i-PUSH-RCT - Examining the impact of maternal perinatal depression on child health outcomes and the role of Innovative Partnership for Universal and Sustainable Healthcare (i-PUSH) intervention: a cluster randomised controlled trial study

Background: The burden of maternal perinatal depression in low- and middle-income countries (LMICs) and its consequences on child health and development are emerging public health problems and are of high priority. Although the pathways connecting maternal perinatal depression and poor childhood outcomes are likely to be complex and varied, perinatal depression during this critical period is more likely to lead to offspring with poor health, development and nutrition outcomes. However, data on maternal mental healthcare, including perinatal depression, is meagre, with limited evidence on feasible detection and treatment strategies, lack of specialist services, lack of guidelines for pregnant and breastfeeding mothers, and stigmatising attitudes among primary healthcare workers and the community. This study aims to investigate the effect of maternal perinatal depression on child health, developmental and nutritional outcomes and whether an innovative partnership for sustainable and healthcare (i-PUSH) intervention using digital technology (mhealth) modifies perinatal depression and its effect on child health, development and nutrition. Methods: This is a longitudinal cluster randomised controlled trial study that uses weekly Health diaries data in Khwisero Sub-county, Kenya. The study aims to evaluate the i-PUSH program-a comprehensive intervention that primarily aims to improve the utilisation of Reproductive and Maternal and Child Health services among women of reproductive age and their young children. The plan is to collect additional data on early childhood development and maternal mental health in relation to COVID-19 pandemic and conduct rigorous analyses of the existing and newly added data from the ongoing i-PUSH study and incorporate capacity building and career development components. The study protocol for the main study was reviewed and approved by the AMREF Health Africa Ethical and Scientific Review Board. New approval will be sought for the new data collection and extension of the analyses. Discussion: The proposed study supports Sustainable Development Goal (SDG) 3 - 'ensure healthy lives and promote wellbeing for all at all ages'. It is particularly important to achieve SGD goals related to maternal and child health (SGDs 3.1 and 3.2) and reducing premature mortality from non-communicable diseases through prevention and treatment and promote mental health and wellbeing (SDG 3.4). The applicant is trained abroad, and an early career researcher (a postdoctoral research scientist) based in Africa at an African-focused research institute. This Career Development Fellowships is a unique opportunity for the applicant's career and professional development both at regional and international levels. It also builds the applicant's research capacity towards independent researcher in maternal and child health research and retains the fellow in sub-Saharan Africa for his future endeavours and contributions.