, Chandra PS. Gender Transformative Interventions for Perinatal Mental Health in Low and Middle Income Countries—A Scoping Review. International Journal of Environmental Research and Public Health. 2022; 19(19):12357. https://doi.org/10.3390/ijerph191912357
Chicago/Turabian StyleRaghavan, Archana, Veena A. Satyanarayana, Jane Fisher, Sundarnag Ganjekar, Monica Shrivastav, Sarita Anand, Vani Sethi, and Prabha S. Chandra. 2022. "Gender Transformative Interventions for Perinatal Mental Health in Low and Middle Income Countries—A Scoping Review" International Journal of Environmental Research and Public Health 19, no. 19: 12357. https://doi.org/10.3390/ijerph191912357