The effect of early stimulation on maternal depression: A cluster randomised controlled trial

Helen Baker-Henningham ^1*, Christine Powell ¹, Susan Walker ¹ and Sally Grantham-McGregor ²

¹ University of the West Indies, Jamaica
² UCL, United Kingdom

^* To whom correspondence should be addressed. E-mail: helen.henningham{at}uwimona.edu.jm.

Accepted 14 August 2005

Abstract

Objective:To determine the effect of early childhood stimulation with undernourished children and their mothers on maternal depression.

Design:A cluster randomised controlled trial.

Setting:Children and their mothers were recruited from 18 government health centres in the parishes of Kingston, St. Andrew and St. Catherine, Jamaica.

Subjects:Mothers of 139 undernourished children (weight for age < -1.5 z-scores) aged 9 to 30 months.

Intervention:Weekly home visits by community health aides for one year. Mothers were shown play activities to do with their child using home made materials and parenting issues were discussed.

Main outcome measure:Frequency of maternal depressive symptoms assessed by questionnaire. Child development was also measured.

Results:Mothers in the intervention group reported a significant reduction in the frequency of depressive symptoms (b = -0.98; 95% confidence interval: -1.53, -0.41). The change was equivalent to 0.43 SD. The number of home visits achieved ranged from 5 to 48. Mothers receiving > 40 visits and mothers receiving between 25-39 visits benefited significantly from the intervention (b = -1.84, 95% CI:-2.97, -0.72 and b = -1.06, 95% CI:-2.02, -0.11 respectively) while mothers receiving < 25 visits did not benefit. At follow up, maternal depression was significantly negatively correlated with children's developmental quotient for boys only (r = -.35, p < .05).

Conclusions:A home-visiting intervention with mothers of undernourished children, with a primary aim of improving child development, had significant benefits for maternal depression. Higher levels of maternal depression were associated with poorer developmental levels for boys only.

Keywords: child development, developing country, maternal depression, psychosocial stimulation

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