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"I Would Not Save The Baby": Fighting Depression During Pregnancy



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Currently, around 450 million people worldwide are suffering from a mental condition, making it one of the leading causes of ill health. Is it possible for others in their community to have the key to help solve this problem?

People in high-income countries often face a lack of mental health, but in middle- and low-income countries the magnitude of the problem may be much worse.

Millions with conditions such as depression, anxiety and schizophrenia struggle to cure themselves due to lack of resources and stigmatization of mental health problems.

Pregnant women are a particular risk group.

In Kenya, for example, symptoms of depression such as fatigue and sleep problems are sometimes dismissed as pure pregnancy symptoms or even blamed for witchcraft.

This lack of care, combined with the high rate of domestic violence, contributed to 0.5% of maternal mortality in 201

5, one of the highest in the world.

Depression in pregnancy is also associated with low birth weight, abuse and breastfeeding problems.

Copyright
African Academy of Sciences

Caption Images

Many pregnant women in rural Kenya use the services of birth attendant

One million people without a psychiatrist

Kenya has only two mental health professionals per 100,000 people and they are concentrated in urban areas. This means that some rural counties have a population of millions, but there are no psychiatrists.

About 75% of people with mental health problems in poorer countries cannot receive medical treatment. This means that many are turning to non-specialized traditional healers, faith practitioners and community health workers.

We have found that training these mental health screening groups can drastically reduce the number of people who do not have access to treatment. [Basedonthefindingsoftraditionalparticipantsinthebirthofbeingtrainedinscreeningfordepressionmorethan1700pregnantwomeninapilotstudyoftheFoundationforResearchandMentalHealthTrainingAfrica.

The study was conducted in Makoueni County, a largely rural part of southeastern Kenya. One of the poorest cities in the country, it has no psychologists resident in the country.

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Caption Images

Makoueni is a large part of rural southeastern Kenya with a population of almost one million people


What are the traditional birth attendants? Births workers are often the first point of contact for pregnant women in rural Africa.
  • While not medically trained, they play a similar role to midwives.
  • When apprenticed, they usually receive cash or payments in kind. from the woman's family
  • In addition to delivering the baby, birth attendants reassure women and help them prepare to become a mother while trying to reduce family conflict. Birth participants used the Edinburgh Postpartum Depression Scale Questionnaire and then the WHO Mental Health Intervention Guide, both intended for use outside clinics and hospitals

  • Domestic Violence

    Screening Results were striking.

    One quarter of the mothers in the study had mild to moderate depression. Three-quarters were abused by an intimate partner, whether physical, sexual or emotional, or controlling behavior. Half are victims of at least two forms of this violence.

    Almost 60% of mothers diagnosed with depression received treatment from their birth attendant based on a World Health Organization program intended for use by non-specialists.

    Copyright
    African Academy of Sciences

    Caption of images

    One role of a birth attendant is to speak through problems that a pregnant woman may have

    The mothers were on average 26 years old, almost half the age between 12 and 24.

    One young mother participating in the study, Ndanu *, was diagnosed with depression.

    She said: "If it were not for this program and the help of a birth attendant, I would not have kept this baby on time and I might not have gone for all antenatal visits.

    “The birth attendant advised me, encouraged me to babysit, telling me that it was not my fault and the children were a blessing and that I should visit the antenatal care center. She promised to check on me and open her house for me to talk to her whenever I wanted. "

    Copyright
    African Academy of Sciences

    Image caption

    Mental health training was based on a program of WHO for non-specialists

    Birth attendants intervene by speaking through problems involving supportive family members and noting any signs of abuse.

    They encouraged depressed mothers to exercise and maintain a regular sleep cycle, restore their social networks, and resume activities they had previously enjoyed. Mothers were also given the opportunity to participate in community activities and join support groups.

    Mueni *, accompanying the birth participating in the study, said: "A pregnant mother opens up to us and we try to understand the causes. for her depression we solve problems through guidance and counseling. If the problem is rooted in her parents or spouse, we engage them and reach an agreement. "

    Mothers who received treatment saw their depressive symptoms decrease by 55% at the end of three months, compared with 26% of those who had no specific intervention.

    Similarly [19659051] Discrete Mental Health Services

    These early findings suggest that educating parents in mental health care could improve the well-being of mothers and their children, not only in Kenya but in all countries where similar community health workers work.

    Birth attendants are usually dos They are well placed to offer cheap and discreet mental health services.

    Training more psychiatrists would be helpful, but it takes a lot of time and funding.

    Birth officers can bridge the gap by offering an affordable, affordable level of basic mental health care in under-resourced areas while ensuring liaison between health professionals and pregnant mothers.

    * Names changed


    About this track

    This analysis was commissioned by BBC from an expert working for an outside organization.

    Dr. Christine Musimi is Head of the Research Ethics and Research Publications Unit at the Mental Health Research and Training Foundation in Africa.

    The Companion Study was born out of Grand Challenges Africa, an initiative funded in part by the African Academy of Sciences (AAS)

    AAS describes itself as a non-profit, non-political organization that aims to transform the life of the African continent through science .


    Edited by Eleanor Lowry


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