Low-income countries have a critical shortage of health professionals. In countries such as Pakistan, Community Health Workers (CHWs) can play an important role in improving access to healthcare services and hence improve health outcomes.To explore the efficacy of a training program; Learning Through Play Plus, a combination of Learning Through Play (LTP) and Thinking Healthy Program (THP) on knowledge and attitudes of CHW's regarding child development, maternal depression and cognitive behaviour.To use focus groups and the training programmes to increase the knowledge of CHWs method: a qualitative approach was used to explore experiences of CHWs who delivered the intervention. Three-day training was provided to 216 CHWs on LTP and THP. Trained facilitators conducted focus groups before and after the training to explore their prior knowledge and expectations. A semi-structured topic guide was developed for this. All the focus groups were audio-recorded. The data were analysed using framework analysis principles.Four key themes emerged from the focus groups; the psychosocial context these women live in (poverty, work-overload, interpersonal conflicts, lack of support from family, lack of awareness of depression and scarcity of mental health services) CHWs perception of depression (role of negative thoughts in depression), the impact of maternal depression on children and the impact of training for CHWs (improvement in CHWs knowledge related to children).Training CHWs improves their knowledge about child development and psychological therapies. This can contribute to improving access to maternal healthcare services and improving child development outcomes
