scholarly journals Perinatal mental health around the world: priorities for research and service development in Africa

2020 ◽  
Vol 17 (3) ◽  
pp. 56-59 ◽  
Author(s):  
Mwawi Ng'oma ◽  
Tesera Bitew ◽  
Malinda Kaiyo-Utete ◽  
Charlotte Hanlon ◽  
Simone Honikman ◽  
...  

Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include intimate partner violence, food insecurity and physical illness; and poor maternal mental health is associated with impairment of infant health and development. Psychological interventions can be integrated into routine maternal and child healthcare in the African context, although the optimal model and intensity of intervention remain unclear and are likely to vary across settings. Future priorities include: extension of research to include neglected psychiatric conditions; large-scale mixed-method studies of the causes and consequences of perinatal common mental disorders; scaling up of locally appropriate evidence-based interventions, including prevention; and advocacy for the right of all women in Africa to safe holistic maternity care.

Author(s):  
Mansour Abdulshafea ◽  
Abdul Hakim Rhouma ◽  
Nadeem Gire ◽  
Ali AlMadhoob ◽  
Usman Arshad ◽  
...  

Abstract Introduction There has been a global increase in the prevalence of common mental disorders (CMD), particularly in conflict hotspots. The limited amount of resources is one of the key barriers to effective treatment within Low- and Middle-income countries (LAMICs). The lack of service provision for mental health disorders in LAMICs has resulted in limited opportunities to conduct mental health research. Libya is a North African country that has suffered from ongoing conflict with the current political unrest in Libya further impacting the mental health of the population. Main text The aim of this review is to conduct a synthesis of evidence regarding the estimated prevalence and associated risk factors of CMD in Libya. A search was completed in the academic databases; PubMed, Medline, EMBASE, PsychINFO, CINHAL, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) from inception to March 2020. Only studies that investigated prevalence and associated risk factors of CMD in Libya were included. A total of 219 studies were identified of which 15 met the inclusion criteria for the review. There were (n = 3) papers investigated the prevalence of depression, (n = 4) studies were focused on stress-related disorders and the remaining papers looked at both anxiety and depression. Statistically, sample sizes of the included studies ranged from (n = 41–13,031) for the prevalence studies (mean = 1188.6, median = 233). Conclusion The status of Libya as a conflict hotspot has led to a reduced level of epidemiological data on mental health, with a vital need to conduct research in CMD. Libya requires better clinical governance which can allow for more scientific research into CMD and enabling the Libyan government to develop evidence-based policy initiatives for CMD.


2010 ◽  
Vol 196 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Madhabika B. Nayak ◽  
Vikram Patel ◽  
Jason C. Bond ◽  
Thomas K. Greenfield

BackgroundThe relationship between partner alcohol use and violence as risk factors for poor mental health in women is unclear.AimsTo describe partner-related and other psychosocial risk factors for common mental disorders in women and examine interrelationships between these factors.MethodData are reported on 821 women aged 18–49 years from a larger population study in north Goa, India. Logistic regression models evaluated the risks for women's common mental disorders and tested for mediation effects in the relationship between partner alcohol use and these disorders.ResultsExcessive partner alcohol use increased the risk for common mental disorders two- to threefold. Partner violence and alcohol-related problems each partially mediated the association between partner excessive alcohol use and these mental disorders. Women's own violence-related attitudes were also independently associated with them.ConclusionsPartner alcohol use, partner violence and women's violence-related attitudes must be addressed to prevent and treat common mental disorders in women.


2011 ◽  
Vol 26 (S2) ◽  
pp. 577-577
Author(s):  
M. Santos ◽  
A.E. Ribeiro

Mental condition is determined by a multiplicity of factors, such as biological, individual, social, economic and environmental. Mental and behavioural disorders are estimated to account for 13% of the global burden of disease, according to the World Health Organization. Despite this evidence, mental health is a neglected and an under-researched area of public health, particularly in low-and-middle-income-countries (LMICs).Recent studies found an association between common mental disorders (CMD), such as depression and anxiety, and poverty. However, investigation on several specific poverty indicators has revealed a much more complex scenario.A recent meta-analysis showed that variables such as education, food insecurity, housing, social class, socio-economic status and financial stress are consistently and strongly associated with CMD. In turn, the disabling effects of mental disorders impair the ability of persons to self-sustain, reflecting a relationship between poverty and mental disorders that has been likened to a vicious cycle.The authors emphasize the need for improvement of LMICs mental health policies.


