Background and Objective:
Various sources indicate the high prevalence rate of depression during prenatal and postnatal periods in Palestine. Therefore, the aim of this study was to test the effectiveness of an integrated mental health and psychosocial support (PSS) intervention in reducing depressive symptoms of mothers in vulnerable communities in Palestine.

Methods:
A cluster randomization trial, conducted on 26 vulnerable communities in the West Bank, was included in the study. A total of 469 pregnant mothers were included in the study, of which 231 were assigned randomly to the control group and 238 were assigned to the intervention group. Data were collected from both groups at the baseline and the end-line of the survey using Edinburgh Postnatal Depression (EPDS) questionnaire. Pregnant women in the intervention clusters were supported with the integrated package including PSS, while pregnant women in the comparison group received routine care by trained community health workers.

Results:
In the pre intervention phase, the prevalence rate of antenatal depression was 10.5% in intervention group and 25.5% among the control group. While in the post Intervention phase, postpartum depression level among the intervention group was lower in comparison to the control group (7.5; 13.7 respectively). In addition, during this phase 4.6% of mothers in the intervention group had an EPDS score > 13 (severe depression), whereas 2.9% had an EPDS score of 10–12 (mild depression). Conversely, 7.9% of mothers in the control group had an EPDS score > 13, while 5.8% had an EPDS score 10–12; this indicated the effectiveness of intervention on decreasing postpartum depression level.

Conclusion and Global Health Implications:
Providing PSS intervention to pregnant women was found to be effective in reducing depressive symptoms, thus it is crucial to integrate it within primary health programs to mothers.