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Doglikuu DBI, Annan JK, Asare S, Yawson H, Takyi O, Dzidzornu FA, Koram HO, Johnson EA. Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey. BMC Womens Health 2023; 23:527. [PMID: 37803413 PMCID: PMC10559541 DOI: 10.1186/s12905-023-02674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Household food insecurity is the situation where individuals and families have limited/uncertain access to nutritionally adequate and safe foods for healthy living. Family size is the number of persons in the family. Household food insecurity and family size are risk factors for depression. However, their synergistic and/or multiplicative effect on depression is not well investigated. This study investigated/examined household food insecurity, family size and their interaction on depression prevalence among teenaged pregnant girls in Ghana. METHODS Population based cluster survey was conducted among 225 teenaged pregnant girls in 20-electoral areas at Twifo-Atti-Morkwa district in the central region of Ghana. Simple random sampling was used to recruit study participants and structured questionnaire used to collect demographic variables. Household Food Insecurity Access Scale (HFIAS) and Revised Children's Anxiety and Depression Scale (RCADS-25) were used to collect data. Multinomial logistic regression models were used to analyzed the data. RESULTS Moderate and high depression prevalence reported among teenaged pregnant girls in Twifo-Atti-Morkwa district were 35.1(28.1-42.1) and 33.5 (26.5-40.5) respectively. Moderate family size (AOR = 1.08, 95%CI = 1.17-3.71) and large-family-size (AOR = 2.78, 95%CI = 3.98-10.19) were significant for depression. Moderate food insecurity (AOR = 0.12, 95%CI = 0.41 - 0.35) and high food insecurity (AOR = 0.27, 95%CI = 0.11-0.71) were significant for depression. Interaction between moderate food insecurity and moderate family size (AOR = 1.69, 95%CI = 2.79-17.51), interaction between high food insecurity and low family size (AOR = 1.24, 95%CI 1.57-11.41) and interaction between high food insecurity and large family size (AOR = 1.01, 95%CI = 1.72-14.57) were significant for depression among teenaged pregnant girls. CONCLUSION There is moderate and high depression prevalence among teenaged pregnant girls in Twifo-Atti-Morkwa district. Interaction between household food insecurity and family size are the major predictors for depression among the teenaged girls in the district. We therefore recommend that public health officers should be up with health education campaigns in the district to create awareness on the depression prevalence among teenaged girls, and urge them to come out and seek support to prevent the catastrophic effect of depression.
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Affiliation(s)
- Dominic Be-Ikuu Doglikuu
- Faculty of Health and Allied Sciences, Department of Nursing and Midwifery, Catholic University of Ghana, Sunyani-Fiapre, Bono Region, Ghana.
- Department of Registered Public Health Nursing, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana.
| | | | - Stephen Asare
- Department of Registered General Nursing, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- College of Health and Allied Sciences, Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Central Region, Cape Coast, Ghana
| | - Hannah Yawson
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- College of Postgraduates studies, Department of Curriculum development, School of Nursing and Midwifery, University of Cape Coast, Central Region, Cape Coast, Ghana
| | - Ohene Takyi
- Department of Registered General Nursing, Ministry of Health, Methodist Health Training Institute, Afosu-Campus, Afosu, Eastern Region, Ghana
| | - Francisca Akpene Dzidzornu
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
| | - Henrietta Oye Koram
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
| | - Edna Ayishetu Johnson
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
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Daliri DB, Afaya A, Afaya RA, Abagye N. Postpartum depression: The prevalence and associated factors among women attending postnatal clinics in the Bawku municipality, Upper East Region of Ghana. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e143. [PMID: 38867815 PMCID: PMC11114418 DOI: 10.1002/pcn5.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 06/14/2024]
Abstract
Introduction This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors. Methods A total of 242 women, 2-12 weeks postpartum, were randomly recruited for this cross-sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD. Results The study showed that 34.7% of the postpartum mothers were within the age range of 25-29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9-56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66-49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23-11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6-8 weeks postpartum (aOR = 7.72, 95% CI 1.71-34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23-8.89, P = 0.018). Conclusion The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.
