Reviewer’s report
Title: 
Psychological interventions for maternal depression among women of
African and Caribbean origin: A systematic review
Version: 
1 
Date: 
22 Nov 2020
Reviewer's report:
Title: Psychological interventions for maternal depression among women of
African and Caribbean origin: A systematic review
Overall comments:
This is a systematic review study focusing on the psychological interventions for
maternal depression among women of African and Caribbean origin. The
methods were sound, and discussion was appropriate but lack on the direction of
the future psychological intervention, i.e. how cultural differences help in the
management (African/Caribbean vs. Caucasian) and what kind of psychological
intervention would be useful in this specific group of peoples. 
Specific comments:
Regarding Abstract. In the abstract, the authors mentioned that culturally
relevant intervention studies were required to build robust evidence to address
this major public health problem and improve service provision and outcomes
for these minority women. It seems to me it is like part of the objective of the
study, and not a conclusion. Please furnish the juice of the conclusion of the
study and some recommendations on how and what kind of psychological
interventions would benefit the group.
Regarding Introduction. The Introduction was fair.
Regarding Methods. The method was fair. A third reviewer was not involved to
settle any discrepancy. Is there any reasons why a third reviewer was not
included in the study?
Regarding Results: For Figure 1. Showing trajectory of the literature review
process, studies excluded was reported as n = 67. The studies with mostly
Caucasians, interventions not focused on parental wellbeing/depression; without
mother and/or child outcomes. Please describe one or two examples of the
studies that was excluded during the trajectory search.
Regarding Discussion
For the Internet-mediated care for maternal distress, nothing was mentioned in
the discussion on up to date approach for Covid-19 infection. As the studies
focus research literature on pre-Covid-19 era, the discussion on telemedicine and
online help should be contemporary and taking into consideration on the current
pandemic state.
Regarding Conclusion. It was stated that, "Maternal experiences are emotionally
demanding considering the delicate nature of care required during the prenatal,
perinatal or postnatal periods. Due to insufficient culturally sensitive care,
maternal depression is more challenging among African and Caribbean mothers
living in HICs. The present review has synthesised intervention studies for
maternal depression among women of African and Caribbean origin. The review
also highlights that there is only limited literature on the topic of maternal
depression and culturally appropriate interventions. Both in-person contact, and
online intervention studies are recommended for African and Caribbean mothers
as the basis for building culturally relevant evidence-based resources for use in
health policy initiatives and clinical practice."
The conclusion of this review is inconclusive, as the authors discussing about the
limitation of the studies and does not give any input on how psychological
interventions for maternal depression among women of African and Caribbean
origin differed from other ethnic groups, for example, Asian ethnic group. The
authors also failed to articulate on the remedies that may help the psychological
interventions, and how cultural differences play into roles. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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