Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: The burden of perinatal depression is high globally but even higher in low- and middle-income countries (LMICs) where it is exacerbated by poverty, gender-based violence, unintended pregnancies, and lack of support. With rates from 18-25% in LMICs, perinatal depression is a significant public health problem affecting both women and their children. Depression causes disability and affects women’s ability to cope with everyday stressors and perinatal depression is linked to poor infant outcomes and socio-emotional and cognitive development problems in children. While providing maternal mental health care is a challenge, there are examples of mental health being integrated into maternal health care platforms in sub-Saharan Africa (SSA). This presentation highlights opportunities for providing integrated, holistic maternal health services.
Methodology: We conducted a review of published studies and an update on ongoing studies to address the prevention and treatment of antenatal and postnatal depression among women in SSA.
Results: With limited resources, providers of maternal healthcare in SSA are exploring options for delivering sustainable mental health services. Within facilities, there are examples of task-shifting depression care and treatment to lay counsellors while at the community level, church-based antenatal support has been used to screen for psychological distress and provide follow-up services. Depending on the context, pregnant and postpartum women may be accessing routine ANC, PMTCT, HIV Care and Treatment, FP, or MCH services; these platforms have opportunities for integrating mental health and creating more comprehensive maternal health care.
Conclusions: Addressing perinatal depression, particularly during pregnancy, provides an opportunity for prevention of poor infant/child outcomes and it engages women in depression treatment earlier in the maternal healthcare continuum, potentially lessening more severe depression episodes during the postnatal period. There is growing evidence for how to integrate mental health and maternal health services, which is of critical importance to women, children, and families.