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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:
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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MARIA Integrated Family Planning and Mental Health Intervention | Experimental | 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. |
|
| Standard Care (Control) | No Intervention | 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. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MARIA Integrated Maternal Mental Health and Family Planning Package | Behavioral | A multi-component integrated package delivered within routine postnatal and immunization visits at primary healthcare centers. Has 7 components
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants adopting any modern contraceptive method since baseline | from baseline until 7 months |
| Measure | Description | Time Frame |
|---|---|---|
| number of women with postpartum depression | Edinburgh Postnatal Depression Scale | from baseline until 7 months |
| number of women who continue the modern contraception | at the end of the 7 months follow up |
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Inclusion Criteria
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Randa K. Saad, MD | Contact | +962781665060 | rsaad@emphnet.net | |
| Sara Abu Khudair | Contact | sabukhudair@emphnet.net |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Alsheikh Hussein | Irbid | Amman Governorate | 11181 | Jordan |
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| ID | Term |
|---|---|
| D019052 | Depression, Postpartum |
| ID | Term |
|---|---|
| D011644 | Puerperal Disorders |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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|
| change in baseline in the number of women who feel empowered | Oxfam Women's Empowerment Measurement Tool | at 7 months |
| change in baseline in the number of women with positive attitude towards pregnancy | Attitude Toward Potential Pregnancy Scale (APPS) | 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 |
| improved provider capacity in family planning and mental health services | at 7 months |
| Alkhaldieh | Al Mafraq | 11181 | Jordan |
|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |