Preprint Article Version 1 This version is not peer-reviewed

The Perinatal Mental Health Project: A Critical Appraisal of Program Viability, Accessibility and Sustainability

Version 1 : Received: 28 October 2018 / Approved: 30 October 2018 / Online: 30 October 2018 (09:28:12 CET)

How to cite: Cui, Q.; Jiang, S.; Nie, Y. The Perinatal Mental Health Project: A Critical Appraisal of Program Viability, Accessibility and Sustainability. Preprints 2018, 2018100721 (doi: 10.20944/preprints201810.0721.v1). Cui, Q.; Jiang, S.; Nie, Y. The Perinatal Mental Health Project: A Critical Appraisal of Program Viability, Accessibility and Sustainability. Preprints 2018, 2018100721 (doi: 10.20944/preprints201810.0721.v1).

Abstract

Background. Perinatal depression is one of the leading causes of disability in perinatal women and is highly prevalent in disadvantaged communities in LMICs. However, care capacity remains low in most LMICs. As such, we decided to find and assess a screening program that addresses perinatal mental health problems in a resource-efficient manner. This leads us to a critically appraisal of the Perinatal Mental Health Project (PMHP), a screening program based in peri-urban Western Cape Town that stresses task sharing and stepped care intervention. Method. PubMed, Ovid Medline (1946 to 2018), and Google Scholar were searched for publications until March 2018, with data or evaluation of the PMHP. PMHP website publications were used for data and interpretation. The program’s viability was evaluated based on criteria published by UK National Screening Council. The program’s impact was analyzed using published patient outcome data. Access to care was evaluated at three barriers to accessing care proposed by Gjerdingen et al. (2007). The financial model was evaluated using the “four-pillars” of sustainable organization financial management proposed by León (2001). Findings. The PMHP’s screening program viability satisfies most criteria of the UK National Screening Council, and the program’s benefits outweigh its harms. Patient self-reports indicate successful impact with several highlights in accessibility. The program also demonstrates financial sustainability and potential for scaling-up. Interpretations. The operation model of the PMHP shows satisfactory viability and sustainability. With modifications fitting local context and government cooperation, this model offers promising potential in bringing public health and economic benefits.

Subject Areas

perinatal; mental health; perinatal mental health program; South Africa

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