Perinatal depression, due to its high prevalence and associations with disability, poor infant development and family disruption, is a major public health problem in developing countries. In non-literate and poor communities where depression is not recognised and where there are no specialists, developing a culturally acceptable, deliverable psychological intervention that community members find useful, presents special challenges but also opportunities. We describe lessons learned from a multi-method formative study to develop and deliver a psychological intervention to depressed mothers and their infants through non-specialist village based health workers.