World Maternal Mental Health Day – hunger and maternal mental health

World Maternal Mental Health Day 

1 May 2019

The increase in life stressors that often occur around pregnancy can make women more vulnerable to mental health problems. In South Africa, one in three women suffers from common mental disorders, such as depression and/or anxiety, during and after pregnancy.

That is why maternal mental health is our priority!

This year, we will again proudly participate in the World Maternal Mental Health Day campaign – supporting a worldwide effort to raise awareness of maternal mental health issues so that more women will get the necessary support and fewer will suffer.

Why we need MMH day

Life changes around pregnancy make women more vulnerable to mental illness. The negative cycle of poverty and mental illness impact on a woman’s ability to function and thrive, further reducing her income-generating potential and increasing suffering. Untreated mental illness in parents may also affect children, with possible long-lasting physical, cognitive and emotional outcomes.

Mental health care provides the necessary support to empower women to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally. Caring for mothers is a positive intervention for long-term social development.

Over the next few weeks, across all our social media platforms, we will highlight the link between food insecurity and maternal mental health.

We hope you will follow our campaign by turning on your post notifications, share our posts and follow the campaign hashtag #maternalMHmatters

 

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Looking back and moving forward for #globalPMH

Our first newsletter of the year reflects on 2018 and takes a sneak peek into projects and research still to come.

 

What a year it’s been!
Find out what we’ve achieved and view the highlights of our activities in 2018 in our Annual Report

Maternal Mental Health: A South African Story

Blogpost EveryMotherCounts

Common mental health problems, such as depression and anxiety, that occur during pregnancy and in the year after childbirth are highly prevalent globally. In developing countries, the rates are much higher than in high-income settings. Women and girls who live in poverty and who experience violence are particularly vulnerable. In South Africa, about 1 in 3 women will experience depression or anxiety during or after their pregnancy.

Poor maternal mental health not only has adverse effects on mothers, but may negatively impact their children. Mental health problems in mothers is linked to maternal and infant mortality. Poor maternal mental health jeopardises the development of the foetus resulting in premature births and low birth weight infants. Social, behavioural and emotional development of children is also affected by the mental health of the mother. Many of these effects may be buffered by the presence of another supportive and well adult caregiver for the child. However, many mothers in resource-scarce settings are socially and emotionally isolated.

Read Carol’s full story on the Every Mother Counts blog.

Source: EveryMotherCounts

How social factors drive up suicide rates among pregnant women

We are reposting our article on maternal suicide on the occasion of #WorldSuicidePreventionDay2018

PMHP Blog

Source: The Conversation/ Perinatal Mental Health Project & Jason Bantjes

Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population. That’s a key finding from a recent study we undertook at Hanover Park.

The research found 12% of pregnant women living in low-resource communities had thought of killing themselves during the previous month. In the same period, an additional 6% of pregnant women reported they had started to enact a suicide plan or attempted to end their lives. Rates of depression and anxiety were also found to be elevated among the pregnant women who took part in the study.

These findings mirror research about high rates of suicidal ideation and behaviour among pregnant women elsewhere in the world. A review of 17 studies in high- and low-income countries found the prevalence of suicidal ideation among pregnant and postpartum…

View original post 456 more words

Hanover Park: trauma and loss – mothers and children in need for mental health support

A recent article in the Daily Maverick emphasised the need for trauma counselling for women and children in the Cape Flats.

Our service site in Hanover Park serves the Greater Athlone health district, including parts of the Cape Flats, since 2012.

We continue to screen thousands of mothers and counsel about 200 per year at the Midwife Obstetric Unit.

Read more about our Hanover Park service here

Read the Daily Maverick article here

PMHP midyear reflection

Our August newsletter includes our latest publications and a shout-out to our fantastic volunteers!

Thank you to Ndivhudzannyi (Ndi) Mphephu, Sasha Roytowski, Rachel Field and Marni Riese for your valuable contributions, without which our work would not be possible!

Click the image below to read our newsletter or sign-up here!

Pregnant women suffer at hands of violent partners in South Africa

Republished article by Tanya Farber in Sunday Times (South Africa)

Many South Africa women‚ already in difficult situations‚ are experiencing violence during pregnancy at the hands of their intimate partners‚ a new study has found.

Of the 376 women who took part in the research‚ 15% had experienced intimate partner violence (IPV) during pregnancy‚ with forms of abuse ranging from sexual and physical to emotional and verbal.

This is against a backdrop of South Africa having intimate partner violence (among all women‚ not just those who are pregnant) which is “double that of the United States of America”‚ and which is as high as 71% in some communities.

The high level of violence during pregnancy in South Africa resulted from a combination of poverty-related factors.

Just published in the international BMC Women’s Health Journal‚ the study was carried out by a team from the University of Cape Town.

The sample was drawn from women attending antenatal services at a primary-level maternity facility in Cape Town.

The researchers found that the high level of violence during pregnancy resulted from a combination of poverty-related factors including food insecurity‚ mental ill-health‚ unemployment‚ unwanted pregnancies‚ and past experiences of abuse.

“In its most severe form‚ violence against pregnant women has been reported as a contributing cause of maternal deaths,” said researchers Sally Field‚ Michael Onah‚ Thandi van Heyningen and Simone Honikman.

It has also been associated with “inadequate uptake of antenatal care‚ with abused women being more likely to delay seeking pregnancy care and to attend fewer antenatal visits.”

For mothers and their unborn babies, results can include “low birth weight‚ foetal death by placental abruption‚ antepartum haemorrhage‚ foetal fracture‚ rupture of the uterus and premature labour”.

