24
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Maternal mental health priorities, help-seeking behaviors, and resources in post-conflict settings: a qualitative study in eastern Uganda

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Limited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders’ perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda.

          Methods

          We employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers ( n = 24), primary health workers ( n = 26), perinatal women ( n = 24), traditional and religious healers ( n = 10), and mental health specialists ( n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith’s Salience Index was used for analysis of free listing data.

          Results

          When asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted.

          Conclusion

          Our findings add to existing literature that describes ‘thinking too much’ idioms as cultural concepts of distress with roots in social adversity. In addition to making feasible and effective treatment available, our findings indicate the importance of prevention strategies that address the social determinants of psychological distress for perinatal women in post-conflict low-resource contexts.

          Electronic supplementary material

          The online version of this article (10.1186/s12888-018-1626-x) contains supplementary material, which is available to authorized users.

          Related collections

          Most cited references34

          • Record: found
          • Abstract: found
          • Article: not found

          Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

          Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
            Bookmark
            • Record: found
            • Abstract: not found
            • Book: not found

            The coding manual for qualitative researcher

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries.

              It is well established that postnatal depression (PND) is prevalent in high-income countries and is associated with negative personal, family and child developmental outcomes. Here, studies on the prevalence of maternal PND in low- and middle-income countries are reviewed and a geographical prevalence map is presented. The impact of PND upon child outcomes is also reviewed. The available evidence suggests that rates of PND are substantial, and in many regions, are higher than those reported for high-income countries. An association between PND and adverse child developmental outcomes was identified in many of the countries examined. Significant heterogeneity in prevalence rates and impact on child outcomes across studies means that the true extent of the disease burden is still unclear. Nonetheless, there is a compelling case for the implementation of interventions to reduce the impact of PND on the quality of the mother-infant relationship and improve child outcomes.
                Bookmark

                Author and article information

                Contributors
                wtol@pcaf.org
                bebrecht@pcaf.org
                raiyo@pcaf.org
                smurray9@jhu.edu
                ajnguyen@virginia.edu
                bkohrt@gwu.edu
                sndyanabangi@gmail.com
                salderman@pcaf.org
                segganemusisi@yahoo.ca
                jnakku@pcaf.org
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                7 February 2018
                7 February 2018
                2018
                : 18
                : 39
                Affiliations
                [1 ]Peter C. Alderman Foundation, plot 855, Mawanda Road, PO Box 20129, Nakawa, Kampala Uganda
                [2 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, Department of Mental Health, , Johns Hopkins Bloomberg School of Public Health, ; 624 N Broadway, Baltimore, MD 21205 USA
                [3 ]ISNI 0000 0000 9136 933X, GRID grid.27755.32, University of Virginia Curry School of Education, ; 405 Emmet St S, Charlottesville, VA 22904 USA
                [4 ]ISNI 0000 0004 1936 9510, GRID grid.253615.6, Department of Psychiatry and Behavioral Sciences, , George Washington University, ; 2120 L St NW Suite 600, Washington, DC 20037 USA
                [5 ]GRID grid.415705.2, Ministry of Health, Republic of Uganda, ; Plot 6, Lourdel Road, Nakasero, Kampala Uganda
                [6 ]Peter C. Alderman Foundation, New York, NY USA
                [7 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Psychiatry, , Makerere University College of Health Sciences, ; P.O. Box 7072, Kampala, Uganda
                [8 ]Butabika National Psychiatric Referral Hospital, Butabika Rd, PO Box 7017, Kampala, Uganda
                Author information
                http://orcid.org/0000-0003-2216-0526
                Article
                1626
                10.1186/s12888-018-1626-x
                5803865
                29415710
                7c11cb6d-2dcf-4418-a818-6b810d89d34f
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 April 2017
                : 30 January 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100008309, Johns Hopkins Bloomberg School of Public Health;
                Award ID: Faculty Innovation Fund
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

                Comments

                Comment on this article