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World Innovation Summit for Health

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Catalogue Item

Perinatal Mental Health Project

Organization: University of Cape Town

Country: South Africa

Forum: Mental health

Initiated in 2002, the Perinatal Mental Health Project (PMHP) seeks to integrate mental health care into routine antenatal and postnatal health care to improve outcomes for both mothers and children.

The innovation is based on a collaborative stepped-care approach and task-sharing strategies:

  • Women are screened for psychological distress at their first antenatal booking
  • Women with three or more risk factors and/or those that screen positive for psychological distress are referred to counseling sessions delivered by trained, non-specialized health workers
  • Counselors refer severe cases to the on-site psychiatrist

To support the service, over 2000 health workers have received training in mental health care since 2008.
Between 2002 and 2013, the Project has reached 26,198 women. 17,671 pregnant women have been screened for mental illness and 3,220 women have received on-site counselling at their maternity facility. A total of 8,367 counselling sessions have been delivered by PMHP staff.

This intervention has been shown to have had a positive impact on mothers’ mental health:

  • 90% of women reporting some or regular thoughts of harming themselves or ending their life at screening no longer reported this at their postnatal follow-up
  • 90% of primary and secondary problems presented before counseling improve, with 50-60% of these being either “much improved” or “resolved”
  • 86% of women report improved depressive symptoms and 84% report a decline in anxiety after counselling.

The total program cost per year of delivering care to one mother is US$19.50. The typical private medical insurance rate for one therapy session is approximately US$750. As such, the PMHP model has delivered over US$510,000 of savings in health expenditure.

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