**6. Screening algorithm**

This section present a screening algorithm that can facilitate provision of maternal mental healthcare that is not readily accessible to pregnant women in Malawi [116]. It is underpinned by the proposition that routine screening in antenatal clinics improves detection of pregnant women with depression and that midwives can be trained to effectively screen for antenatal depression, offer psychoeducation and, make appropriate referrals. The aim of the algorithm is to improve the health of pregnant women and the child they are expecting. The algorithm includes aim, rationale, scope, objectives, principles underpinning algorithm, and components of algorithm.

#### **6.1 Rationale for the algorithm**

The algorithm will ensure a standardised and quality assured approach for detecting and dealing with pregnant women who have or are at risk of developing depression. It will make it possible for midwives to detect pregnant women with depression at an early stage and be able to put in place appropriate support systems for these women. In addition, the algorithm allows for the involvement of the pregnant women and their families in discussions about their care and treatment options. Furthermore, it ensures that information about pregnant women with depression is documented and shared appropriately with all relevant practitioners providing care. Collaborative care for adults with depression which produces substantial clinical improvements and has a high prospect of long-term cost savings is recommended. Collaborative care of depression includes a systematic, multicomponent, and team-based approach that strengthens and supports selfcare, while assuring that effective medical, preventive, and health maintenance interventions take place to improve the quality and outcome of patient care. Therefore, the Algorithm recommends effective collaboration of antenatal services and mental health services for effective screening of antenatal depression.

#### **6.2 Scope of the algorithm**

The Algorithm is specifically designed for pregnant women with depression and it is not intended to cover the whole spectrum of pregnant women with other

*Screening for Antenatal Depression by Midwives in Low Resource Settings in Primary Care… DOI: http://dx.doi.org/10.5772/intechopen.97411*

mental disorders. It focuses on improving the quality and accessibility of maternal mental healthcare by integrating routine screening for depression into antenatal services so that pregnant women with, or at risk of, depression are timeously detected, and the appropriate treatment can commence. The Algorithm is intended to reflect optimum practice in routine screening for depression and the management of pregnant women at risk or with depression in antenatal clinics in Malawi.
