England’s Family Hubs and Start for Life (SfL) Programme Guidance recommends strengthening early years services by increasing workforce capacity and capability through innovative skill mix models. However, evidence regarding how different innovative early years skill mix workforce models operate, function, and influence outcomes remains limited. To address this gap, five local authorities in England that are existing SfL sites received funding from the Department of Health and Social Care (DHSC) to design and pilot innovative early years skill mix workforce models to enhance their Family Hub offers and better support families with children under two.

The evaluation is guided by each site’s Theory of Change and uses a mixed-methods design. The study consists of five workstreams. First, pilot models will be mapped through documentary analysis, including content analysis of role descriptions and audits of workforce activities recorded in clinical diaries. Second, system-level mechanisms, facilitators, and barriers to implementation will be examined through reviews of service and management data and semi-structured interviews with key stakeholders. Third, relational structures underpinning effective practice will be explored using 75 family-level case studies and Social Network Analysis to assess professional networks and their influence on family and practitioner experiences. Fourth, impacts will be estimated using Synthetic Control Methods to assess effects on Healthy Child Programme outcomes, alongside cost and cost-benefit analyses. Finally, the broader application of skill mix working will be explored through semi-structured interviews and case studies across additional local authorities.

Infant mental health (IMH), an area which focuses on the social and emotional development of infants in the context of the parent-infant relationship, has become an increasingly prominent field of both research and clinical practice worldwide. IMH network groups are initiatives which aim to facilitate continuous learning in the IMH approach, provide an opportunity for case discussion and encourage reflective practice. This study aimed to explore the experiences of staff working within an adult mental health (AMH) service and their participation in a perinatal IMH network group (PIMH-NG).

This study had a qualitative research design and the data were collected using a focus group methodology. Participants were recruited from a PIMH-NG which aimed to provide staff working within an AMH setting with the opportunity for continuous development of IMH knowledge. The data were analysed using thematic analysis.

The data gathered from the focus group indicated that staff participating in a PIMH-NG enhanced their clinical skill, reflective practice and supported the dissemination of IMH knowledge throughout their respective teams. The PIMH-NG facilitated this work by providing the opportunity for continuous learning, reflective group discussion and ongoing peer support.

The findings of this study indicate that incorporating elements of an IMH model into AMH services can be beneficial for staff, service users and overall service delivery and development. These findings may be used to develop the structure and content of future network groups of this nature.

Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.

This cRCT randomized 32 women's groups – 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.

In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.

This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.

Less than 3% of articles published in the peer reviewed literature include data from low- and middle-income countries – where 90% of the world's infants live.

In this paper, we discuss the context of infancy in Africa and the conditions of adversity obtaining in Africa.

We discuss the implications of poverty on parenting, and linked to this outline the impact of maternal depression on infant development.

We outline three features of the field of infant mental health research in Africa, and issue a call for action about what we believe is needed in order to develop the field in the next decade.