Depression is a common perinatal complication that can have a profound, adverse effect on
maternal and child health outcomes. The proposed study will directly address this important,
but understudied area by evaluating the feasibility and preliminary effect of an innovative,
integrated intervention approach, BEST-maCARE [Better Education, Support, Treatment for
maternal Capacity, Adherence, REtention in care]. The multi-component intervention is guided
by a model drawn from self-regulation and bioecological systems theory. Proactive counseling
personalized to the patient and socio-cultural context is delivered by trained clinic
personnel (e.g., counselors) to build problem solving and coping skills and linkages to
mental health, HIV treatment and ancillary services. The theory-guided intervention approach
has been found effective in improving the health behavior and outcomes (e.g., virologic) of
vulnerable, marginalized HIV+ women and men in rural and urban settings in the US
(AI38858-ACTG 731; R01NR05108). Although the investigators formative research suggests that
it is well suited for the target population, its usefulness in addressing significant gaps in
care among perinatal women.
l women with co-morbid conditions in a different socio-cultural, limited resource setting has
not been studied.