Integrating Family Planning and Mental Health Services Into Postnatal Care for Migrant, Refugee, and Underserved Jordanian Women
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 920
- 试验地点
- 2
- 主要终点
- Number of Participants adopting any modern contraceptive method since baseline
研究概览
简要总结
The goal of this clinical trial is to learn whether an integrated package of mental health screening, brief psychosocial support, and family planning counseling delivered within routine postnatal care can improve reproductive and mental health outcomes in postpartum migrant, refugee, and underserved Jordanian women aged 15-49 attending primary health centers in Mafraq Governorate and the Al-Ghour region of Jordan. The main questions it aims to answer are:
- Does the MARIA intervention increase the use of modern contraceptive methods among postnatal women compared to standard care?
- Does the MARIA intervention reduce the prevalence and severity of postpartum depression symptoms compared to standard care?
Researchers will compare women attending health centers that deliver the full MARIA package (integrated mental health screening, brief psychosocial support, and family planning counseling) to women attending health centers that provide standard care (routine immunization and child health services without the MARIA components) to see if the intervention improves contraceptive use and reduces postpartum depression.
Participants will:
- Complete a 10-question mental health screening tool (Edinburgh Postnatal Depression Scale) at their routine immunization visit
- Receive a brief educational session, psychosocial support, or a referral to specialist mental health services - depending on their screening result
- Receive family planning counseling and information about contraceptive options during the same visit
- Be followed up by a community health worker, as needed
- Participate in three interviews - one in person at enrollment and two by telephone at 4 and 7 months after joining
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 15 Years 至 49 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Postpartum women aged 15-49 years
- •Attending selected primary healthcare centers for infant immunization or healthy child visits
- •Unmet family planning need: interested in using contraception but currently not doing so
- •Living in study villages (Mafraq or Al-Ghour)
- •Migrant, refugee, or underserved Jordanian women
排除标准
- •Currently using a modern contraceptive method
- •Unmarried women
- •Unable to provide informed consent
- •Planning to leave the study area within 7 months
研究组 & 干预措施
MARIA Integrated Family Planning and Mental Health Intervention
Primary healthcare centers randomized to the intervention arm, where the MARIA package is delivered: mental health screening using the Edinburgh Postnatal Depression Scale, stepped-care psychosocial support (Protocols P1-P4), integrated family planning counseling, community health worker follow-up, and supportive supervision of primary healthcare providers.
干预措施: MARIA Integrated Maternal Mental Health and Family Planning Package (Behavioral)
Standard Care (Control)
Primary healthcare centers randomized to the control arm, where women receive routine primary health care services - standard immunization and child health visits - without any MARIA package components. No Edinburgh Postnatal Depression Scale screening, no structured psychosocial protocols, no MARIA provider training, and no community health worker outreach are delivered.
结局指标
主要结局
Number of Participants adopting any modern contraceptive method since baseline
时间窗: from baseline until 7 months
次要结局
- improved provider capacity in family planning and mental health services(at 7 months)
- number of women with postpartum depression(from baseline until 7 months)
- number of women who continue the modern contraception(at the end of the 7 months follow up)
- change in baseline in the number of women who feel empowered(at 7 months)
- change in baseline in the number of women with positive attitude towards pregnancy(at 7 months)
- number of women with improved knowledge of family planning since baseline(at 7 months)
- improved couple communication since baseline(at 7 months)