Integrating mental health screening into routine community maternal and child health activity: experience from Prevention of Mother-to-child HIV transmission (PMTCT) trial in Nigeria.

Theddeus Iheanacho,Jude Ohaeri,Michael Obiefune,Chinenye O Ezeanolue,Echezona E Ezeanolue,Okey C Nwanyanwu,John E Ehiri,Gbenga Ogedegbe

doi:10.1007/s00127-014-0952-7

Abstract

PurposeAlthough the prevalence of mental health disorders in Nigeria is comparable to most developed countries, access to mental health care in Nigeria is limited. Improving access to care requires innovative approaches that deliver mental health interventions at the community level. The aim of this study was to determine the feasibility and acceptability of integrating mental health screening into an existing community-based program for prevention of mother-to-child transmission of HIV targeted at pregnant women and their male partners.MethodsPregnant women and their male partners from 117 churches enrolled in the healthy beginning initiative (HBI) in southeast Nigeria participated in the mental health screening project. Two members from each church were trained as church-based health advisors to administer the 12-item general health questionnaire.ResultsNinety-three percent of the pregnant women and their male partners agreed to participate and fully completed the questionnaire. Overall, 21.7 % of the respondents scored above the threshold of 11 indicating significant psychological distress, with women having significantly higher scores than men.ConclusionMental health screening is feasible and well accepted among a cohort of pregnant women and their male partners. Church members can be trained as health advisors to administer mental health screening. Mental health interventions can be developed on the framework of the HBI.

Highlights

Burden of mental health in NigeriaNigeria exemplifies the severe gap in mental health care common in low- and middle-income countries (LMIC) [1] with an estimated 150 psychiatrists available in a country of 160 million people
Pregnant women and their male partners from 117 churches enrolled in the healthy beginning initiative (HBI) in southeast Nigeria participated in the mental health screening project
Church members can be trained as health advisors to administer mental health screening

Summary

Introduction

Nigeria exemplifies the severe gap in mental health care common in low- and middle-income countries (LMIC) [1] with an estimated 150 psychiatrists available in a country of 160 million people. There are limited data from Nigeria on maternal access to mental health care during and after pregnancy. Available studies indicate that only about 10 % of adults with mental illness in Nigeria receive any care irrespective of severity [2]. Mental health care during pregnancy is scarce and is limited to major urban hospitals. Most pregnant women and their families get support from their religious organizations during pregnancy [11, 13]. Religious organizations offer special prayer sessions for pregnant couples and celebrate with the families at special services after childbirth [14]

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Conclusion