2012 ◽  
Vol 9 (3) ◽  
pp. 213-217
Author(s):  
A Risal

Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms typically encountered in community and primary care settings. Risk factors for these disorders are mainly lower socio-economic status, psychological illnesses, poor reproductive health, gender disadvantage and physical ill-health. WHO has recommended that treatment of all these disorders should be based in primary care to be more effective and accessible to all the community people. The structure of mental health care in primary care is generally understood in terms of the “pathways to care” model and it plays a major role in countries like ours where community-based mental health services do not exist. Both the psychological and pharmacological therapies are found to be equally effective for treating these disorders. Integration of mental health into primary care can be considered as the stepping stone in the way forward to tackle the barriers and problems in effective management of common mental disorders in the community. The acute shortage of mental health professionals and the relatively low levels of awareness about mental disorders make it mandatory that primary health care should remain the single largest sector for mental health care in low and middle income countries like ours.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6308 Kathmandu Univ Med J 2011;9(3):213-7  


2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Bruna Kulik Hassan ◽  
Guilherme Loureiro Werneck ◽  
Maria Helena Hasselmann

ABSTRACT OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026). We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010). Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041). CONCLUSIONS Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 295-295
Author(s):  
Christine Walters ◽  
Joel Komakech ◽  
Hasina Rakotomanana ◽  
Barbara Stoecker

Abstract Objectives This study aimed to determine the association between child dietary diversity, household food insecurity, child stunting, and maternal mental health symptoms in the Vakinankaratra region of Madagascar. Methods This cross-sectional study included 391 mother-child dyads. The World Health Organization (WHO) standards were used for defining child dietary diversity and child stunting and the Household Food Insecurity Access Scale (HFIAS) was used for food insecurity scores. Maternal symptoms of common mental disorders were assessed using the WHO Self-Reporting Questionnaire (SRQ), which was translated into Malagasy and pre-tested; a cutoff of seven was used to indicate the occurrence of symptoms of common mental disorders. Multivariate linear and logistic regression models adjusted for strata, cluster, and confounding variables were conducted with statistical significance set at P < 0.05. Results More than half (56.8%) of the mothers reported symptoms of common mental disorders and more than half of the children (69.4%) were stunted. The mean HFIAS score was 10.3 (±5.6) and mean child dietary diversity score was 3.0 (±1.31). Symptoms of common mental disorders were significantly associated with child dietary diversity score in the bivariate analysis but became nonsignificant in the final adjusted model (β = –0.22, P = 0.06, R2 = 0.07). In the adjusted model, having symptoms of common mental disorders was significantly associated with higher HFIAS score (β = 3.45, P < 0.0001, R2 = 0.13) and HFIAS scores were significantly associated with having symptoms of common mental disorders (AOR = 1.31 [1.09–1.17], P < 0.0001). Maternal symptoms of common mental disorders were significantly associated with stunting (AOR = 1.68 [1.02–2.78], P < 0.05). Conclusions Maternal mental health and household food insecurity were significantly associated in this rural area of the Vakinankaratra region in Madagascar. Furthermore, assessing maternal symptoms of common mental disorders and referring mothers for mental health care appears to be an important consideration for improving child stunting in the region. Funding Sources Oklahoma State University.


2017 ◽  
Vol 48 (1) ◽  
pp. 32-47 ◽  
Author(s):  
Debra Kaminer ◽  
Michael Owen ◽  
Byron Schwartz

The scarcity of mental health resources in low- and middle-income countries requires the identification of effective interventions that can be taken to scale in a cost-efficient manner. Yet the evidence base for treatment of common mental disorders in low- and middle-income countries remains limited. As one of the better resourced countries on the African continent, South Africa could potentially play a leading role in developing an African evidence base for mental health care. This study sought to describe and evaluate the South African evidence base for treating common mental disorders. A systematic review of randomised controlled trials for depression, substance use, and anxiety in the adult South African population from 2000 to mid-2015 was conducted. Eligible studies were assessed for their consistency with recommendations for mental health interventions in low- and middle-income countries and for methodological and reporting rigour. A total of 16 RCTs satisfied the inclusion criteria, of which 8 targeted depression, 6 targeted substance use, and 2 targeted anxiety symptoms. There has been a strong trend towards alignment with prevailing recommendations for delivery of mental health interventions in resource-scarce regions. While there are some promising findings with regard to effectiveness of specific interventions, replication, costing, and dissemination studies are still required and there is still an urgent need for treatment studies for anxiety disorders, which are the most common class of common mental disorder in South Africa. The review also indicates that research design and reporting practices in South African mental health intervention research could be enhanced and recommendations towards this are suggested.


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