Summary of the results of the literature search
The relevance and quality assessment in this literature review resulted in the inclusion of 167 full-text articles, systematic literature reviews and meta-analyses, identified from a literature search that in total captured of 4,274 individual studies. All the included articles focused on high-income countries. The PRISMA flowchart for the literature search results is presented in Appendices 2. The Nordic contribution was limited: In this report, of the 167 meta-analyses and systematic reviews that were reviewed, 58 (35%) included studies conducted in one or more of the Nordic countries.
The main findings are presented below under each component of the WHO maternal well-being framework. To some extent, the Nordic perspective has been strengthened by reviews of the Nordic expert group discussions and highlighted in separate information boxes.
Summary of the results of the intervention information portal search
In the first phase of the review, a total of 64 psychosocial interventions assessed as effective were identified, targeting the perinatal period or a period extending into it. Because the classification of effectiveness varied across information portals, another, more detailed review of effectiveness levels was conducted. Following this second review, 28 interventions were identified as effective or promising in Nordic databases (see Appendices 3) and were selected for the review in this report.
Most of the interventions rated as effective were targeted at mental health risks, with the majority of these aimed at mothers with pre- or postpartum depression. Eight universal intervention programmes were aimed at parents, designed to support parenting skills and promote early interaction. Seven intervention programmes were clearly therapeutic in nature, addressing existing problems, while 13 were preventive intervention programmes targeted at risk groups (see Figure 2). Some of the intervention programmes were universal but also had adaptions to specific risk groups (for example, ICDP, The incredible years and NBO).
A total of 18 interventions for the perinatal period were found in international (UK & US) databases (see Appendix 5) that were not included in an earlier review of Nordic databases. Four of these international interventions were universal intervention programmes aimed at parents, 13 were preventive intervention programmes targeted at risk groups and only one intervention programme was therapeutic. None of these included Nordic evaluations or research, and all were probably implemented outside the Nordic context. Notably, US sources highlighted several intervention programmes for adolescent mothers and also named one culturally specific target group. These target groups were less visible in the interventions evaluated in Nordic countries. When selecting psychosocial interventions for this review, we considered the potential value of promising evidence as a starting point to address solutions for urgent needs. Even if an intervention’s effectiveness has not yet been firmly established, exploring the links between identified risks and possible solutions, and ongoing research on these, may still be worthwhile. This also provides insights into which interventions should be further explored in the Nordic context. The main findings are presented below under each component of the WHO maternal well-being framework.