Using technology to detect maternal depression

This blog is an interview with Prasansa Subba, Assistant Project Coordinator at TPO Nepal, about the StandStrong project which seeks to identify maternal depression through the use of technology.

Could you tell us a little bit about your experience at TPO Nepal?

I joined TPO Nepal in 2011 and since then have been working in Programme for Improving Mental Health Care (PRIME). It is through this project that I got the opportunity to pursue my M.Phil. in Public Mental Health specializing on maternal depression from University of Cape Town. Apart from PRIME, I have been engaged in several other research projects, for example post-earthquake need assessment, validation study of Post Traumatic Growth Inventory etc. Under my leadership I have also carried out research projects such as mCIDT and am currently leading StandStrong.

What is StandStrong project and how does it work?

‘StandStrong’ stands for Sensing technology to personalize adolescent maternal depression treatment in low resource settings. This project is funded by Bill and Melinda Gates Foundation. Here, we use two sensing technologies (proximity beacon and mobile phones) with adolescent mothers and their babies under 1 year of age. We assume these two devices would help us to identify risk factors of post-natal depression.

Studies show that depressed mothers are less likely to spend time with their children, have less verbal interaction and less mobility. The idea is to attach the proximity beacon to the infant and mobile with the mother. The mobile has Standstrong app installed with features such as episodic audio recording and GPS. When in use, these two devices accumulate data on time spent together by the mother and her baby, pattern of their verbal interaction and the mother’s mobility. We use these devices with both depressed and non-depressed mothers in the first stage to compare the generated data and assess its feasibility and acceptability through qualitative interviews. In the second stage, we take user’s experience into account and modify the app to make it user friendly. And in the third stage, we use it with a cohort of depressed postnatal women and collect their data which can be then reviewed by the mother as well as by service providers. Based on this, the service providers will provide tailored psychosocial intervention to the depressed mothers.

How will it contribute to the well-being of mother and children?

One of the major global challenges for maternal depression is timely detection and treatment. If we can detect depression early, it not only benefits the mother but their children and family as well. The best thing about this project is that it focuses on adolescents and maternal depression, both of which have not received much attention. Secondly, it is trying to bring in the technology to see how it can complement to bring about positive changes in the lives of these young mothers. Through this project we want to ensure that the risk factors are identified at the earliest, and they receive appropriate treatment.

The current intervention being provided for maternal depression at health facilities through PRIME is generic; one size may not fit all. So, we believe that the data collected from these devices will be useful to the service providers to sort of get an idea how the women’s everyday life is like and identify areas that need the most attention.

Why is technology necessary in the context of maternal depression?

There may be chances that information important to identify and treat maternal depression are not available to the service provider. For example, depressed women may be experiencing irritation and therefore may be avoiding being around with her child. This is crucial for the service provider to know, but this type of information often go unreported as such symptoms are taken more as a personal rather than a health problem. Technology can be useful to bridge this gap. As described earlier, the devices we are using and its properties are helpful in monitoring the daily lives of mother and her child, after which tailored intervention can be provided.

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