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THP-TAP, a tech-supported peer-delivered intervention, proves non-inferior to the standard WHO-THP in relieving perinatal depression at 3 months postpartum.
A landmark study has found that a technology-assisted, peer-delivered version of the World Health Organization’s (WHO) Thinking Healthy Programme (THP) is just as effective as the traditional version in treating perinatal depression (mood disorder). Perinatal depression, which affects 1 in 4 women in low- and middle-income countries, poses a serious public health challenge—particularly where health systems are overstretched. While the WHO-THP is a proven cognitive-behavioral therapy-based intervention, its scale-up has been limited by resource constraints and a shortage of trained health workers.
To address this, Atif Rahman and other researchers co-developed a technology-assisted peer-delivered THP (THP-TAP) in collaboration with end users. This digital adaptation uses tablet-based tools to support women with lived experience of perinatal depression in delivering the intervention. From June 2022 to May 2023, a randomized controlled noninferiority trial was performed across 70 village clusters.
A total of 980 women battling perinatal depression were incorporated through primary health centers and randomized to get either THP-TAP or standard WHO-THP. At 3 months postnatal, 846 participants (86.3%) were assessed. The difference in remission rates between the two groups was 8.91%, with the lower bound of the one-sided 97.5% confidence interval at 4.25% — above the prespecified noninferiority margin of −10% (P<0.0001). This confirms that THP-TAP is non-inferior to WHO-THP.
The findings highlight THP-TAP as a viable and scalable alternative for delivering maternal mental health support in resource-constrained settings, leveraging digital tools and community peers to extend care where it's most needed.
Nature Medicine
Technology-assisted cognitive-behavioral therapy for perinatal depression delivered by lived-experience peers: a cluster-randomized noninferiority trial
Atif Rahman et al.
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