Abstract
Maternal mental health is a serious yet neglected problem in developing countries, posing threats to maternal and child health and well-being (Haithar et al., 2018). Globally, maternal depression affects 15-57% of mothers (Shidhaye and Giri, 2014), with even higher prevalence of up to 71% among mothers of undernourished children (Abdullahi et al., 2021; Haithar et al., 2018; Stewart et al., 2011). Poor mental health may diminish the mother’s capacity to adequately provide childcare and child-feeding, as well as her ability to adopt and sustain positive behavior change (WHO, 2011). Maternal mental health also affects women’s socioeconomic empowerment and parental investments, which may in turn impact child nutrition and access to health services (Baranov et al., 2020; Lund et al., 2022). Child undernutrition, linked to nearly half of all child deaths, affects 149 million children worldwide with irreversible effects on health, brain development, education, and labor market outcomes (Black et al., 2008; Victora et al., 2008; World Bank, 2020).
This study seeks to implement Problem Management Plus (PM+), an evidence-based psychological intervention introduced by the World Health Organization, in the context of a malnutrition treatment program, to address the crucial link between maternal mental health and child undernutrition. PM+ is designed for individuals experiencing stress, emotional difficulties, and mild to moderate mental health disorders, addressing both psychological and practical problems related to maternal mental health and caregiving. Delivered by trained non-specialist community health workers (CHWs) over six sessions, PM+ integrates cognitive-behavioral and problem-solving approaches. Multiple studies demonstrated PM+’s efficacy among distressed populations in Nepal and Kenya (Bryant et al. 2017; Jordans et al., 2021), but its effectiveness among caregivers of young children has not been explored.
This study will implement a randomized control trial (RCT) targeting a sample of 1,000 mothers/caregivers of undernourished children under five years old, with at least mild common mental health symptoms. Conducted within Taimaka’s existing community-based management of acute malnutrition (CMAM) program in the outpatient setting of northeastern Nigeria, caregiver-child dyads will be recruited from Taimaka’s outpatient program of CMAM. Participants will be randomly assigned to either the treatment group, receiving PM+ alongside standard care, or the control group, receiving only standard care for acute child malnutrition.