"Passing through difficult times": Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention
This study was conducted to explore the perceptions of perinatal women and key maternal care health workers about perinatal depression and the health service needs required to inform development of a culturally sensitive and acceptable psychosocial intervention. This qualitative study used a descrip...
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| Veröffentlicht in: | PloS one 2019-06, Vol.14 (6), p.e0217102 |
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| creator | Ng'oma, Mwawi Meltzer-Brody, Samantha Chirwa, Ellen Stewart, Robert C |
| description | This study was conducted to explore the perceptions of perinatal women and key maternal care health workers about perinatal depression and the health service needs required to inform development of a culturally sensitive and acceptable psychosocial intervention.
This qualitative study used a descriptive exploratory design; it is the first phase of a larger mixed methods study aimed at adapting a psychosocial intervention for perinatal depression. We conducted in-depth interviews with 22 women who screened positive for depression using a locally validated Chichewa version of the Edinburgh Postnatal Depression Scale at antenatal and postnatal clinics in 1 rural and 1 urban health care setting in Lilongwe District, Malawi. We also conducted 10 key informant interviews with maternal care health workers. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of perinatal depression and health service needs. Interviews were transcribed, translated and analysed using content analysis approach.
Perinatal depression was recognized as a common mental health problem that affected self-care activities and functioning of women in the perinatal period. Financial difficulties, relationship problems (polygamy, lack of support, neglect, and infidelity), traumatic events (intimate partner violence and loss) and fear of birth outcomes were identified as causes of depression. All study participants acknowledged the need for support and an intervention that will address the identified challenges. Additionally, they viewed strengthening the health delivery system as crucial to effectively address their needs and gaps identified in the system.
The results of this study support plans to develop a family focused intervention for perinatal depression in Malawi addressing relationship, psychosocial and economic issues. It also highlights the importance of strengthening the health delivery system especially at primary care level where the majority of women access care in Malawi and across Sub-Saharan Africa. |
| doi_str_mv | 10.1371/journal.pone.0217102 |
| format | Article |
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This qualitative study used a descriptive exploratory design; it is the first phase of a larger mixed methods study aimed at adapting a psychosocial intervention for perinatal depression. We conducted in-depth interviews with 22 women who screened positive for depression using a locally validated Chichewa version of the Edinburgh Postnatal Depression Scale at antenatal and postnatal clinics in 1 rural and 1 urban health care setting in Lilongwe District, Malawi. We also conducted 10 key informant interviews with maternal care health workers. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of perinatal depression and health service needs. Interviews were transcribed, translated and analysed using content analysis approach.
Perinatal depression was recognized as a common mental health problem that affected self-care activities and functioning of women in the perinatal period. Financial difficulties, relationship problems (polygamy, lack of support, neglect, and infidelity), traumatic events (intimate partner violence and loss) and fear of birth outcomes were identified as causes of depression. All study participants acknowledged the need for support and an intervention that will address the identified challenges. Additionally, they viewed strengthening the health delivery system as crucial to effectively address their needs and gaps identified in the system.
The results of this study support plans to develop a family focused intervention for perinatal depression in Malawi addressing relationship, psychosocial and economic issues. It also highlights the importance of strengthening the health delivery system especially at primary care level where the majority of women access care in Malawi and across Sub-Saharan Africa.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0217102</identifier><identifier>PMID: 31211776</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Aggression ; AIDS ; Beliefs, opinions and attitudes ; Care and treatment ; Children & youth ; Childrens health ; Community Health Workers - psychology ; Content analysis ; Culture ; Delivery of Health Care - statistics & numerical data ; Depression (Mood disorder) ; Depression - ethnology ; Depression - psychology ; Depression - therapy ; Domestic violence ; Family ; Female ; Health care ; Health Knowledge, Attitudes, Practice ; Health services ; Humans ; Informed consent ; Intervention ; Malawi - ethnology ; Male ; Maternal & child health ; Medical personnel ; Medicine ; Medicine and Health Sciences ; Mental depression ; Mental disorders ; Mental health ; Mental health personnel ; Mental health services ; Middle Aged ; Mothers ; People and Places ; Polygamy ; Population ; Postpartum depression ; Pregnancy ; Pregnancy Complications - ethnology ; Pregnancy Complications - psychology ; Pregnancy Complications - therapy ; Pregnancy Outcome ; Psychological aspects ; Public health ; Qualitative Research ; Research and Analysis Methods ; Risk factors ; Social Sciences ; Social Support ; Studies ; Violence ; Women ; Womens health ; Workers ; Young Adult</subject><ispartof>PloS one, 2019-06, Vol.14 (6), p.e0217102</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Ng’oma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Ng’oma et al 2019 Ng’oma et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6b787c49b95ae97e864b64ea3f1da9a51fee1a57cdfeef47f9c243b5912a767b3</citedby><cites>FETCH-LOGICAL-c692t-6b787c49b95ae97e864b64ea3f1da9a51fee1a57cdfeef47f9c243b5912a767b3</cites><orcidid>0000-0002-3258-1343</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581242/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581242/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31211776$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Doherty, Tanya</contributor><creatorcontrib>Ng'oma, Mwawi</creatorcontrib><creatorcontrib>Meltzer-Brody, Samantha</creatorcontrib><creatorcontrib>Chirwa, Ellen</creatorcontrib><creatorcontrib>Stewart, Robert C</creatorcontrib><title>"Passing through difficult times": Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>This study was conducted to explore the perceptions of perinatal women and key maternal care health workers about perinatal depression and the health service needs required to inform development of a culturally sensitive and acceptable psychosocial intervention.
