# Co-designing the FOotpaths foR Adolescent MAternal Mental HeAlth (FOR MAMA) intervention for pregnant teens in Malawi

## TL;DR

This study co-designed a mental health intervention for pregnant teens in Malawi by incorporating input from stakeholders like teens, families, and healthcare workers.

## Contribution

The paper introduces a co-designed, scalable mental health intervention tailored for perinatal adolescents in Malawi using stakeholder feedback.

## Key findings

- Participants emphasized the need for information on mental health causes and coping strategies.
- Healthcare workers were preferred as intervention providers, with a focus on weekly antenatal sessions.
- Stakeholders supported both self-help and guided formats, with follow-up to ensure engagement.

## Abstract

This study aimed to gain insights into stakeholders’ priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi.

Participatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8) and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the Template for Intervention Description and Replication checklist.

Participants emphasized the need for information on causes and symptoms of common mental problems and for developing coping strategies: a) those focused on external stressors—problem-solving, financial literacy and interpersonal skills—and b) emotion-focused approach behaviours—behavioural activation, relaxation and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. All stakeholder groups felt there was a need for follow-up to ensure that adolescents correctly engaged with the intervention material.

Findings informed the design of a brief multicomponent guided intervention for adolescents in the antenatal period.