ASHA Bangladesh: An Integrated Intervention Combining Depression Treatment and Poverty Alleviation for Low-Income Rural Women

What this Trial Is About

Researchers are evaluating the effects of combining poverty alleviation with depression treatment compared to depression treatment alone in low-income rural Bangladeshi women aged 18 to 45 who have depression. The study aims to find out if adding poverty alleviation improves depression symptoms at 6 months, reduces relapse at 18 months, and enhances treatment uptake and retention. Other outcomes include economic vulnerability, anxiety, culturally specific symptoms, quality of life, and function. The study includes a mixed methods evaluation examining how well the interventions are adopted and delivered. Participants are randomly assigned to one of two groups. The control group receives six sessions of a group-based psychotherapy adapted from the WHO Problem Management Plus program, focusing on problem solving, social support, behavioral activation, and relaxation. The experimental group receives the same psychotherapy plus a poverty alleviation package that includes financial literacy education, savings accounts, consumption support (equivalent to 1 kg of rice per day for six months), three goats with 12 months of feed and veterinary care, gardening supplies, and agricultural skill building. Participants in both groups take part in research interviews at 6, 12, and 18 months to assess depression and other outcomes. The study measures changes in depressive symptoms primarily at 6 months, with additional assessments of relapse, economic status, anxiety, function, quality of life, and tension over 18 months. A thorough implementation evaluation includes interviews with participants and staff to understand treatment adoption, retention, and fidelity. The total participation period spans 18 months.

ASHA Bangladesh--An Integrated Intervention to Address Poverty and Depression