Understanding Healthcare Professionals’ Knowledge on Perinatal Depression among Women in a Tertiary Hospital in Ghana: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Study Setting
2.3. Population and Sampling Technique
2.4. Data Collection Process
2.5. Data Analysis
Trustworthiness
3. Results
3.1. Background Characteristics of Participants
3.2. Main Findings
3.3. Theme 1—Ineffective Communication
“We ask of their general well-being and about their babies but we do not include their emotional aspect. This has been the norm. It could be due to our traditional and social values. It could be that their husbands don’t treat them well but they won’t tell you unless you have your own way of getting such information and it could be cultural barriers and also stigma for those who have had mental illness in the past, they might not volunteer the information because of stigma.”M 03
“Well, one, they do not have the knowledge that they should seek for intervention if they have emotional problems; they do not see it as a mental problem. Then, two, their culture will tell them it is spiritual so they should pray about it and the third one is stigma”M 06
“I will not agree with the culture aspect. I will agree to maybe stigma. Because of stigma that’s why most women don’t really talk about their problem even when asked.”M 02
3.3.1. Referral Lapses
“When a consult letter is sent to the psychiatric unit, sometimes it takes them days before they go and see the woman and it is bad and discouraging!”M 01
“Most of the time, because staff at the peripheral hospitals don’t do assessment on patients properly by screening and just refer them to us, we also receive them and start treatment without screening and it becomes hard to have any suspicions of depression”M 06
“Some women refuse to attend antenatal clinics until their third trimester. These hospitals they attend at the last minute, will refuse to care for them and would just refer them to us without prior communication or whatsoever. This becomes frustrating as we may not have any idea about the woman’s previous medical history”M 03
3.3.2. Long Waiting Time
“Oh yes, we are aware that when people come and there’s a queue, they will go elsewhere another time. So staying long before seeing a doctor can determine whether people should seek help”M 04
“Long waiting times as it stands now is inevitable. We have to see patients who had deliveries and those who underwent caesarean sections as well as those on admissions with pregnancy-related complications first, before we see those for OPDs”D 1
“The doctors, I believe would not like to waste any further time of their patients who may seem tired and therefore will be more concern on their physical aspect in order to see all the other women in queue”M 08
3.3.3. Lack of Confidentiality
“It is true and again all go down to what they have seen and how peoples’ personal information has been handled. A lot of times, two doctors are consulting in the same area and everybody can hear you and nobody is comfortable in that kind of setting. So there is no privacy”M 04.
“Erm…we usually take social history of the patient, family history and then delve in more when taking such histories. At times the person knows that the mom had this very condition around this particular time but for stigmatization she is not ready to tell you that yes, my mother said she had this, she had that or it was my senior sister, no!. So the only answer she will be giving to you will be no, just for you to let her go through the process then she can then have time for herself”M 05
“I believe that, even the relatives of perinatal women only open-up when she has been diagnosed of post-partum depression or when they send her to the hospital and report of depression”D 3
3.4. Theme 2: Poor Attitude towards Patients
“We are not ready to listen; we are ready to give instructions but we are not ready to get feedbacks. The manner in which we ask questions will give us the feedback we are looking for or the feedback we are not expecting”M 01.
“How you, as a midwife goes about it, how you approach the patient and how you present things to her. Approach can make her refuse”M 02.
“Sometimes the workload makes it difficult for you to observe your client well. Unfortunately, at times we turn a deaf ear (laugh) to the affected person”M 06
3.4.1. Low Level of Knowledge
“We lack more skills and knowledge on perinatal depression”M 01
“I think many health workers might not know the severity but those who might come with mild problems, we don’t screen them and it is as a result of lack of knowledge by health workers…”D 01.
“Actually, management of the Directorate usually organise workshops for us but most at times it is centered on respectful maternity care and not on perinatal mental health.”M 08.
3.4.2. No Screening Tools
“’We don’t routinely screen. There are no screening tools available here’
“’There is no particular screening tool we use. When we see signs of depression or aggression and we admit immediately after which we sedate’”D 2
“We admit them immediately. It’s a matter of prioritizing especially in severely depressive cases. Medications like anxiolytics are served, then a consultation letter is sent to the psychiatrist.”D 1.