Also‚ they add that a “strong association” had been shown between thoughts of suicide and violence experienced by pregnant women.

They said that in South Africa‚ “high levels of violence occur within a context of multiple contributing social dynamics. These include prominent patriarchal norms where masculinity is associated with the defence of honour‚ harshness‚ and risk-taking.”

They added: “Poverty and gender inequalities contribute to the structural determinants of violence.

“Women in stable but unmarried relationships were more likely to have reported experiencing IPV than those who were married.”

Where to from here? The researchers said the study contributed towards a greater understanding of the risk profile for IPV among pregnant women in low-income settings.

 

This research and other PMHP findings are available open-source online!

Bringing mental health of mothers into the spotlight in Africa

In most societies, mothers are the primary providers of care to young children. This is a demanding task and the mental health of a mother is not only essential to her well-being, but that of her child’s physical health, nutrition and psychological well-being. However, most child development programmes do not adequately address maternal mental health.

Recent research has shown that about 20% of mothers in developing countries experience some form of mental health problems during or after childbirth. The United Nation’s Secretary-General António Guterres has recently acknowledged that the issue of mental health remains a largely neglected issue and announced the UN’s commitment to “working with partners to promote full mental health and well-being for all”.

Moreover, professionals in the field are pointing out that the mental health of mothers is critical to the success of the UN Sustainable Development Goals on health, nutrition and gender equality (SDG 3, 2 and 5).

In South Africa, the rate of pregnant and postnatal mothers suffering from common mental disorders (depression and/or anxiety) can reach up to one in three. Many of them are poor, come from disadvantaged communities and face many obstacles in accessing services and care.

Across Africa, the majority of women experiencing challenges to their mental health during the perinatal period (pregnancy and up to one year after the birth) are also exposed to gender-based violence, economic and gender inequalities, physical illnesses (including HIV), complications of childbirth and the stresses of childcare. Suicide has been identified as one of the leading causes of maternal death worldwide.

Unfortunately, health care systems in most African countries are not equipped to deal with the complex health and social challenges faced by most mothers. With competing physical health priorities and constrained resources, mental health care remains seriously neglected.

To challenge the status-quo and to improve the mental health of mothers in Africa, a group of individuals and organisations are working together in the newly established African Alliance for Maternal Mental Health (AAMMH).

AAMMH believes that a multi-sectoral approach is needed to tackle the causes of poor maternal mental health in Africa. The alliance calls for the integration of existing evidence-based interventions for the detection, prevention and treatment of maternal mental health problems into reproductive and child health programmes, supported by mental health services with specialist expertise.

This call for action is very close to the PMHP’s mission to develop and advocate for accessible maternal mental health care that can be delivered effectively in low-resource settings. We have thus become involved with the Global Alliance for Maternal Mental Health (GAMMH) over the past year since its formation and are now a proud founding partner of its first regional off-shoot, the AAMMH.

Together with colleagues in Malawi, we have been preparing for the upcoming launch on the 19 June in Lilongwe, Malawi. Prior to the launch, we will conduct a training workshop with health care providers and managers in maternal, mental and child health. On the launch day itself, we will be delivering a keynote address sharing the experience of the PMHP and will also be conducting a workshop towards establishing strategies for working partnerships across sectors for maternal mental health.

We hope our experience and work in South Africa, and in other low and middle-income countries, will contribute to the development and growth of this pan-African advocacy initiative. At the same time, we look forward to collaborating and learning from advocates, practitioners, trainers and researchers across Africa to strengthen the work we do in South Africa.

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The African Alliance for Maternal Mental Health (AAMMH) is part of the Global Alliance of Maternal Mental Health and works in close collaboration with the Marcé Society African Regional Group.

AAMMH will be officially launched in Lilongwe, Malawi on 19 June 2018. You can follow the event by using the hashtag #AAMMH #GAMMH

Read more about aims and objectives of the AAMMH here.

Good News in June

During the first half of 2018, we have produced a training video on Empathic Engagement Skills, published a number of research papers and have been busy all around.

Read our latest newsletter or subscribe to get the latest developments straight into your inbox.

(no worries, we are only sending a newsletter every couple of months!)


Click on the image to read the June newsletter 

Addressing the Maternal Mental Health Diagnosis Gap through screening tools

Source: Maternal Health Task Force blog

Diagnosis gap in Low- and Middle-Income Countries (LMICs)

Despite contributing significantly to maternal deaths and unproductive life years, common perinatal mental disorders (CPMD) often go undetected among women in low-resource regions. This can mean that up to 80% of women remain untreated in such settings. Resource-constrained primary care centers, high patient volumes, lack of recognition by health workers as well as increased task shifting to semi-skilled health workers contribute to this treatment gap. In order to encourage timely identification of CPMD among mothers followed by referrals, antenatal care provision centers are a promising platform in LMICs due to the high level of touchpoints between expectant women and health systems. In South Africa, for example, a mother’s contact rate with any antenatal care facilities is quite high at approximately 91%. […]

Empathic engagement training

Lead author Thandi van Heyningen shares insight into progress and next steps for improving maternal mental health in low-resource settings:

“Where health system resources are scarce, one way of improving detection and improving access to treatment, is to integrate these services into existing, routine, primary health care services using a stepped care approach. Improving detection through routine antenatal screening may provide a vital first step, however there is a need to generate further evidence on the feasibility and acceptability of existing screening tools for use in such settings, and by non-specialist health care workers.”

Read the full paper “Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women” in the MHTF-PLOS collection on NCDs and maternal health
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