title: "Someone like us": delivering maternal mental health through peers in two South Asian contexts.
abstract: BACKGROUND
  Peer-led psychosocial interventions are one solution to address the great paucity of skilled mental health human resources in South Asia. The aim of this study was to explore peer-delivered care for maternal depression in two diverse contexts in South Asia.
  
  
  METHODS
  The study was carried out in the urban setting of Goa, India and rural setting in Rawalpindi, Pakistan. In total, 61 in-depth interviews (IDIs) and 3 focus group discussions (FGDs), and 38 IDIs and 10 FGDs, were conducted with multiple stakeholders in urban Goa and rural Rawalpindi respectively. We used the framework approach to analyze data.
  
  
  RESULTS
  Peers from the same community were the most preferred delivery agents of a community-based psychosocial intervention in both sites. There were contextual similarities and differences between the two sites. Preferred characteristics among peers included local, middle-aged, educated mothers with similar experiences to participants, good communication skills and a good character. Key differences between the two contexts included a greater emphasis on the peer׳s family social standing in rural Rawalpindi and financial incentives as motivators for individual peers in urban Goa.
  
  
  CONCLUSIONS
  Generalizability of our findings is limited to two specific contexts in a vast and diverse region.
  
  
  CONCLUSIONS
  Our study demonstrates that peers have the potential to deliver maternal psychosocial interventions in low-income settings. There are contextual differences in the preferred characteristics and motivators between the sites, and these should be carefully considered in program implementation.
authors.affiliation: 1205 Avenue Docteur Penfield, Department of Psychology, McGill University, Montreal Quebec, Canada H3A 1B1. Electronic address: daisy.singla@mail.mcgill.ca.
authors.forename: Daisy
authors.initials: D
authors.lastname: Singla
authors.affiliation: Sangath Center, Succour, Bardez, Porvorim 403501, Goa, India.
authors.forename: Anisha
authors.initials: A
authors.lastname: Lazarus
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Najia
authors.initials: N
authors.lastname: Atif
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Siham
authors.initials: S
authors.lastname: Sikander
authors.affiliation: Sangath Center, Succour, Bardez, Porvorim 403501, Goa, India.
authors.forename: Urvita
authors.initials: U
authors.lastname: Bhatia
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Ikhlaq
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Anum
authors.initials: A
authors.lastname: Nisar
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Sonia
authors.initials: S
authors.lastname: Khan
authors.affiliation: Human Development Research Foundation, Pakistan.
authors.forename: Daniela
authors.initials: D
authors.lastname: Fuhr
authors.affiliation: Sangath Center, Succour, Bardez, Porvorim 403501, Goa, India; Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E7HT, United Kingdom; Center for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
authors.affiliation: Human Development Research Foundation, Pakistan; Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3BX, United Kingdom. Electronic address: Atif.Rahman@liverpool.ac.uk.
authors.forename: Atif
authors.initials: A
authors.lastname: Rahman
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000379:methods*; D005190:Family; D005260:Female; D017144:Focus Groups; D006801:Humans; D007194:India; D008297:Male; D008427:Maternal Health Services; D008429:Maternal Welfare; D008603:Mental Health; D008605:Mental Health Services; D008875:Middle Aged; D010154:Pakistan; D010379:Peer Group; D011203:Poverty; D011247:Pregnancy; D012424:Rural Population
keywords: Community-based intervention; Human resources; Maternal depression; Peer characteristics; Peers
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