Globally, poor maternal mental health represents a major public health challenge. Affecting up to one in five women, mental health conditions during and after pregnancy can have long-term adverse effects for women and children.

CHIME addresses the development priorities of the Gambia, Lesotho and South Africa in the areas of maternal mental health and gender equality (Sustainable Development Goals 3 and 5).

In these settings, many women are already living in adversity. Pregnancy is a time of particular vulnerability for these women and, for women in Lesotho and Gambia in particular, this is compounded by maternal and infant mortality rates that are among the highest in the world.

In these countries, mental health services are negligible, owing to a critical shortage of skilled professionals (e.g., 2 psychiatrists for a population of 2.5 million in the Gambia) and challenges around financing and policy at government level.

In South Africa, where health and research infrastructure are more developed, important progress has been made with respect to mental health policies, such as the introduction of routine screening, and trialling of task-shared interventions to assess and manage common mental disorders in the perinatal period. But under-investment, under-resourcing and major implementation challenges have prevented progress and scaling up.

A low-cost, culturally embedded and universally available preventive intervention such as CHIME offers the potential for broad impact on maternal mental health and wellbeing, with long-lasting positive consequences for these mothers, their children and families and cascading effects for their communities and societies.