Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial
Maternal depression affects one in five women in Malawi. Integrated interventions simultaneously addressing multiple risks are a promising strategy to improve mental health. This study evaluated the impact of a nutrition-sensitive social behaviour change (SBC) intervention (agriculture and livelihoo...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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BMJ
2026
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| Subjects: | |
| Online Access: | https://hdl.handle.net/10568/179714 |
| _version_ | 1855541188111630336 |
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| author | Bliznashka, Lilia Nwabuikwu, Odiche Ahun, Marilyn N Roschnik, Natalie Phiri, Brenda Gondwe-Matekesa, Esnatt Kachinjika, Monice Mvula, Peter Munthali, Alister Maggio, Daniel Katundu, Mangani Maleta, Kenneth Gladstone, Melissa Gelli, Aulo MAZIKO trial team |
| author_browse | Ahun, Marilyn N Bliznashka, Lilia Gelli, Aulo Gladstone, Melissa Gondwe-Matekesa, Esnatt Kachinjika, Monice Katundu, Mangani MAZIKO trial team Maggio, Daniel Maleta, Kenneth Munthali, Alister Mvula, Peter Nwabuikwu, Odiche Phiri, Brenda Roschnik, Natalie |
| author_facet | Bliznashka, Lilia Nwabuikwu, Odiche Ahun, Marilyn N Roschnik, Natalie Phiri, Brenda Gondwe-Matekesa, Esnatt Kachinjika, Monice Mvula, Peter Munthali, Alister Maggio, Daniel Katundu, Mangani Maleta, Kenneth Gladstone, Melissa Gelli, Aulo MAZIKO trial team |
| author_sort | Bliznashka, Lilia |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Maternal depression affects one in five women in Malawi. Integrated interventions simultaneously addressing multiple risks are a promising strategy to improve mental health. This study evaluated the impact of a nutrition-sensitive social behaviour change (SBC) intervention (agriculture and livelihoods, male engagement and Caring for the Caregiver) with or without cash transfers on maternal perinatal depression during the lean season in rural Malawi. A midline survey for a cluster-randomised controlled trial was conducted, where 156 clusters were randomly assigned to four arms (39 clusters/arm): (1) standard of care (SoC), (2) SBC, (3) SBC+low cash (US$17 per month) and (4) SBC+high cash (US$43 per month). Pregnant women and mothers of children <2 years of age (n=2677) were enrolled at baseline (May–June 2022). A subsample of 1303 women was followed-up at midline (November–December 2023). Maternal perinatal depression was assessed using the Self-Reporting Questionnaire with a score of ≥8 indicating symptoms consistent with depression. Intervention effects were estimated using linear mixed effects models. At midline, SBC+high cash reduced depression scores relative to SoC (mean difference −1.13 (95% CI −1.96 to –0.31)) but had no impact on the proportion of women with depressive symptoms. Relative to SoC, SBC+low cash and SBC alone had no impact on depression scores or the proportion of women with depressive symptoms. Relative to SBC alone, adding cash to SBC reduced depression scores and the proportion of women with depressive symptoms regardless of the size of the cash transfer. Cash transfers integrated with SBC can benefit maternal perinatal mental health in rural Malawi during the lean season. |
| format | Journal Article |
| id | CGSpace179714 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | BMJ |
| publisherStr | BMJ |
| record_format | dspace |
| spelling | CGSpace1797142026-01-12T21:42:41Z Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial Bliznashka, Lilia Nwabuikwu, Odiche Ahun, Marilyn N Roschnik, Natalie Phiri, Brenda Gondwe-Matekesa, Esnatt Kachinjika, Monice Mvula, Peter Munthali, Alister Maggio, Daniel Katundu, Mangani Maleta, Kenneth Gladstone, Melissa Gelli, Aulo MAZIKO trial team capacity building rural areas cash transfers social protection nutrition gender randomized controlled trials Maternal depression affects one in five women in Malawi. Integrated interventions simultaneously addressing multiple risks are a promising strategy to improve mental health. This study evaluated the impact of a nutrition-sensitive social behaviour change (SBC) intervention (agriculture and livelihoods, male engagement and Caring for the Caregiver) with or without cash transfers on maternal perinatal depression during the lean season in rural Malawi. A midline survey for a cluster-randomised controlled trial was conducted, where 156 clusters were randomly assigned to four arms (39 clusters/arm): (1) standard of care (SoC), (2) SBC, (3) SBC+low cash (US$17 per month) and (4) SBC+high cash (US$43 per month). Pregnant women and mothers of children <2 years of age (n=2677) were enrolled at baseline (May–June 2022). A subsample of 1303 women was followed-up at midline (November–December 2023). Maternal perinatal depression was assessed using the Self-Reporting Questionnaire with a score of ≥8 indicating symptoms consistent with depression. Intervention effects were estimated using linear mixed effects models. At midline, SBC+high cash reduced depression scores relative to SoC (mean difference −1.13 (95% CI −1.96 to –0.31)) but had no impact on the proportion of women with depressive symptoms. Relative to SoC, SBC+low cash and SBC alone had no impact on depression scores or the proportion of women with depressive symptoms. Relative to SBC alone, adding cash to SBC reduced depression scores and the proportion of women with depressive symptoms regardless of the size of the cash transfer. Cash transfers integrated with SBC can benefit maternal perinatal mental health in rural Malawi during the lean season. 2026-01 2026-01-12T21:42:40Z 2026-01-12T21:42:40Z Journal Article https://hdl.handle.net/10568/179714 en https://hdl.handle.net/10568/140691 https://hdl.handle.net/10568/148967 https://hdl.handle.net/10568/169272 Open Access BMJ Bliznashka, Lilia; Nwabuikwu, Odiche; Ahun, Marilyn N.; Roschnik, Natalie; Phiri, Brenda; et al. 2026. Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial. BMJ Global Health 11(1): e018860. https://doi.org/10.1136/bmjgh-2025-018860 |
| spellingShingle | capacity building rural areas cash transfers social protection nutrition gender randomized controlled trials Bliznashka, Lilia Nwabuikwu, Odiche Ahun, Marilyn N Roschnik, Natalie Phiri, Brenda Gondwe-Matekesa, Esnatt Kachinjika, Monice Mvula, Peter Munthali, Alister Maggio, Daniel Katundu, Mangani Maleta, Kenneth Gladstone, Melissa Gelli, Aulo MAZIKO trial team Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title | Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title_full | Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title_fullStr | Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title_full_unstemmed | Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title_short | Effect of combining lower- and higher-value monthly cash transfers with nutrition-sensitive agriculture, male engagement and psychosocial intervention on maternal depressive symptoms in rural Malawi: A secondary analysis of a cluster-randomised controlled trial |
| title_sort | effect of combining lower and higher value monthly cash transfers with nutrition sensitive agriculture male engagement and psychosocial intervention on maternal depressive symptoms in rural malawi a secondary analysis of a cluster randomised controlled trial |
| topic | capacity building rural areas cash transfers social protection nutrition gender randomized controlled trials |
| url | https://hdl.handle.net/10568/179714 |
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