Abstract
BackgroundPerinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). This study aims to explore the barriers and facilitators, as well as perceptions about the feasibility and acceptability of plans to deliver perinatal mental health care in primary care settings in a low income, rural district in Uganda.MethodsSix focus group discussions comprising separate groups of pregnant and postpartum women and village health teams as well as eight key informant interviews were conducted in the local language using a topic guide. Transcribed data were translated into English, analyzed, and coded. Key themes were identified using a thematic analysis approach.ResultsParticipants perceived that there was an important unmet need for perinatal mental health care in the district. There was evidence of significant gaps in knowledge about mental health problems as well as negative attitudes amongst mothers and health care providers towards sufferers. Poverty and inability to afford transport to services, poor partner support and stigma were thought to add to the difficulties of perinatal women accessing care. There was an awareness of the need for interventions to respond to this neglected public health problem and a willingness of both community- and facility-based health care providers to provide care for mothers with mental health problems if equipped to do so by adequate training.ConclusionThis study highlights the acceptability and relevance of perinatal mental health care in a rural, low-income country community. It also underscores some of the key barriers and potential facilitators to delivery of such care in primary care settings. The results of this study have implications for mental health service planning and development for perinatal populations in Uganda and will be useful in informing the development of integrated maternal mental health care in this rural district and in similar settings in other low and middle income countries.
Highlights
Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs)
Knowledge and attitudes concerning perinatal mental health problems We explored knowledge about mental health problems among pregnant and postnatal women
Women attending the antenatal clinic described a range of behavioral symptoms of mental health problems in a mother: Many of the women said they did not really know what the effects of mental illness in the mother or their baby would be, but they believed that it could cause the mother to be “struck by pressure”
Summary
Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). Perinatal mental disorders are an important public health problem, especially in low- and middle-income countries (LMICs) [1]. These are mental disorders that occur either in pregnancy or the postpartum period and include antenatal and postnatal common mental disorders (CMD) and the severe mental disorders (SMD). The fifth edition of the Diagnostic and Statistical Manual of mental disorders [2] recognizes the occurrence of mood and psychotic disorders both in pregnancy and the postpartum period. Postpartum onset psychotic disorders on the other hand are characterized by abnormal firmly held beliefs (delusions) centered on the baby, abnormal perception of the environment (hallucinations), disturbances in thinking, speech and behavior
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