ArticleInternational journal of mental health systems2016
Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study.
Article in International journal of mental health systems, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Pooled it
- Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks.Implementation science : IS · 2022Pooled it
- Technology-assisted cognitive-behavioral therapy for perinatal depression delivered by lived-experience peers: a cluster-randomized noninferiority trial.Nature medicine · 2025Trial
- Trial
- Delivering the Thinking Healthy Programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study.BMC psychiatry · 2023Trial
- Peer-delivered systems-integrated suicide prevention for women in Pakistan: a protocol for hybrid type II pilot cluster randomized controlled trial.Pilot and feasibility studies · 2026Article
- Unmet Needs in Mental Health: A Cross-Sectional Study on Contact Coverage Gaps and Access to Care for Depression and Anxiety Among Adults in Kailali, Nepal.Brain and behavior · 2026Article
- The Acceptability and Appropriateness of Delivering Postnatal Mental Health Support at Community Health Centers.Annals of the New York Academy of Sciences · 2026Article
- Peer-Led Models Focussed on Emotional Distress and Suicide Prevention: A Scoping Review.International journal of environmental research and public health · 2026Article
- "Global mental health (Cambridge, England) · 2026Article
- Understanding the impact of the PM4M intervention on women's mental wellbeing in Zambia and lessons for implementation: a qualitative study.Frontiers in psychiatry · 2026Article
- Strategies for spreading, scaling and sustaining perinatal mental health interventions in low- and middle-income countries (LMICs): A scoping review and thematic synthesis.Global mental health (Cambridge, England) · 2026Review
- "The satisfaction we get by doing this, you do not get it with any money": Experiences, and motivations of, and strategies used by community volunteers delivering social or health interventions in India.PLOS global public health · 2026Article
- Delivering low-intensity psychological interventions in low- and middle-income countries: A systematic review and meta-ethnographic synthesis of lay health workers' experiences.Global mental health (Cambridge, England) · 2026Review
- Understanding the role and organization of health workers delivering non-communicable disease management in primary care in low- and middle-income countries: a scoping review.BMC primary care · 2025Article
- Exploring barriers and facilitators of mental health care in Sudurpaschim Province, Nepal: a socioecological qualitative study of patients with depression and anxiety and health care professionals.BMC health services research · 2025Article
- Article
- Feasibility and acceptability of community-based psychosocial interventions delivered by nonspecialists for perinatal common mental disorders: A systematic review using an implementation science framework.Global mental health (Cambridge, England) · 2025Review
- Assessing the Quality of Maternal Mental Illness Care Across Maternity Care Settings in Southwestern Uganda.Cureus · 2024Article
- Identification of mothers with mental health problems is accidental: perceptions of health care providers on availability, access, and support for maternal mental health care for adolescent mothers in Malawi.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundPerinatal depression is a public health problem in low and middle income countries. Although effective psychosocial interventions exist, a major limitation to their scale up is the scarcity of mental health professionals. The aim of this study was to explore the facilitators and barriers to the acceptability of peer volunteers (PVs)-volunteer lay women from the community with shared socio-demographic and life experiences with the target population-as delivery agents of a psychosocial intervention for perinatal depression in a rural area of Pakistan.
methodsThis qualitative study was embedded in the pilot phase of a larger peer-delivered mental health programme. Forty nine participants were included: depressed mothers (n = 21), PVs (n = 8), primary health care staff (n = 5), husbands (n = 5) and mothers-in-law (n = 10). Data were collected through in-depth interviews and focus groups and analysed using the Framework Analysis approach.
resultsThe PVs were accepted as delivery agents by all key stakeholders. Facilitators included the PVs' personal attributes such as being local, trustworthy, empathetic, and having similar experiences of motherhood. The perceived usefulness and cultural appropriateness of the intervention and linkages with the primary health care (PHC) system was vital to their legitimacy and credibility. The PVs' motivation was important, and factors influencing this were: appropriate selection; effective training and supervision; community endorsement of their role, and appropriate incentivisation. Barriers included women's lack of autonomy, certain cultural beliefs, stigma associated with depression, lack of some mothers' engagement and resistance from some families.
conclusionPVs are a potential human resource for the delivery of a psychosocial intervention for perinatal depression in this rural area of Pakistan. The use of such delivery agents could be considered for other under-resourced settings globally.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.