This workshop will examine methodological issues in the design and evaluation of programs which aim to reduce maternal depression after childbirth.

Designing effective evaluation of social and health programs presents a challenge to both researchers and health service providers. Questions to be faced include:

• how do we base our intervention programs on the best available evidence?
• how do we design evaluation to determine if programs, once implemented, are really effective?
• what are the arguments for and against the randomised trial as an evaluation tool?
• how do we know if an intervention is giving us good value for money?

The importance of these questions becomes clear when considering the considerable amount of program activity aimed at reducing postnatal depression in Victoria over the last decade. Curiously, there has been little interest in rigorous evaluation of funded programs. Comparisons of women 'receiving' programs with women not involved have been rare Programs have often come and gone, attaining little more than pilot status. Many programs ignore the social contexts in which women become mothers, despite the weight of evidence in support of such factors being critical to women's experiences of depression. Some programs have simply become part of standard care with little or no evaluation of the outcomes for mothers.

Drawing on their experiences of researching maternal depression in Victoria over the last decade and, more recently of designing a primary care and community based intervention program to improve the emotional and physical health of mothers after childbirth, the presenters will argue the need for randomised trials in evaluating health programs and present the case for a community randomised trial to improve maternal emotional health after birth - and they invite other conference participants to join them in lively debate.