Trial reportSocial science & medicine (1982)2023
Maternal depression, alcohol use, and transient effects of perinatal paraprofessional home visiting in South Africa: Eight-year follow-up of a cluster randomized controlled trial.
Trial report in Social science & medicine (1982), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How effective are community health workers in managing and preventing perinatal depression in sub-Saharan Africa? A systematic review of quantitative evidence.Health policy and planning · 2026Pooled it
- Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy.The Cochrane database of systematic reviews · 2024Pooled it
- Early childhood and early adolescent predictors of internalising symptoms in adolescents: findings from a longitudinal study in a high-risk South African environment.Social psychiatry and psychiatric epidemiology · 2026Article
- Prevalence, risk and protective factors of postpartum depression and anxiety symptoms in the Allada district, Benin.Social psychiatry and psychiatric epidemiology · 2026Article
- Unseen and underserved: A scoping review of perinatal mental health interventions in Sub-Saharan Africa.PLOS mental health · 2026Article
- Women's mental health: current status and evolutionary perspectives.Evolutionary human sciences · 2026Review
- Investigative Approaches to Resilient Emotion Regulation Neurodevelopment in a South African Birth Cohort.Biological psychiatry global open science · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundSouth African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries.
methodsWe examined maternal outcomes at 5- and 8-years' post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time.
resultsMaternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period.
conclusionsDissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains from targeted interventions and address community social-cultural factors. HIV/AIDS continues to spread in this population.
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