A Narrative Review of Implementing Nonpharmacological Interventions for Antenatal Depression in Low Resource Settings With Implications for Palestine.

Antenatal depression affects a substantial proportion of pregnant women and is associated with adverse maternal and infant outcomes, particularly in settings where specialist mental health services are limited. The purpose of this narrative review was to synthesize evidence on the effectiveness and implementation feasibility of nonpharmacological interventions for antenatal depression in low-resource settings, with particular attention to task sharing, cultural adaptation, and relevance to Palestine. A targeted search of PubMed, ScienceDirect, SpringerLink, JMIR Publications, Google Scholar, and an Arabic-language journal was conducted to 30 September 2025. Eligible studies included pregnant women with depressive disorders or clinically relevant depressive symptoms, as well as prevention-oriented antenatal samples in which depressive symptoms were a prespecified outcome. Eligible publications evaluated nonpharmacological interventions using randomized, quasi-experimental, or prospective pre-post designs; linked reports of pregnancy or neonatal outcomes from otherwise eligible antenatal intervention programs were also considered. Twenty-two studies met the inclusion criteria. Generally favorable findings were reported for cognitive behavioral therapy (CBT)- and interpersonal psychotherapy (IPT)-based interventions delivered in individual, group, task-shared, and brief clinic-based formats, although the strength and consistency of evidence varied by study design and population. Favorable findings were also reported for depression-specific acupuncture, brief mindfulness and mind-body programs, nurse-supported counseling, and culturally or spiritually integrated approaches, although the strength of inference varied by study design. Supervised digital formats and task-shared models involving primary health workers, nurses, and midwives showed promise for extending care in constrained systems, whereas unguided self-help approaches produced less consistent findings. Implementation reporting was uneven: service integration, task sharing, brief delivery, and supervised formats supported preliminary feasibility, whereas formal measures of acceptability, fidelity, cost, population reach, and sustainability were infrequently reported. The review identified several potentially implementable nonpharmacological options for antenatal depression in low-resource settings, particularly brief psychological therapies, task-shared models, selected supervised mindfulness formats, nurse-supported counseling, and culturally adapted programs. However, locally codesigned pragmatic studies are required before broad implementation in Palestine and similar humanitarian or resource-constrained settings.