Implementation of a task-shared psychosocial intervention for perinatal depression in South Africa: A grounded theory process evaluation

Perinatal depression carries significant levels of disability for both women and their infants, but there is a large treatment gap for this condition in low and middle-income countries (LMICs). To address this gap, task-sharing using community health workers (CHWs) to provide psychosocial interventions for perinatal depression is increasingly common. Many of these interventions have shown significant positive effects on maternal mood, however not all have done so. This study used data from a task-shared psychosocial intervention for perinatal depression in Cape Town, South Africa, the ‘Africa Focus on Intervention Research for Mental Health’ (AFFIRM-SA) randomised controlled trial (RCT). It aimed to examine the processes that occurred within the delivery of the counselling intervention, and to use these findings to provide recommendations for psychosocial task sharing in LMICs.