Dr Siham Sikander PhD

Research Overview

I have been applying my clinical knowledge as a psychiatrist to promote public mental health services. My focus has been on addressing maternal mental health and well-being as well as promoting early childhood development within low resource settings. I have been developing task-shared public health interventions to address the above-mentioned interests.
Task-sharing (ie non-specialist delivered interventions) and use of digital technologies have been the cornerstone innovations in my interventions. I have been employing principles of co-design, with multi-disciplinary teams, and using primary health care platforms for the implementation of these interventions. I have used community health workers and lay Peers (other women) deliver such interventions; to address issues of scalability and coverage of public health interventions.
I have developed strategies to identify, recruit, train and supervise lay Peers (as an alternative human resource) within community settings addressing the treatment gap of maternal mental health and psycho social well-being in low resource settings. This peers-based model have shown to be acceptable, feasible and cost effective first level contact within diverse community settings like Pakistan and India.

I have extensive experience of evaluating public health interventions, employing implementation science and randomized controlled trial designs.
Apart from this, I also have extensive experience of establishing and following birth cohorts in low resource settings. I have over 70 peer reviewed publications in journals like Lancet etc.

I am supporting a number of ongoing projects at Mersey Care NHS Trust.
While some international research projects are as follows:

1) ENHANCE: NIHR, UK funded.
My Role: Co-Investigator on the grant. Lead of Teaching/Training
ENHANCE is a four year multi-country collaborative research programme. It has a main research component (based in Pakistan) & a capacity building component which is spread across Nepal, Sri Lanka, Bangladesh and Pakistan. (See teaching). I am part of the expert group providing inputs to the development of a technology-assisted psycho-social perinatal depression intervention delivered by Peers. This is a task-shifted intervention which has been developed for delivery via lay peers (other women) to treat perinatal depression. It has a large cluster randomized trial which I Co-lead.

2) Bachpan Cohort Study:
My Role: Co-Chief Investigator.
Bachpan (meaning childhood in local language) cohort is a study of depressed and non depressed women ongoing since 2014 in rural settings of Pakistan. It is a pregnancy-birth cohort currently following up mother-child dyads. The children are currently turning 7 years old. We have 8 data points from pregnancy to 6 years of child's age. I provide oversight, supervision of field teams and interface with policy forums (health and civil society organizations working on child rights) to facilitate translation and uptake of findings. Next round of developing a grant proposal to explore the ever expanding social interaction of preteens (9 years olds) and add data on school environment (including engagement), their self-esteem, coping strategies, teacher and peer relation. Using an ecological framework explore what factors promote resilience among preteens. All this will inform in developing a prevention intervention to promote socio-emotional and behavioural outcomes of preteen and adolescents.

3) Suicide Prevention Programme: Funded by NIMH, US. Chief Investigator Dr Ashley Hagaman from Yale University, USA
My Role: Mentor and Advisor
The Suicide prevention programme is a fellowship programme. It includes three phases, i) formative phase to understand the perceptions of the women with suicidal ideation and to understand what types of health care staff or peers and community support structures will be feasible to provide brief prevention programme for suicidal prevention. ii) co-production phase of a brief suicide prevention programme iii) pilot randomized trial to test the feasibility and acceptability of the brief task-shifted community based suicide prevention programme in Pakistan.