Identifying and treating maternal mental health difficulties in Afghanistan: A feasibility study

 

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dc.contributor.author Tomlinson, Mark
dc.contributor.author Chaudhery, Deepika
dc.contributor.author Ahmadzai, Habibullah
dc.contributor.author Rodríguez Gómez, Sofía
dc.contributor.author Rodríguez Gómez, Cécile
dc.contributor.author van Heyningen, Thandi
dc.contributor.author Chopra, Mickey
dc.date.accessioned 2021-06-30T08:03:28Z
dc.date.available 2021-06-30T08:03:28Z
dc.date.issued 2020-10-27
dc.identifier.uri https://doi.org/10.1186/s13033-020-00407-1
dc.identifier.uri http://hdl.handle.net/11427/33422
dc.description.abstract Background: The disproportionately high burden of mental disorders in low- and middle-income countries, coupled with the overwhelming lack of resources, requires an innovative approach to intervention and response. This study evaluated the feasibility of delivering a maternal mental health service in a severely-resource constrained setting as part of routine service delivery. Methods: This exploratory feasibility study was undertaken at two health facilities in Afghanistan that did not have specialist mental health workers. Women who had given birth in the past 12 months were screened for depressive symptoms with the PHQ9 and invited to participate in a psychological intervention which was offered through an infant feeding scheme. Results: Of the 215 women screened, 131 (60.9%) met the PHQ9 criteria for referral to the intervention. The screening prevalence of postnatal depression was 61%, using a PHQ9 cut-off score of 12. Additionally, 29% of women registered as suicidal on the PHQ9. Several demographic and psychosocial variables were associated with depressive symptoms in this sample, including nutritional status of the infant, anxiety symptoms, vegetative and mood symptoms, marital difficulties, intimate partner violence, social isolation, acute stress and experience of trauma. Of the 47 (65%) women who attended all six sessions of the intervention, all had significantly decreased PHQ9 scores post-intervention. Conclusion: In poorly resourced environments, where the prevalence of postnatal depression is high, a shift in response from specialist-based to primary health care-level intervention may be a viable way to provide maternal mental health care. It is recommended that such programmes also consider home-visiting components and be integrated into existing infant and child health programmes. Manualised, evidence-based psychological interventions, delivered by non-specialist health workers, can improve outcomes where resources are scarce.
dc.source International Journal of Mental Health Systems
dc.source.uri https://bmcwomenshealth.biomedcentral.com/
dc.title Identifying and treating maternal mental health difficulties in Afghanistan: A feasibility study
dc.date.updated 2020-11-01T04:28:58Z
dc.language.rfc3066 en
dc.rights.holder The Author(s)
dc.source.journalvolume 14
dc.source.journalissue 1
dc.source.pagination 75
dc.identifier.ris TY - AU - Tomlinson, Mark AU - Chaudhery, Deepika AU - Ahmadzai, Habibullah AU - Rodríguez Gómez, Sofía AU - Rodríguez Gómez, Cécile AU - van Heyningen, Thandi AU - Chopra, Mickey AB - Background: The disproportionately high burden of mental disorders in low- and middle-income countries, coupled with the overwhelming lack of resources, requires an innovative approach to intervention and response. This study evaluated the feasibility of delivering a maternal mental health service in a severely-resource constrained setting as part of routine service delivery. Methods: This exploratory feasibility study was undertaken at two health facilities in Afghanistan that did not have specialist mental health workers. Women who had given birth in the past 12 months were screened for depressive symptoms with the PHQ9 and invited to participate in a psychological intervention which was offered through an infant feeding scheme. Results: Of the 215 women screened, 131 (60.9%) met the PHQ9 criteria for referral to the intervention. The screening prevalence of postnatal depression was 61%, using a PHQ9 cut-off score of 12. Additionally, 29% of women registered as suicidal on the PHQ9. Several demographic and psychosocial variables were associated with depressive symptoms in this sample, including nutritional status of the infant, anxiety symptoms, vegetative and mood symptoms, marital difficulties, intimate partner violence, social isolation, acute stress and experience of trauma. Of the 47 (65%) women who attended all six sessions of the intervention, all had significantly decreased PHQ9 scores post-intervention. Conclusion: In poorly resourced environments, where the prevalence of postnatal depression is high, a shift in response from specialist-based to primary health care-level intervention may be a viable way to provide maternal mental health care. It is recommended that such programmes also consider home-visiting components and be integrated into existing infant and child health programmes. Manualised, evidence-based psychological interventions, delivered by non-specialist health workers, can improve outcomes where resources are scarce. DA - 2020-10-27 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - International Journal of Mental Health Systems LK - https://open.uct.ac.za PY - 2020 T1 - Identifying and treating maternal mental health difficulties in Afghanistan: A feasibility study TI - Identifying and treating maternal mental health difficulties in Afghanistan: A feasibility study UR - http://hdl.handle.net/11427/33422 ER - en_ZA


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