Co-designing maternal mental health interventions and implementation strategies under climate stress in Nigeria: a participatory workshop
Abstract
BackgroundClimate change is a risk multiplier in low- and middle-income countries, threatening maternal mental health and early childhood development. In Nigeria, environmental shocks intensify these risks, yet responses remain fragmented across sectors. Using a participatory implementation-science approach, this study co-designed a psychosocial intervention package and accompanying implementation strategies to protect maternal mental health under climate stress.MethodsA full-day co-creation workshop was conducted in Enugu, Nigeria, involving 16 stakeholders (affected mothers, community health workers, community leaders, data collectors, and policymakers). Grounded in prior systematic review, national quantitative, and qualitative evidence, the workshop utilised participatory inquiry to map implementation determinants and the Expert Recommendations for Implementing Change (ERIC) taxonomy to select and categorise implementation strategies. Participants progressed through determinant mapping, appraisal of candidate components from Low-Intensity Psychological Interventions (LIPI) and WHO Problem Management Plus (PM+), delivery framework co-design, and strategy prioritisation via dot-voting.ResultsStakeholders identified environmental shocks as key drivers of maternal anxiety, distress, and trauma. From eight candidate components, participants retained five for the preliminary Climate Adaptation and Psychosocial Support (CANOPY) candidate package: behavioural activation, cognitive restructuring, managing worries and problems, lifestyle, and strengthening social support. Three PM + components were discarded as duplicative, whereas strengthening social support was added to leverage existing community networks. Participants developed three preliminary delivery frameworks pairing psychosocial support with environmental protection. These frameworks represent proposed delivery channels requiring further operational specification. Voting favoured immediate, actionable implementation strategies and frontline health-system strengthening over slower legislative and structural reforms.ConclusionStakeholders pragmatically prioritised feasible, frontline community and health system strategies over structural policies. Prospective implementation of the CANOPY package would likely require addressing workforce shortages and stigma while leveraging informal social safety nets and faith-based structures. Voting outcomes are presented as exploratory participant preferences within the workshop, and prospective implementation of CANOPY is presented as a future step requiring further operationalisation and evaluation.
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BibTeX
@article{idemiliaronu2026codesigning,
title = {{Co-designing maternal mental health interventions and implementation strategies under climate stress in Nigeria: a participatory workshop}},
author = {Ngozi Idemili-Aronu and Nzube Ekpunobi and John Jemisenia and Deborah Aluh and Ikechukwu Alex Okoli and Rathi Ravindrarajah and Zahra Mulla and Tung Le and Martie van Tongeren and Echezona Edozie Ezeanolue and Amy Blakemore and Jahanara Miah and Asri Maharani},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1952665},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1952665},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Co-designing maternal mental health interventions and implementation strategies under climate stress in Nigeria: a participatory workshop
AU - Ngozi Idemili-Aronu
AU - Nzube Ekpunobi
AU - John Jemisenia
AU - Deborah Aluh
AU - Ikechukwu Alex Okoli
AU - Rathi Ravindrarajah
AU - Zahra Mulla
AU - Tung Le
AU - Martie van Tongeren
AU - Echezona Edozie Ezeanolue
AU - Amy Blakemore
AU - Jahanara Miah
AU - Asri Maharani
PY - 2026
DA - 2026/11/04
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1952665
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1952665
AB - BackgroundClimate change is a risk multiplier in low- and middle-income countries, threatening maternal mental health and early childhood development. In Nigeria, environmental shocks intensify these risks, yet responses remain fragmented across sectors. Using a participatory implementation-science approach, this study co-designed a psychosocial intervention package and accompanying implementation strategies to protect maternal mental health under climate stress.MethodsA full-day co-creation workshop was conducted in Enugu, Nigeria, involving 16 stakeholders (affected mothers, community health workers, community leaders, data collectors, and policymakers). Grounded in prior systematic review, national quantitative, and qualitative evidence, the workshop utilised participatory inquiry to map implementation determinants and the Expert Recommendations for Implementing Change (ERIC) taxonomy to select and categorise implementation strategies. Participants progressed through determinant mapping, appraisal of candidate components from Low-Intensity Psychological Interventions (LIPI) and WHO Problem Management Plus (PM+), delivery framework co-design, and strategy prioritisation via dot-voting.ResultsStakeholders identified environmental shocks as key drivers of maternal anxiety, distress, and trauma. From eight candidate components, participants retained five for the preliminary Climate Adaptation and Psychosocial Support (CANOPY) candidate package: behavioural activation, cognitive restructuring, managing worries and problems, lifestyle, and strengthening social support. Three PM + components were discarded as duplicative, whereas strengthening social support was added to leverage existing community networks. Participants developed three preliminary delivery frameworks pairing psychosocial support with environmental protection. These frameworks represent proposed delivery channels requiring further operational specification. Voting favoured immediate, actionable implementation strategies and frontline health-system strengthening over slower legislative and structural reforms.ConclusionStakeholders pragmatically prioritised feasible, frontline community and health system strategies over structural policies. Prospective implementation of the CANOPY package would likely require addressing workforce shortages and stigma while leveraging informal social safety nets and faith-based structures. Voting outcomes are presented as exploratory participant preferences within the workshop, and prospective implementation of CANOPY is presented as a future step requiring further operationalisation and evaluation.
SN - 2296-2565
ER -