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The ASHA (Hope) Project: Testing an Integrated Depression Treatment and Economic Strengthening Intervention in Rural Bangladesh: A Pilot Randomized Controlled Trial

Author

Listed:
  • Alison Karasz

    (Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA)

  • Shabnam Anne

    (Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Mohakhali, Dhaka 1212, Bangladesh)

  • Jena Derakhshani Hamadani

    (Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Mohakhali, Dhaka 1212, Bangladesh)

  • Fahmida Tofail

    (Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Mohakhali, Dhaka 1212, Bangladesh)

Abstract

Depression, a debilitating disorder, is highly prevalent among low-income women in low- and middle-income countries. Standard psychotherapeutic approaches may be helpful, but low treatment uptake, low retention, and transient treatment effects reduce the benefit of therapy. This pilot randomized controlled trial examined the effectiveness and feasibility of an integrated depression treatment/economic strengthening intervention. The study took place in two villages in the Sirajganj district in rural Bangladesh. Forty-eight low-income women with depressive symptoms (Patient Health Questionnaire (PHQ-9) score ≥ 10) were recruited and randomized to intervention or control arms. The intervention included a six-month group-based, fortnightly depression management and financial literacy intervention, which was followed by a cash-transfer of $186 (equivalent to the cost of two goats) at 12 months’ follow-up. The cash transfer could be used to purchase a productive asset (e.g., agricultural animals). The control arm received no intervention. Findings showed significant reduction in depression scores in the intervention group. The mean PHQ-9 score decreased from 14.5 to 5.5 (B ± SE, −9.2 ± 0.8 95% CI −10.9, −7.5, p < 0.01) compared to no change in the control group. Most other psycho-social outcomes, including tension, self-esteem, hope, social-support, and participation in household economic decision-making, also improved with intervention. An integrated depression treatment and financial empowerment intervention was found to be highly effective among rural low-income women with depression. Next steps involve formal testing of the model in a larger trial.

Suggested Citation

  • Alison Karasz & Shabnam Anne & Jena Derakhshani Hamadani & Fahmida Tofail, 2021. "The ASHA (Hope) Project: Testing an Integrated Depression Treatment and Economic Strengthening Intervention in Rural Bangladesh: A Pilot Randomized Controlled Trial," IJERPH, MDPI, vol. 18(1), pages 1-11, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:1:p:279-:d:473692
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    References listed on IDEAS

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    1. Christopher Blattman & Julian C. Jamison & Margaret Sheridan, 2015. "Reducing crime and violence: Experimental evidence from cognitive behavioral therapy in Liberia," NBER Working Papers 21204, National Bureau of Economic Research, Inc.
    2. Karasz, Alison, 2005. "Cultural differences in conceptual models of depression," Social Science & Medicine, Elsevier, vol. 60(7), pages 1625-1635, April.
    3. Sherbourne, Cathy Donald & Stewart, Anita L., 1991. "The MOS social support survey," Social Science & Medicine, Elsevier, vol. 32(6), pages 705-714, January.
    4. Karimli, Leyla & Ssewamala, Fred M. & Neilands, Torsten B. & Wells, Christine R. & Bermudez, Laura Gauer, 2019. "Poverty, economic strengthening, and mental health among AIDS orphaned children in Uganda: Mediation model in a randomized clinical trial," Social Science & Medicine, Elsevier, vol. 228(C), pages 17-24.
    5. Johannes Haushofer & Jeremy Shapiro, 2016. "The Short-term Impact of Unconditional Cash Transfers to the Poor: ExperimentalEvidence from Kenya," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1973-2042.
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