This scoping review collected and analysed peer-reviewed full-text empirical research articles written in English between 2015 and 2025. Included was primary research that was published (journal articles, chapters). Details of the criteria are indicated in Table 1.

The University of the Free State’s (UFS) online library was utilised to access and search electronic databases. This increased the likelihood of finding research conducted in SSA. The following databases were selected with the assistance of an expert librarian to maximise the likelihood of finding research conducted in SSA, including PubMed, Scopus, Web of Science, EBSCOhost and Google Scholar. Additionally, a hand search was performed, along with a review of the reference lists of included articles, to identify any additional studies missed in the database search.

Keywords used were a combination of Boolean operators ‘OR’ & ‘AND’. Searched words included:

This approach facilitated the retrieval of sources that specifically addressed the relevant subjects. While there are 49 countries in SSA, the extracted studies represented 28 countries, as studies from these countries were the only ones available within the search parameters. It was found that literature from Francophone and Lusophone countries was underrepresented; this may be because of language barriers. As a result, the majority of studies extracted were from the following countries: South Africa, Kenya, Nigeria, Ethiopia, Tanzania, Zimbabwe, Zambia, Malawi, Ghana and Liberia.

Following a comprehensive literature search, all studies were reviewed to identify those meeting the eligibility criteria. Initially, 735 studies were. After removing duplicates, 512 studies remained for title and abstract screening, during which 137 were excluded based on their titles and/or abstracts. Subsequently, 375 full-text articles were assessed, with 371 excluded for not meeting the inclusion criteria. These were studies that focused on one perinatal MHC and/or on a specific group of women (adolescents/teenagers and/or perinatal women living with HIV and AIDS or diabetes). Ultimately, only four studies fulfilled all eligibility requirements. The four studies included in the synthesis used different approaches, which enriched the synthesis by capturing diverse perspectives and methodological insights. This variation strengthened the comprehensiveness and credibility of the findings. The selection process was documented using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) flow diagram (Figure 1) to ensure transparency and replicability.

Data extraction was conducted by ML, MM and with assistance from a UFS librarian. Relevant data from the selected studies were extracted and organised into a standardised data extraction form. This form included fields for the author(s), publication year, study approach and design, sample size, setting (geographical location and healthcare context) and key findings related to service delivery strategies as shown in Table 2.

Ethical approval for the scoping review was not necessary; however, it was obtained as a waiver under a larger study for the ongoing PhD research.

Table 2 describes studies and interventions in terms of inclusion and exclusion criteria. Included studies encompass different research designs, including two mixed-method designs, one case study, and one cross-sectional diagnostic tool development study. All these four studies included women of all ages; however, they largely focused on pregnant women, excluding women in the postnatal period. The studies also describe different types of strategies, which include screening, stepped care models (screening, counselling, and referral services integrated into routine antenatal care) and task sharing. All the studies were conducted in Cape Town, South Africa.

Table 2 describes studies in terms of inclusion and exclusion criteria, location, publication size and date, language, outcome, and intervention.

In their study, Honikman et al. (2025) demonstrated how integrating counselling and referring patients can improve access and outcomes for women experiencing psychological distress. Counselling includes psychoeducation, emotional support sessions and problem-solving. Within healthcare environments, counselling may be delivered by trained health workers or non-specialist providers such as community health workers and mentor mothers. Similarly, Devkota et al. (2017) found that counselling significantly enhances positive outcomes during pregnancy by improving women’s knowledge, shaping more supportive attitudes, and promoting safer health practices. Referral services complement counselling by ensuring that women with mental health needs are connected to appropriate services. More recently, a study conducted by Honikman et al. (2025) highlighted that stepped care models enhanced service delivery and approachability to maternal mental health needs in primary maternity care. Even so, gaps remain in the consistency of these services. For example, Van Heyningen et al. (2019) found that referral pathways were unclear, there is a limited availability of mental health professionals, especially within the public sector, and training and supervision inadequacies persist. As a result, these strategies may collectively provide a practical and scalable framework to improve the reach, quality and impact of perinatal mental health care, particularly in low-resource settings. Implementing them effectively requires multisectoral collaboration, political will and sustained investment.