Abstract
BackgroundMaternal mental health care is a neglected area in low and middle income countries (LAMIC) such as South Africa, where maternal and child health care priorities are focused on reducing maternal and infant mortality and promoting infant physical health. In the context of a paucity of mental health specialists, the aim of this study was to understand the explanatory models of illness held by women with maternal depression with the view to informing the development of an appropriate counselling intervention using a task sharing approach.MethodsTwenty semi-structured qualitative interviews were conducted with mothers from a poor socio-economic area who were diagnosed with depression at the time of attending a primary health care facility. Follow-up interviews were conducted with 10 participants in their homes.ResultsDimensions of poverty, particularly food and financial insecurity and insecure accommodation; unwanted pregnancy; and interpersonal conflict, particularly partner rejection, infidelity and general lack of support were reported as the causes of depression. Exacerbating factors included negative thoughts and social isolation. Respondents embraced the notion of task sharing, indicating that counselling provided by general health care providers either individually or in groups could be helpful.ConclusionCounselling interventions drawing on techniques from cognitive behavioural therapy and problem solving therapy within a task sharing approach are recommended to build self-efficacy to address their material conditions and relationship problems in poorly resourced primary health care facilities in South Africa.
Highlights
Maternal mental health care is a neglected area in low and middle income countries (LAMIC) such as South Africa, where maternal and child health care priorities are focused on reducing maternal and infant mortality and promoting infant physical health
Maternal mental health is an internationally recognised public health concern [1,2,3] and the high burden of disease associated with postnatal depression is well documented in both high income countries (HICs) and low and middle income countries (LAMICs) [4,5]
In South Africa, current data suggest higher prevalence rates than these global estimates, with isolated studies on postnatal depression (PND) providing an estimated prevalence rate ranging from 16.4% in the township of Soweto to 39% in Khayelitsha, an informal settlement in
Summary
Maternal mental health care is a neglected area in low and middle income countries (LAMIC) such as South Africa, where maternal and child health care priorities are focused on reducing maternal and infant mortality and promoting infant physical health. In South Africa, current data suggest higher prevalence rates than these global estimates, with isolated studies on postnatal depression (PND) providing an estimated prevalence rate ranging from 16.4% in the township of Soweto to 39% in Khayelitsha, an informal settlement in in the face of a 12 month treatment gap of between 76% to 85% for people with severe mental disorders in low-income countries [11], and a75% treatment gap for common mental disorders in South Africa [12], the high burden of maternal depression poses a public health threat [13] This is because PND can impact negatively on an infant’s socio-emotional and cognitive development as a result of maternal neglect, poor maternal responsiveness and impaired attachment relationship between mother and infant [5,14]. Untreated PND is a human rights issue as it compromises codes of social justice for children who receive substandard maternal care as well as compromised quality of life for women with maternal depression [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
