Delivering a WHO-developed, evidence-based treatment for depression over WhatsApp to thousands in India.
We partnered with Kaya Guides on a grant to help it deliver and scale Step-by-Step, a WHO-developed program, to treat depression over WhatsApp in India.
Grant Description
Depression affects an estimated 62.5 million people in India each year, but more than 85% may receive no treatment; in the country's poorest states, there are as few as 0.05 psychiatrists per 100,000 people.
Kaya Guides implements the World Health Organization’s Step-by-Step program, a guided self-help intervention that has demonstrated reductions in depression in multiple randomized controlled trials. Delivered through a combination of chatbot-based lessons, videos, and weekly 15-minute calls with trained counselors over eight weeks, the program is designed for settings with severe shortages of mental health professionals.
This grant was selected in part because of the evidence base for the Step-by-Step program and the potential cost-effectiveness of delivering it at scale over WhatsApp.
Tested in three randomized controlled trials in Lebanon, Step-by-Step has shown moderate to large reductions in depression. Kaya Guides is the first organization to implement the program independently, and its internal program data reports an average six-point reduction in Patient Health Questionnaire-9 (PHQ-9) depression scores among participants, comparable to the WHO's trial results.
Because Kaya Guides' program relies on an automated WhatsApp chatbot with light-touch support from lay counselors rather than licensed mental health professionals, its costs are driven mostly by fixed technology and training expenses rather than costs that scale with each additional participant—meaning cost per participant could fall substantially as the program reaches more people, reinforcing its potential cost-effectiveness at scale.