Maternal mental health in primary care in five low- and middle-income countries : a situational analysis

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dc.contributor.authorBaron, Emily C.en_ZA
dc.contributor.authorHanlon, Charlotteen_ZA
dc.contributor.authorMall, Sumayaen_ZA
dc.contributor.authorHonikman, Simoneen_ZA
dc.contributor.authorBreuer, Ericaen_ZA
dc.contributor.authorKathree, Tasneemen_ZA
dc.contributor.authorLuitel, Nagendra P.en_ZA
dc.contributor.authorNakku, Julieten_ZA
dc.contributor.authorLund, Cricken_ZA
dc.contributor.authorMedhin, Girmayen_ZA
dc.contributor.authorPatel, Vikramen_ZA
dc.contributor.authorPetersen, Ingeen_ZA
dc.contributor.authorShrivastava, Sanjayen_ZA
dc.contributor.authorTomlinson, Marken_ZA
dc.date.accessioned2017-01-25T12:04:11Z
dc.date.available2017-01-25T12:04:11Z
dc.date.issued2016-02-16
dc.date.updated2016-12-09T12:11:48Z
dc.descriptionCITATION: Baron, E. C., et al. 2016. Maternal mental health in primary care in five low- and middle-income countries : a situational analysis. BMC Health Services Research, 16:53, doi:10.1186/s12913-016-1291-z.
dc.descriptionThe original publication is available at http://bmchealthservres.biomedcentral.com
dc.description.abstractBackground: The integration of maternal mental health into primary health care has been advocated to reduce the mental health treatment gap in low- and middle-income countries (LMICs). This study reports findings of a cross-country situation analysis on maternal mental health and services available in five LMICs, to inform the development of integrated maternal mental health services integrated into primary health care. Methods: The situation analysis was conducted in five districts in Ethiopia, India, Nepal, South Africa and Uganda, as part of the Programme for Improving Mental Health Care (PRIME). The analysis reports secondary data on the prevalence and impact of priority maternal mental disorders (perinatal depression, alcohol use disorders during pregnancy and puerperal psychosis), existing policies, plans and services for maternal mental health, and other relevant contextual factors, such as explanatory models for mental illness. Results: Limited data were available at the district level, although generalizable data from other sites was identified in most cases. Community and facility-based prevalences ranged widely across PRIME countries for perinatal depression (3–50 %) and alcohol consumption during pregnancy (5–51 %). Maternal mental health was included in mental health policies in South Africa, India and Ethiopia, and a mental health care plan was in the process of being implemented in South Africa. No district reported dedicated maternal mental health services, but referrals to specialised care in psychiatric units or general hospitals were possible. No information was available on coverage for maternal mental health care. Challenges to the provision of maternal mental health care included; limited evidence on feasible detection and treatment strategies for maternal mental disorders, lack of mental health specialists in the public health sector, lack of prescribing guidelines for pregnant and breastfeeding women, and stigmatising attitudes among primary health care staff and the community. Conclusions: It is difficult to anticipate demand for mental health care at district level in the five countries, given the lack of evidence on the prevalence and treatment coverage of women with maternal mental disorders. Limited evidence on effective psychosocial interventions was also noted, and must be addressed for mental health programmes, such as PRIME, to implement feasible and effective services.
dc.description.urihttp://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1291-z
dc.description.versionPublisher's version
dc.format.extent16 pagesen_ZA
dc.identifier.citationBaron, E. C., et al. 2016. Maternal mental health in primary care in five low- and middle-income countries : a situational analysis. BMC Health Services Research, 16:53, doi:10.1186/s12913-016-1291-z
dc.identifier.issn1472-6963 (Online)
dc.identifier.otherdoi:10.1186/s12913-016-1291-z
dc.identifier.urihttp://hdl.handle.net/10019.1/100531
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthor retains copyright
dc.subjectMaternal mental healthen_ZA
dc.subjectMental illnessen_ZA
dc.subjectPrimary health care -- Developing countriesen_ZA
dc.subjectPuerperal psychosesen_ZA
dc.subjectCommunity mental health servicesen_ZA
dc.titleMaternal mental health in primary care in five low- and middle-income countries : a situational analysisen_ZA
dc.typeArticleen_ZA
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