Context
Perinatal depression, stress, and anxiety affect around one in three women in South Africa, and up to one in two in some communities. High prevalence is linked to socio-economic adversity, HIV/AIDS, intimate partner violence and loss levels of support.

Progress has been made through maternity care policies, national guidelines, and the introduction of routine screening. Studies show treatments can be delivered effectively in resource-poor settings using task-sharing approaches. However, under-investment has prevented large-scale implementation.

Partners
Perinatal Mental Health Project; Alan J Flisher Centre for Public Mental Health, University of Cape Town.

Key Findings

Lifetime costs amount to USD 2.8 billion per annual cohort of births (USD 2.9 billion if PTSD and suicide are included). This includes losses in quality of life (USD 1.8 billion), productivity (USD 1.1 billion), and healthcare costs (USD 3.5 million).

Impact
Findings informed the National Mental Health Policy Framework and Strategic Plan 2023–2030 and were widely promoted across media and events.

🔗 Read more in Global Mental Health (paper) and Inspire the Mind (blog).

Context
Perinatal depression and anxiety affects at least one in five women. Prevalence is higher in populations most strongly affected by unemployment, trauma, and intimate partner violence.

Brazil has made strong progress in maternal and child health, but mental health remains under-addressed. Data show that 82% of women with perinatal depression are not identified due to lack of training, screening tools, resources and stigma.

Partners:

Universidade Presbiteriana Mackenzie; Universidade de São Paulo.

Key Findings

Estimated costs: USD 4.86 billion (USD 4.93 billion including maternal suicide). Costs include losses in quality of life (USD 2.65 billion), productivity (USD 2.16 billion), and healthcare costs (USD 50 million).

Impact
Findings discussed with policymakers, translated into reports, and presented at national and international events.

🔗 Read more in Journal of Affective Disorders (paper).

Context
Pakistan has high birth rates and very high prevalence of perinatal mental illness and suicidality, linked to gender inequality, intimate partner violence, and low levels of social support.

The President’s Programme for Mental Health (2019) and the WHO-endorsed Thinking Healthy Programme and Learning through Play represent major milestones in policy and practice. The interventions integrate psychosocial support into maternal health care and have been scaled in research and routine practice, though inflation and disasters challenge sustainability.

Partners

Pakistan Institute of Living and Learning; Health Services Academy; Human Development Research Foundation; Global Maternal Mental Health Alliance; Liverpool University; Manchester University

Key Findings

Lifetime costs are USD 16.5 billion (USD 16.6 billion including maternal suicide). Most costs relate to quality-of-life losses (USD 15.8 billion). Productivity losses are smaller due to unemployment and low wages, and healthcare costs are very low due to lack of provision.

Impact
Findings support advocacy for universal health coverage and scaling of evidence-based programmes like Thinking Healthy and Learning Through Play.

🔗 Read more in Journal of Affective Disorders (paper).

Context
Around 30% of women in Malawi experience perinatal depression, stress, or anxiety. Risk factors include HIV/AIDS, low social support, and intimate partner violence.

Screening tools and interventions such as Thinking Healthy Programme, Problem Management Plus, and Friendship Bench have been piloted in some regions. They are based on task-shifting approaches often utilising volunteers or low paid staff.

Partners
African Alliance for Maternal Mental Health; Kamuzu University of Health Sciences; University of North Carolina; Government of Malawi (Reproductive Health Unit, NCD & Mental Health Unit); NGOs Partners in Health and Saint John of God.

Key Findings

In 2022: Costs USD 0.66m, health benefits USD 0.36m, net benefit USD 35k. By 2026: Costs USD 1.03m, health benefits USD 0.93m, net benefit USD 520k. Return-on-Investment ratios increased from 1.05 (2022) to 1.45 (2026). Results are sensitive to staff salary increases.

Impact
Proof-of-concept work widely disseminated nationally and internationally, including at the Marcé Society and Malawi Mental Health Conference.

🔗 Read more in PLOS ONE (paper).