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Long term follow-up of the Thinking Healthy Programme

Perinatal Depression Intervention

The goal of this project was to look for any long term impacts on offspring resulting from their mothers participating in a successful perinatal depression intervention cRCT, the Thinking Healthy Programme (THP), in Pakistan. Approximately 7 years after the end of the intervention, together with the creators of the THP and a partnership with the Human Development Research Foundation (HDRF), we re-enrolled and interviewed 84% of the mother-child dyads from the original RCT. The original THP delivered culturally-adapted cognitive behavioral therapy (CBT) to depressed mothers through trained peer counselors and community health workers (Lancet 2008).

Our analysis revealed that there were no lasting effects on child cognitive, socioemotional or physical outcomes resulting from the intervention (here). Ongoing analyses are focusing on the contribution of the social context, e.g. SES, the presence of the grandmother, or whether the husband migrates for work, as potential moderating factors in the association between the intervention, changes in maternal depression symptoms, and child outcomes. We are also exploring other predictors of child development beyond maternal depression, such as exposure to adverse childhood experiences.

Other collaborative analyses with economist colleagues Victoria Baranov, Sonia Bhalotra, and Pietro Biroli we are focusing on women’s financial empowerment, parenting, investments in children, and models of early human capital formation.

Co-investigators on this project include: Siham Sikander, Atif Rahman, Sonia Bhalotra

The study was funded by Grand Challenges Canada, #0038 to Maselko/Sikander. In collaboration with Human Development Research Foundation (HDRF

Family interview

HDRF team



Effect of an Early Perinatal Depression Intervention on Long-term Child Development Outcomes: follow-up of the Thinking Healthy Programme randomized controlled trial.

Lancet Psychiatry, 2015; 2(7): 609-617. doi: 10.1016/S2215-0366(15)00109

  • Maselko J., Sikander S., Bhalotra S., Bangash O., ^Ganga N., Mukherjee S., Egger H., Franz L., Bibi A., Liaqat R., Kanwal M., Abbasi T., Noor M., Ameen N., Rahman A. 

Child mental health and maternal depression history in Pakistan.  

Social Psychiatry and Psychiatric Epidemiology, 2016; 51 (1): 49-62. doi: 10.1007/s00127-015-1143-x

  • Maselko J., Sikander S., Bangash O., Bhalotra S., Franz L., Ganga N., Guru Rajan D., O’Donnell K., Rahman A.



Working Papers


Persistence in Treatment Effects of Maternal Depression: Evidence from Follow Up of a Randomized Controlled Trial in Pakistan.

  • With Sonia Bhalotra, Victoria Baranov, Siham Sikander, et al.


Does Maternal Depression Hamper Child Development? Evidence from a Randomized Control Trial.

  • With Victoria Baranov and Sonia Bhalotra


Determinants of positive socioemotional development among school aged children in rural Pakistan.

  • Maselko J., O’Donnell K., Sikander S., Bhalotra S.



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