Category Archives: Early Childhood Development
The negative cycle of mental ill-health and poverty is particularly relevant for women and their infants during the perinatal period. During this time, major life transitions render women more vulnerable to mental illness from social, economic and gender-based perspectives.
Those with the most need for mental health support, have the least access. Overburdened maternal and mental health services have not been able to address adequately this significant unmet need. There have been limited attempts at a programmatic level, to integrate mental health care within maternal care services.
The perinatal period, where women are accessing health services for their obstetric care, presents a unique opportunity to intervene in the event of mental distress. Preventive work involving screening and counselling may have far-reaching impact for women, their offspring and future generations.
Mental health care is a notoriously neglected area – even more so in “healthy” pregnant and postnatal women. The focus on the physical to the detriment of the emotional is particularly felt now against the backdrop of HIV and AIDS. The public health service has been unable to address the mental health needs of women from poorer communities – neither within maternity services nor within mental health services. This is despite a wide body of evidence showing that distress in the mother may have long-lasting physical, cognitive and emotional effects on her children.
The PMHP aims to integrate mental health service routinely, within the primary maternal care environment.
Based at selected government MoU facilities in Cape Town, we offer counselling and support services focused on the emotional wellbeing of pregnant women with a strong focus on postnatal and clinical depression.
We know a mom who is clinically depressed has a lot of negative outcomes. Those negative outcomes are not just for the mom, they can also have long-term implications for children.
Researchers and clinicians alike have been particularly concerned about the effects of maternal depression during and after pregnancy on children.
But a new study suggests that a mother’s depression during the preschool years may be more harmful to children than either her prenatal or immediately postnatal depression. It is the first study to track the effects of maternal depression on children from pregnancy until the children turn 5.
Domestic violence is any physical, sexual, psychological or economic abuse that takes place between people who are sharing, or have recently shared a home.
In Africa, there is more violence against women than on any other continent. Three women are killed by their partners in South Africa every day, thats twice as many women than in the United States of America. Violence during pregnancy has negative effects for both the mother and the child. Abused women are more likely to delay getting pregnancy care and to attend fewer antenatal visits.
Our recent research study looked at pregnant women who experience domestic violence in Hanover Park, Cape Town. We looked at the profile of women who reported domestic violence and what factors in their lives were associated with this abuse.
We found that women who were experiencing domestic violence were more likely than those without domestic violence to:
– have a current mental health problem like depression, anxiety, suicidal thoughts or behaviours, alcohol or drug abuse
– have had past mental health problems
– have experienced past abuse
– not feel supported by their partner
– not likely feel pleased about being pregnant
– more likely experience food insecurity and not have a job
Out of this study with developed a learning brief which targets any service providers who interact with vulnerable women and children, especially those service providers who work with pregnant women. Such services providers can arise from nongovernmental organisations (NGOs) or civil society organisations and may be healthcare providers or social service providers.
Find this and more on our resources for professionals pages.
While perinatal mood and anxiety disorders (PMAD) have a global footprint, the majority of research related to this group of illnesses has come largely from more affluent, Westernized countries. Similarly, the tools used to detect and screen for PMADs were developed and tested in these Westernized countries.
The instrument most commonly used to detect PMADs is the Edinburgh Postnatal Depression Scale (EPDS), which was originally developed in Great Britain. While it has been translated into many different languages and used in many different countries, it is unclear if these translated versions of the EPDS accurately identify PMAD in disparate, non-English speaking countries. Specifically there has been concern that simply translating the EPDS may not fully capture the cultural determinants of mood and anxiety disorders.
Particularly vulnerable to mental health problems are the women who are pregnant or have recently given birth living in resource-constrained, low- and lower-middle-income countries (LALMICs) as defined by the World Bank. A recent systematic review appraised formally validated local language versions of the EPDS used in resource-constrained settings (Shrestha et al., 2016).
Integrating therapy, other services, or information into routine visits can make getting help easier and chip away at the stigma regarding postpartum depression.
Unlike the “baby blues,” which are commonly associated with mild feelings of worry and fatigue after having a baby, postpartum depression is a mood disorder characterized by a broad range of symptoms including anxiety, extreme sadness, and exhaustion.
A number of new studies have found that stress, depression or anxiety during and after pregnancy can have long lasting effects on the development of your child.
We have translated some of those findings into an Issue Brief and added some of our recommendations for evidence based interventions for parents.
This Issue Brief outlines not only the risk factors for parents, but also encourages the building of resilience to prevent or lessen the negative impacts for children.
“Caring for mothers and fathers – is caring for the future”
Depression during and after pregnancy is affecting up to one in five women globally.
Previous studies from around the world suggest that depression during and after pregnancy affects the bonding between mother and child and can have direct implications for infant survival and early childhood development.
In this new review, the authors focused mainly on low and middle income countries and are calling for urgent interventions for mothers and children.
There is a substantial lack of research specific to women in poorer countries, where interventions such as cognitive behavioural therapy may not be available
– Prof Vivette Glover, Imperial College London
Previously, research into perinatal depression has focused on high income countries. But current studies suggest that the problem is more common in low- and middle-income countries, some even suggest that up to 50% of women living in adversity are experiencing depression during or after pregnancy.
Therefor more resources are needed to support expectant and new mothers. Urgent investment is needed in research and the development of appropriate low cost interventions that are specific to these areas.
Our partner – organisation, PRIME, was recently featured on NDTV’s programme Every Life Counts in a news clip zooming in on perinatal depression in India. A full feature will be aired in September.
Perinatal depression continues to be a stigmatised and poorly addressed problem in many low- and middle-income countries. In India it’s no different and the burden of this disease increases every year. Watch the clip below and keep an eye out for the full feature in September.
A manual for psychosocial management of perinatal depression
This new publication is the first of a new World Health Organization (WHO) series on low-intensity psychological interventions.
The manual outlines an evidence-based approach describing how community health workers can reduce prenatal depression through evidence-based cognitive-behavioural techniques recommended by the mhGAP programme.
Find the manual here:
Find out more about the Mental Health Gap Action Programme (mhGAP) here:
This Sunday, 15. June, many countries around the world are celebrating fathers day
to recognize the contribution that fathers and father figures make to the lives of their children.
To celebrates fatherhood and underline the importance of male parenting we have updated our Leaflets for fathers.
Fathers who play with their children can make an important contribution to their child’s development and growth.
To find more resources for mothers, health workers or read our learning briefs follow the link to our website
@ Illustrations by Graeme Arendse