Detection and care practices for postpartum depressive symptoms in public-sector obstetric units in Mexico: Qualitative results from a resource-constrained setting

Integrated Maternal Care Strategies in Low- and Middle-Income Countries: A Systematic Review

Background and aim:

Ineffective organisation of care leads to increased morbidity and mortality in neonates and their mothers. We aimed to identify and describe strategies used in low- and middle-income countries that attempt to deliver coherent, coordinated, and continuous services (i.e., integrated care) and how the various strategies affect the organisation of care.

Methods:

We conducted a systematic literature review to identify, appraise, and synthesise relevant evidence about strategies for integrating maternal care in low- and middle-income countries, searching multiple electronic databases.

Results:

Fourteen studies met our inclusion criteria. We identified five types of integration strategies: 1) organisational, 2) service/professional, 3) functional, 4) organisational combined with normative strategies, and 5) clinical combined with functional integration strategies. The most frequent types of strategies were organisational, and service/professional integration strategies. We did not identify any publications describing systemic integration strategies implemented in low- and middle-income countries.

Conclusions:

Most types of strategies described in theory have been implemented and studied in low- and middle-income countries. Our findings suggest that different types of strategies may lead to comparable organisational outcomes. For example, organisational integration strategies and professional or service integration strategies may similarly influence inter-organisational collaboration. Inter-organisational collaboration may play a particularly important role in the context of maternal care integration.

Depressive symptoms during pregnancy and postpartum: a prospective cohort study

PURPOSE

The aim was to determine the prevalence and risk factors of postpartum depression, and changes over time from pregnancy to postpartum period.

DESIGN AND METHODS

A prospective cohort study was conducted in 23 cities in Turkey, with 497 pregnant women.

FINDINGS

Of women, 13.5% had a high level of depressive symptoms during pregnancy and 4.8% during the postpartum period. Significant relationships emerged between total Edinburgh Postnatal Depression Scale score and mean age of participants and their husbands, duration of marriage, parity, and history of receiving professional psychological support.

PRACTICE IMPLICATIONS

Family planning education could be an important intervention to prevent depression in young couples.