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

dc.contributor.authorTomlinson, Mark (Mark R.)en_ZA
dc.contributor.authorChaudhery, Deepikaen_ZA
dc.contributor.authorAhmadzai, Habibullahen_ZA
dc.contributor.authorRodriguez Gomez, Sofiaen_ZA
dc.contributor.authorBizouerne, Cecileen_ZA
dc.contributor.authorVan Heyningen, Thandien_ZA
dc.contributor.authorChopra, Mickeyen_ZA
dc.date.issued2020
dc.descriptionCITATION: Tomlinson, M. 2020. Identifying and treating maternal mental health difficulties in Afghanistan : a feasibility study. International Journal of Mental Health Systems, 14:75, doi:10.1186/s13033-020-00407-1.
dc.descriptionThe original publication is available at https://ijmhs.biomedcentral.com
dc.description.abstractBackground: 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.en
dc.description.urihttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00407-1
dc.description.versionPublisher's version
dc.format.extent8 pages ; illustrations
dc.identifier.citationTomlinson, M. 2020. Identifying and treating maternal mental health difficulties in Afghanistan : a feasibility study. International Journal of Mental Health Systems, 14:75, doi:10.1186/s13033-020-00407-1
dc.identifier.issn1752-4458 (online)
dc.identifier.otherdoi:10.1186/s13033-020-00407-1
dc.identifier.urihttp://hdl.handle.net/10019.1/110422
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectMothers -- Mental health -- Afghanistanen_ZA
dc.subjectPostpartum depression -- Incidence --Afghanistanen_ZA
dc.subjectMother and infant -- Psychological aspects -- Afghanistanen_ZA
dc.titleIdentifying and treating maternal mental health difficulties in Afghanistan : a feasibility studyen_ZA
dc.typeArticle
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