Journal Publications
Together with our local and international collaborators, numerous journal articles have been published from OPHID’s work. A selection of these can be found here.
Background
Maternal mental morbidity and low perinatal health service utilisation in resource-constrained settings contribute substantially to the global burden of poor maternal, newborn, and child health. The community-based Mbereko+Men program in rural Zimbabwe engaged women and men in complementary activities to improve men’s support for women and babies, coparents’ equitable, informed health decision-making, and ultimately, maternal mental health and care-seeking for maternal and newborn health services. The study aimed to test the effectiveness of the Mbereko+Men program on maternal mental health at 0-6 months after childbirth.
Methods
We conducted a cluster-randomised controlled pragmatic trial using a two-arm parallel design with four clusters per arm. Data was data collected through cross-sectional surveys before and after the implementation of the intervention or standard care. Rural health facility catchments in Mutasa District, Zimbabwe, were randomised using a true random number sequence. Survey participants were women who had given birth within 0-6 months and their male coparents. The primary outcome was women’s mean Edinburgh Postnatal Depression Scale (EPDS) score. Secondary outcomes captured care-seeking, men’s supportive behaviours, and gender dynamics in coparent relationships. Masking was not used. All clusters were included in the analysis. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001014943) in October 2020.
Results
Between April 13 and May 20, 2016, 457 women and 242 men participated in the pre-intervention survey; between October 19 and November 30, 2017, 433 women and 273 men participated in the post-intervention survey. Women’s mean EPDS scores declined in both arms. The decline was 34% greater in the intervention arm (adjusted risk ratio = 0.66; 95% confidence interval = 0.48, 0.90, P = 0.008). Improvements in care-seeking, men’s support, and coparents’ relationships were detected.
Conclusions
A low-intensity gender-synchronised intervention engaged women and men to improve maternal mental health and care-seeking in a setting characterised by gender inequality and demand-side barriers to care.
Patel D, Matyanga P, Nyamundaya T, Chimedza D, Webb K, Engelsmann B. Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe. J Int AIDS Soc. 2012 Jul 11;15 Suppl 2:17404. doi: 10.7448/IAS.15.4.17404.
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Ciaranello AL, Leroy V, Rusibamayila A, Freedberg KA, Shapiro R, Engelsmann B, Lockman S, Kelly KA, Dabis F, Walensky RP. Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival. AIDS. 2014 Jul;28 Suppl 3:S287-99. doi: 10.1097/QAD.0000000000000337.
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Ciaranello AL, Perez F, Engelsmann B, Walensky RP, Mushavi A, Rusibamayila A, Keatinge J, Park JE, Maruva M, Cerda R, Wood R, Dabis F, Freedberg KA.Cost-effectiveness of World Health Organization 2010 Guidelines for Prevention of Mother-to-Child HIV Transmission in Zimbabwe. Clin Infect Dis. 2013 Feb;56(3):430-46. doi: 10.1093/cid/cis858. Epub 2012 Nov 30.
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Ciaranello AL, Perez F, Maruva M, Chu J, Engelsmann B, Keatinge J, Walensky RP, Mushavi A, Mugwagwa R, Dabis F, Freedberg KA; CEPAC-International Investigators. WHO 2010 guidelines for prevention of mother-to-child HIV transmission in Zimbabwe: modeling clinical outcomes in infants and mothers. PLoS One. 2011;6(6):e20224. doi: 10.1371/journal.pone.0020224. Epub 2011 Jun 2.
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Ciaranello AL, Perez F, Keatinge J, Park JE, Engelsmann B, Maruva M, Walensky RP, Dabis F, Chu J, Rusibamayila A, Mushavi A, Freedberg KA. What will it take to eliminate pediatric HIV? Reaching WHO target rates of mother-to-child HIV transmission in Zimbabwe: a model-based analysis. PLoS Med. 2012 Jan;9(1):e1001156. doi: 10.1371/journal.pmed.1001156. Epub 2012 Jan 10.
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Perez F, Aung KD, Ndoro T, Engelsmann B, Dabis F. Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study. BMC Public Health. 2008 Dec 5;8:401. doi: 10.1186/1471-2458-8-401.
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Mugore L, Engelsmann B, Ndoro T, Dabis F, Perez F. An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe. AIDS Care. 2008 Jul;20(6):660-6. doi: 10.1080/09540120701687034.
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Perez F, Zvandaziva C, Engelsmann B, Dabis F. Acceptability of routine HIV testing ("opt-out") in antenatal services in two rural districts of Zimbabwe. J Acquir Immune Defic Syndr. 2006 Apr 1;41(4):514-20.
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Orne-Gliemann J, Mukotekwa T, Perez F, Miller A, Sakarovitch C, Glenshaw M, Engelsmann B, Dabis F. 9. Improved knowledge and practices among end-users of mother-to-child transmission of HIV prevention services in rural Zimbabwe. Trop Med Int Health. 2006 Mar;11(3):341-9.
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