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Affiliation(s)
- Dennis Bomansang Daliri
- Department of Global and International Health, School of Public HealthUniversity for Development StudiesTamaleGhana
- Presbyterian Psychiatric HospitalBolgatangaGhana
| | - Agani Afaya
- Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
- Mo‐Im Kim Nursing Research Institute, College of NursingYonsei UniversitySeoulSouth Korea
| | - Richard Adongo Afaya
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Nancy Abagye
- Department of Midwifery, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Adams YJ, Miller ML, Agbenyo JS, Ehla EE, Clinton GA. Postpartum care needs assessment: women's understanding of postpartum care, practices, barriers, and educational needs. BMC Pregnancy Childbirth 2023; 23:502. [PMID: 37420215 DOI: 10.1186/s12884-023-05813-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/25/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Complications in the postpartum period pose substantial risks to women and can result in significant maternal morbidity and mortality. However, there is much less attention on postpartum care compared to pregnancy and childbirth. The goal of this study was to gather information on women's knowledge of postpartum care and complications, recovery practices after childbirth, perceived barriers to receiving care during the postpartum period, and educational needs in four health centers. The findings can inform the development of appropriate curriculum and interventions for postnatal care education in similar settings. METHODS A descriptive qualitative study design was employed. Eight focus group discussions were conducted among 54 postpartum women who delivered in four health centers in Sagnarigu District in Tamale, Ghana. Audio recordings of focus group data were transcribed and translated, and thematic analysis was conducted. RESULTS There were six main themes that emerged from the focus group discussions: 1) baby focused postpartum care; 2) postpartum practices; 3) inadequate knowledge ofpostpartum danger signs; 4) barriers to accessing postpartum care 5) experiences of poor mental health; and 6) need for postpartum education. CONCLUSIONS Postpartum care for women in this study was primarily perceived as care of the baby post-delivery and missing key information on physical and mental health care for the mother. This can result in poor adjustment postpartum and critically, a lack of knowledge on danger signs for common causes of morbidity and mortality in the postpartum period. Future research needs to understand how to communicate important information on postpartum mental and physical health to better protect mothers in the region.
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Agyekum BA. Perceptions and experiences of prenatal mental health: A qualitative study among pregnant women in Ghana. Health Psychol Open 2023; 10:20551029231202316. [PMID: 37720202 PMCID: PMC10504840 DOI: 10.1177/20551029231202316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Prenatal mental health problems can have adverse effects on the health and wellbeing of the mother as well as her baby. However, the factors associated with its etiology, expression, and coping mechanisms in Ghana remain understudied. This qualitative study explored the perceptions and experiences of prenatal mental health problems among 21 pregnant women in Accra through semi-structured interviews. Interpretative Phenomenological Analysis led to three dominant themes; "conceptions of prenatal mental disorders" (sub-themes: awareness and constructions of prenatal mental health problems), "experiences of mental health problems" (sub-themes: symptoms of prenatal mental health problems and causal attributions of prenatal mental health problems) and "coping mechanisms of the pregnancy experience" (subthemes: faith, social support and work). The lack of knowledge of mental health disorders in this study and the expression of contextually relevant and culturally defined constructions and experiences of prenatal mental health problems, highlight the need for the development of culturally suitable interventions within the Ghanaian context.
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Lau E, Adams YJ, Ghiaseddin R, Sobiech K, Ehla EE. Knowledge of Postbirth Warning Signs and Postpartum Education Among Women in Ghana. J Obstet Gynecol Neonatal Nurs 2023; 52:309-319. [PMID: 37295460 DOI: 10.1016/j.jogn.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE To assess the relationship between postpartum education and knowledge of postbirth warning signs among women in Ghana. DESIGN Cross-sectional survey. SETTING Tamale West Hospital in Tamale Metropolitan Area, Ghana. PARTICIPANTS Women (N = 151) who gave birth to healthy newborns and were admitted to the postnatal ward. METHODS We collected data from surveys distributed in the hospital. The survey included items for sociodemographic characteristics, obstetric history, postpartum education provided, and knowledge of nine common postbirth warning signs. We used descriptive statistics and multivariate logistic regression models to analyze the data. RESULTS Participants reported knowing an average of 5.2 of 9 (SD = 2.84) postbirth warning signs. Severe bleeding (94.70%, n = 143), fever (82.12%, n = 124), and severe headache (72.19%, n = 109) were the postbirth warning signs most frequently identified by participants. Swelling in the leg (37.09%, n = 56) and thoughts of hurting oneself (33.11%, n = 50) were the postbirth warning signs least frequently identified by participants. Knowledge about postbirth warning signs was positively associated with reports of receiving educational handouts on the postnatal ward (adjusted OR = 4.64, 95% confidence interval [1.27, 17.04]) and reports that four or more postpartum complications were taught before hospital discharge (adjusted OR = 27.97, 95% confidence interval [7.55, 103.57]) compared to zero to three postpartum complications. CONCLUSION All women need comprehensive discharge education on the warning signs of complications after birth. Promoting knowledge of postbirth warning signs can decrease delays in seeking care and contribute to the reduction of maternal mortality in Ghana.
