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Educational Interventions for Perinatal Depression Management Among Non-Specialist Providers in Resource-Constrained
Muhammad Khairi Mohd Salleh1, Noran Naqiah Hairi1, Rama Krishna Supramanian1
1Social and Preventive Medicine Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Abstract:
This descriptive systematic review synthesizes evidence from resource-constrained primary and non-specialist care settings on the structural components of educational interventions for frontline health care workers regarding perinatal depression (PND). A comprehensive search was conducted across CINAHL, Cochrane Library, PubMed, and Scopus for experimental and quasi-experimental studies published between January 1, 2019, and August 31, 2025, in Resource-Constrained Settings. Three quasi-experimental, non-randomized studies met the pre-specified inclusion criteria, representing a total of 351 participants across Nigeria, Saudi Arabia, and Thailand. Quality appraisal conducted via the Risk of Bias in Non-randomized Studies of Interventions, Version 2 (ROBINS-I V2) tool judged all 3 studies to be at an overall critical risk of bias. A descriptive narrative synthesis was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) guidelines, as high clinical and methodological heterogeneity precluded a statistical meta-analysis. Preliminary patterns across the included studies suggest that educational models in these settings commonly feature standardized reference frameworks such as the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) and structured active learning approaches. Multi-session delivery formats, cascade (train-the-trainer) models, and practical clinical phases accompanied by remote mobile supervision were reported alongside improvements in immediate provider-level metrics. The extremely narrow evidence base, high attrition rates, lack of comparative control groups, and complete absence of patient outcomes severely constrain the ability to draw definitive conclusions regarding intervention effectiveness or causal mechanisms. The findings are presented as hypothesis-generating, emphasizing the critical need for methodologically rigorous trials in global maternal mental health.
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