Title : Partners in healing: Community-based peer support for bereaved mothers in Pakistan
Abstract:
Aim & Objective: While Peer support interventions for stillbirth or neonatal loss are well established in high income countries, they remain negligible in low- and middle-income countries (LMICs) including Pakistan. The objective of this study was to co-design a culturally adapted bereavement care intervention incorporating peer support, informed by lived experiences of stillbirth and neonatal deaths. The primary objectives were to evaluate the feasibility, acceptability, and emotional impact of this intervention among Pakistani bereaved mothers.
Design: Sequential mixed-method design.
Methods: Seven mothers with lived experience of stillbirth & neonatal death were recruited in a Community Engagement and Involvement (CEI) group. Following informed consent, participants were trained as volunteer peer supporters using a need-based session plan with Good Clinical Practice (GCP) standards. The research team-provided on going structured supervision. A total of 35 bereaved mothers were recruited in the intervention cohort from the main study (Development and feasibility of multi component intervention to improve bereavement support in Pakistan (NBC-4-87/NBC-824/22/646), of whom 14 chose to have telephone-based peer support. In depth qualitative interviews were conducted with both peer supporters and bereaved mothers to explore their experience, perceived effect and acceptability of the intervention.
Results: Peer support provided emotional validation, decreased isolation, and helped grieving mothers to resume a sense of normalcy. Mothers reported that peer support had special comforting that could not be offered by formal healthcare professionals. Peer supporters reported personal healing and empowerment through involvement, and improved communication and interpersonal skills by their involvement. Both peer supporters and mothers underscored the importance of ongoing emotional support and shared sorrow. Confidentiality, consistency, and empathy stood out as key components of peer support. Peer supporters also described their role in suicide prevention among bereaved mothers and promoting awareness at community level.
Conclusion: Integrating CEI groups into bereavement care increases cultural appropriateness and ensures that interventions are rooted in lived experience. This model supports trust, community ownership, and emotional resistance. Peer support emerged as a mutually healthy model—facilitating healing not just for bereaved mothers but also for peer supporters. By nesting this model within community systems, bereavement support can be rendered more accessible, acceptable, and sustainable in LMICs such as Pakistan.
Keywords: Peer Support, Stillbirth, Bereavement Care, Community Engagement, Maternal Mental Health, Pakistan.
