TABLE 2.
Summary of results.
| Author | Study design | Sample size | Setting | Strategy | Results | Recommendations |
|---|---|---|---|---|---|---|
| Abrahams et al. (2019) | Mixed-method study (Quantitative analysis and cognitive interviewing) | 66 women (first antenatal visit) | Midwife Obstetric Unit, Hanover Park, Cape Town, South Africa | 4-item screening tool | There is a need to develop culturally validating screening tools for common perinatal MHCs. | The authors emphasise the need for increased investment in mental health infrastructure, particularly in maternal care settings, and advocate for the integration of mental health services into routine perinatal care, the importance of culturally sensitive interventions, the value of community-based approaches and the training of healthcare providers to better identify and manage perinatal MHCs. |
| Boisits et al. (2021) | A mixed-method formative study | 20 health workers and 37 pregnant women | Across four Midwife Obstetric Units, Cape Town, South Africa | Task-shared, low-intensity psychological counselling intervention | The study informed common counselling elements (problem-solving, psychoeducation, basic counselling skills). The findings highlighted that mental health literacy was low. Many women did not recognise symptoms as mental conditions, often describing then ‘in’ behavioural or physical terms. | Mental health literacy among pregnant women was low. Use of task sharing via CHWs to deliver short, structured psychological interventions for perinatal anxiety and depression within existing public health infrastructure. Incorporate key therapeutic components such as problem-solving, behavioural activation, psychoeducation, and basic counselling skills. Use local idioms/metaphors to increase acceptability. |
| Honikman et al. (2025) | Case study / descriptive evaluation of a complex intervention | N/A | Low-resource, high-volume public health maternity facilities, Cape Town, South Africa | A collaborative, stepped-care model: Routine screening for perinatal MHCs (depression, anxiety); Task-sharing with non-specialist providers; Counselling and referral services |
The strategies demonstrated the feasibility of embedding mental health care into routine maternity services. Overall, there was an increased identification of women with perinatal mental health concerns. As a result, a total of 414 sessions were conducted with mental health counsellors for engagement, assessment and triage. Psychotherapy and social support were offered to 392 women, of whom 348 accepted. |
To scale up integrated mental health services in primary care, train non-specialist providers, and use stepped care to optimise resources. |
| Van Heyningen et al. (2019) | A cross-sectional diagnostic tool development study | 376 pregnant women | Primary-level obstetric clinic, Cape Town, South Africa | A 9-item ultra-short screening tool | The tool demonstrated strong psychometric validity for detecting antenatal depression, anxiety and suicidal ideation. | Implementation of screening tools in low-resource settings can improve early detection and intervention for common perinatal MHCs. |
Note: Please see full reference list of this article: Lediga, M.I., Mulondo, M.A. & Tsoka-Gwegweni, J.M., 2026, ‘Service delivery strategies for perinatal mental health in sub-Saharan Africa: A scoping review’, Health SA Gesondheid 31(0), a3222. https://doi.org/10.4102/hsag.v31i0.3222 for more information.
MHC, mental health condition; CHW, Community health workers.