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Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial
Last registered on September 09, 2019

Pre-Trial

Trial Information
General Information
Title
Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial
RCT ID
AEARCTR-0004687
Initial registration date
September 08, 2019
Last updated
September 09, 2019 9:57 AM EDT
Location(s)
Region
Primary Investigator
Affiliation
University of Melbourne
Other Primary Investigator(s)
Additional Trial Information
Status
Completed
Start date
2005-04-01
End date
2007-06-30
Secondary IDs
ISRCTN 65316374
Abstract
We evaluate the medium-term impacts of treating maternal depression on women’s mental health, financial empowerment, and parenting decisions. We leverage variation induced by a cluster- randomized control trial that provided psychotherapy to 903 prenatally depressed mothers in rural Pakistan. It was one of the world’s largest psychotherapy interventions, and it dramatically reduced postpartum depression. Seven years after psychotherapy concluded, we returned to the study site to find that impacts on women’s mental health had persisted, with a 17% reduction in depression rates. The intervention also improved women’s financial empowerment and increased both time- and money-intensive parental investments by between 0.2 and 0.3 standard deviations.
External Link(s)
Registration Citation
Citation
Baranov, Victoria. 2019. "Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial." AEA RCT Registry. September 09. https://doi.org/10.1257/rct.4687-1.0.
Experimental Details
Interventions
Intervention(s)
The intervention group received a 16-session Early Multimodal Intervention (EMI), based on cognitive behavioral therapy, delivered by 40 trained Lady Health Workers (LHWs) to mothers in the intervention group. Control group received an enhanced antenatal and postnatal follow-up by a different group of LHWs (16 structured visits monitored by the research team).

Intervention Start Date
2005-07-01
Intervention End Date
2007-06-30
Primary Outcomes
Primary Outcomes (end points)
At the 7-year follow-up, the key outcomes are women's mental health (depression, depression severity, recovery trajectory), decision-making (empowerment, parental investment, parental style, fertility), and child development (physical, cognitive, and socio-emotional).
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The groups were randomized on the basis of union council (smallest rural administrative area with population of approximately 10 - 15,000).

The study was conducted in two rural sub-districts of Rawalpindi district in Northern Punjab, Pakistan. The study area consisted of 40 union councils with a population of 500,000. All women in the study area, in their third trimester of pregnancy, formed the study population.

All recruited subjects were interviewed by trained and clinically experienced members of the research team using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID DSM-IV), a semi-structured interview for the diagnosis of psychiatric disorder. Recruitment continued for about one year until 450 women meeting the SCID criteria for current major depressive episode were recruited into each arm of the study.
Experimental Design Details
Randomization Method
Randomization of the union councils was carried out by the trial center in Rawalpindi.
Randomization Unit
Clusters (union councils).
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
40
Sample size: planned number of observations
900
Sample size (or number of clusters) by treatment arms
20 control union councils, 20 treatment
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
IRB Approval Date
IRB Approval Number
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports and Papers
Preliminary Reports
Relevant Papers