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Asare SF, Rodriguez-Muñoz MF. Understanding Healthcare Professionals' Knowledge on Perinatal Depression among Women in a Tertiary Hospital in Ghana: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15960. [PMID: 36498033 PMCID: PMC9740295 DOI: 10.3390/ijerph192315960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Health conditions affecting women in the perinatal period still account for a major contribution to disease burden in Sub-Saharan Africa, yet there is a dearth of empirical research to understanding health professionals' perspective on their experiences and how they care for perinatal women in depression. We used a qualitative exploratory descriptive approach through a face- to face-interview to explore the knowledge of 11 health professionals of Komfo Anokye Teaching Hospital, Kumasi- Ghana. Interviews were taped recorded and transcribed verbatim. The study adopted Haase's modification of Colaizzi's method for the analysis. Four main themes emerged: ineffective communication (Referral lapses among care providers, long waiting time, lack of confidentiality), workload (Inefficient staff to meet perinatal women's need, no screening tools and time constraints), Reaction to patients symptoms (Identifying patient's symptoms, assessment through patient's centeredness and Education and counselling). Our results emerged that time constraints, stigmatization and lack of awareness delayed the care and management of perinatal depression among healthcare professionals in the hospital setting. There is the need to improve healthcare professionals' knowledge on perinatal depression and it is imperative for the hospital administrators to invest in continuous training and professional development for healthcare professionals.
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Affiliation(s)
- Sandra Fremah Asare
- Department of Personality, Assessment and Psychological Treatment, Universidad Nacional de Educación a Distancia, 28015 Madrid, Spain
- Discipline of Nursing, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
- Seventh-Day Adventist Nursing and Midwifery Training College, Kwadaso, Kumasi P.O. Box PC 96, Ghana
| | - Maria F. Rodriguez-Muñoz
- Department of Personality, Assessment and Psychological Treatment, Universidad Nacional de Educación a Distancia, 28015 Madrid, Spain
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Wu Y, Ye R, Wang Q, Sun C, Ji Y, Zhou H, Chang W. Association of COVID-19 Lockdown during the Perinatal Period with Postpartum Depression: Evidence from Rural Areas of Western China. HEALTH COMMUNICATION 2022; 37:1488-1495. [PMID: 35172658 DOI: 10.1080/10410236.2022.2036425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 lockdown has posed unique challenges to postpartum women, but its association with postpartum depression is not well understood in the Global South. This study aims to evaluate the association between COVID-19 lockdown and postpartum depression in rural areas of western China. A multi-stage random cluster sampling method was used to select a cohort of pregnant and postpartum women with infants aged 0-6 months. We conducted an in-person survey before the COVID-19 lockdown and a phone survey right after the lockdown ended. We used multivariate regression models to evaluate the association between lockdown and postpartum depression. Subgroup analysis was performed to explore the role of social support. The overall prevalence of postpartum depression was 13.3%. Postpartum women who experienced the lockdown were less likely to be depressed than those who did not (adjusted odds ratio (aOR) = .43, 95% confidence interval (CI) = [.27, .70]). Lockdown was negatively associated with postpartum depression among postpartum women with low level of social support (aOR = .30, 95% CI = [.18, .51]). COVID-19 lockdown was associated with lower likelihood of postpartum depression, potentially due to increased support from family. Future research is needed to explore targeted interventions to prevent postpartum depression among women from migrant worker families in rural China.
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Affiliation(s)
- Yuju Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Ruixue Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Qinagzhi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Chang Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Yadong Ji
- Communication Studies, North Central College
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Wei Chang
- Harvard Chan School of Public Health, Harvard University
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Wang L, Kroenke K, Stump TE, Monahan PO. Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 68:74-82. [PMID: 33360526 PMCID: PMC9112666 DOI: 10.1016/j.genhosppsych.2020.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/13/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Perinatal depression (PND) is a prevalent and disabling problem both during pregnancy and the postpartum period. The legacy screening measure has been the Edinburgh Postnatal Depression Scale (EPDS). This systematic review examines the validity of the PHQ-9 as a screener for PND. METHODS The following databases were searched from January 2001 (when the PHQ-9 was first published) through June 2020: MEDLINE, Embase, and PsychInfo. Studies that compared the PHQ-9 to a criterion standard psychiatric interview were used to determine the operating characteristics of sensitivity, specificity and area under the curve (AUC). Studies comparing the PHQ-9 to the EPDS and other depression scales evaluated convergent validity. RESULTS A total of 35 articles were eligible for criterion (n = 10) or convergent (n = 25) validity. Meta-analysis of the 7 criterion validity studies using the standard PHQ-9 cut point ≥10 showed a pooled sensitivity, specificity and AUC of 0.84, 0.81 and 0.89, respectively. Operating characteristics of the PHQ-9 and EPDS were nearly identical in head-to-head comparison studies. The median correlation between the PHQ-9 and EPDS was 0.59, and categorical agreement was moderate. CONCLUSIONS The PHQ-9 appears to be a viable option for perinatal depression screening with operating characteristics similar to the legacy EPDS.
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Affiliation(s)
- Larry Wang
- Indiana University, School of Medicine, Indianapolis, IN, United States.
| | - Kurt Kroenke
- Indiana University, School of Medicine, Indianapolis, IN, United States; Regenstrief Institute Inc, Indianapolis, IN, United States.
| | - Timothy E. Stump
- Department of Biostatistics, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, IN, USA
| | - Patrick O. Monahan
- Department of Biostatistics, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, IN, USA
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