Best practice for community-based management of postnatal depression in developing countries: A systematic review.

Postnatal depression (PND) is a common disorder that can be profoundly disabling for affected mothers and their infants. We reviewed published articles on the community-based management of PND in developing countries. Our aim was to propose recommendations to help women with PND. Various databases were searched for English articles from 2000 to 2014. Twelve articles met the selection criteria. We found that interventions involving cognitive behavioral therapy, infant stimulation, and problem solving can improve outcomes for PND. Challenges to implementation included: dependence on specific cadres of health workers; motivation and capacity of delivery agents for additional responsibilities; high level of supervision required; and lack of structures and mechanisms to ensure fidelity. Recommendations are proposed that can potentially assist future efforts at addressing PND in women, especially in developing countries. Further research is required to address these gaps.