This qualitative study used a descriptive exploratory design; it is the first phase of a larger mixed methods study aimed at adapting a psychosocial intervention for perinatal depression. We conducted in-depth interviews with 22 women who screened positive for depression using a locally validated Chichewa version of the Edinburgh Postnatal Depression Scale at antenatal and postnatal clinics in 1 rural and 1 urban health care setting in Lilongwe District, Malawi. We also conducted 10 key informant interviews with maternal care health workers. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of perinatal depression and health service needs. Interviews were transcribed, translated and analysed using content analysis approach.
Perinatal depression was recognized as a common mental health problem that affected self-care activities and functioning of women in the perinatal period. Financial difficulties, relationship problems (polygamy, lack of support, neglect, and infidelity), traumatic events (intimate partner violence and loss) and fear of birth outcomes were identified as causes of depression. All study participants acknowledged the need for support and an intervention that will address the identified challenges. Additionally, they viewed strengthening the health delivery system as crucial to effectively address their needs and gaps identified in the system.
The results of this study support plans to develop a family focused intervention for perinatal depression in Malawi addressing relationship, psychosocial and economic issues. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ng'oma, Mwawi</au><au>Meltzer-Brody, Samantha</au><au>Chirwa, Ellen</au><au>Stewart, Robert C</au><au>Doherty, Tanya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>"Passing through difficult times": Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-06-18</date><risdate>2019</risdate><volume>14</volume><issue>6</issue><spage>e0217102</spage><pages>e0217102-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This study was conducted to explore the perceptions of perinatal women and key maternal care health workers about perinatal depression and the health service needs required to inform development of a culturally sensitive and acceptable psychosocial intervention.
This qualitative study used a descriptive exploratory design; it is the first phase of a larger mixed methods study aimed at adapting a psychosocial intervention for perinatal depression. We conducted in-depth interviews with 22 women who screened positive for depression using a locally validated Chichewa version of the Edinburgh Postnatal Depression Scale at antenatal and postnatal clinics in 1 rural and 1 urban health care setting in Lilongwe District, Malawi. We also conducted 10 key informant interviews with maternal care health workers. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of perinatal depression and health service needs. Interviews were transcribed, translated and analysed using content analysis approach.
Perinatal depression was recognized as a common mental health problem that affected self-care activities and functioning of women in the perinatal period. Financial difficulties, relationship problems (polygamy, lack of support, neglect, and infidelity), traumatic events (intimate partner violence and loss) and fear of birth outcomes were identified as causes of depression. All study participants acknowledged the need for support and an intervention that will address the identified challenges. Additionally, they viewed strengthening the health delivery system as crucial to effectively address their needs and gaps identified in the system.
The results of this study support plans to develop a family focused intervention for perinatal depression in Malawi addressing relationship, psychosocial and economic issues. It also highlights the importance of strengthening the health delivery system especially at primary care level where the majority of women access care in Malawi and across Sub-Saharan Africa.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31211776</pmid><doi>10.1371/journal.pone.0217102</doi><tpages>e0217102</tpages><orcidid>https://orcid.org/0000-0002-3258-1343</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-06, Vol.14 (6), p.e0217102 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2275334337 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adult Aggression AIDS Beliefs, opinions and attitudes Care and treatment Children & youth Childrens health Community Health Workers - psychology Content analysis Culture Delivery of Health Care - statistics & numerical data Depression (Mood disorder) Depression - ethnology Depression - psychology Depression - therapy Domestic violence Family Female Health care Health Knowledge, Attitudes, Practice Health services Humans Informed consent Intervention Malawi - ethnology Male Maternal & child health Medical personnel Medicine Medicine and Health Sciences Mental depression Mental disorders Mental health Mental health personnel Mental health services Middle Aged Mothers People and Places Polygamy Population Postpartum depression Pregnancy Pregnancy Complications - ethnology Pregnancy Complications - psychology Pregnancy Complications - therapy Pregnancy Outcome Psychological aspects Public health Qualitative Research Research and Analysis Methods Risk factors Social Sciences Social Support Studies Violence Women Womens health Workers Young Adult |
| title | "Passing through difficult times": Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T17%3A13%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=%22Passing%20through%20difficult%20times%22:%20Perceptions%20of%20perinatal%20depression%20and%20treatment%20needs%20in%20Malawi%20-%20A%20qualitative%20study%20to%20inform%20the%20development%20of%20a%20culturally%20sensitive%20intervention&rft.jtitle=PloS%20one&rft.au=Ng'oma,%20Mwawi&rft.date=2019-06-18&rft.volume=14&rft.issue=6&rft.spage=e0217102&rft.pages=e0217102-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0217102&rft_dat=%3Cgale_plos_%3EA589603441%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2275334337&rft_id=info:pmid/31211776&rft_galeid=A589603441&rft_doaj_id=oai_doaj_org_article_44db2d2d2b104450b85b1361a016a604&rfr_iscdi=true |