3.5. Theme 3: Workload
“So when I am supposed to see 20 or 50 women within my shift, what am I supposed to do? Definitely, I wouldn’t touch on individual things but everything on the general. So it’s the general information that goes around without paying attention to the individual thing”M 04.
“I think it’s the nature of our work too. The pressure, so we are always in a hurry to care of a patient, we are not so much concerned about going into detail”M 05.
3.5.1. Insufficient Staff to Meet Perinatal Women’s Need
“No, I heard they have trained two (2) or three (3) people on that. So, without…Yeah so without them I don’t think generally we have anyone to cover up for them if they are not around, that is we don’t know anything about. So ideally, I think we have to train each and every one; we have to have workshop for us to know about it but it hasn’t been done yet”M 03.
“The number of women who come for postnatal and antenatal care outnumber us. The women we see in a day are huge, that is also another reason why”M 07.
3.5.2. Time Constraints
“I think we don’t get time to sit the patients down and listen to them because of the workload and pressure. We have to work on time so we don’t get enough time for one person”M 06
“I think that the barriers might be time constraints with the patient because if you want to delve into a patient’s social issues and she may not be willingly giving out information you are going to spend quite some time with her whiles others will be waiting”M 07
3.6. Theme 4: Reaction to Patients Detected Symptoms
“It was terrible! The woman looked so depressed and lean during antenatal care. After asking her if there was something bothering her, she simply said no but I could sense that something was wrong! Or perhaps she might be a facility user”M 01.
“In fact, as a doctor, the best way is to look out for risk factors though it is sometimes worrying. Some women may have had previous episodes.”D 2.
“To be sincere, we sometimes become confused as to how to handle a nursing mother who suddenly becomes aggressive towards staff and baby shortly after delivery. All we do is to call for more hands”M 07
“We usually sedate them with 10 mg i.v. diazepam when we see that the woman is aggressive and then we refer to the psychiatry unit”M 08
“Ideally our first line for postpartum depression is that, we go for ECT (Electroconvulsive therapy). The reason is, that produces quick respond because the mother has to feed the baby”D 2
3.6.1. Identifying Patients’ Symptoms
“Commonest one being postnatal blues and this mimic depression because one is likely to have symptoms of depression being tearful, sad, losing interest in things you had interest in even the baby one has labored and struggled in pain she may not want to attend to the baby”D 1
“we inform the doctor and he would refer the patient to the psychiatrist”M 01.
“If the patient has delusions and hallucinations, hearing voices and possibly having believe that people want to harm her, actions may change, she may refuse food and some follow the commanding voices and throw their children away….but we do our best to prevent such”M 08
3.6.2. Assessment through Patient’s Centeredness
“At the psychiatry unit, we have the biological and psychological treatment for perinatal depression. Individually, there is psychotherapy to help modify the thinking behaviors of mothers. Biological treatments using antidepressants and of course we add physical treatment like electroconvulsive therapy (ECT) which is very effective in managing depression”D 3.
“First of all, because we know the condition we get closer to them to ask questions and this will lead you to the core point and the answers they give you will let you know she is depressed”M 01
“Erm…well I will look at their pregnancy, birth, issues surrounding pregnancy, financial and social issues and then the cultural background of the person is coming from and again whether the person has some underlying medical conditions like diabetes, hypertension or any other social issues; her dependents, whether the person is bereaved or has lost something important. These are the issues I will look at to determine the cause”M 02
3.6.3. Education and Counselling
“Yes! So, we can have a general health education on maybe depression then we can tail it down to individual woman. We can have erm… role play, videos telling them or making them see the need for the screen”M 04
“Sometimes you have to counsel the patent and it depends on what the patient will tell you. If you have to involve the psychiatrist you do. Or if you can solve, it depends on what she tells you that will help you take a decision”M 06
“Yes, I have experience one before. So you encourage her to talk to a close relative if she is having any problem and also advise her that it is part of postnatal process and she will resolve from it soon or later. Then you encourage her to take her medication”M 02
4. Discussion
5. Strengths and Limitations
6. Implications for Policy and Practice
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
- a.
- Please what do you know about perinatal depression?
- -
- Your knowledge
- -
- Factors
- b.
- What is it like for a woman who is experiencing depression?
- -
- Specific symptoms
- -
- Common complaints
- -
- Observations
- c.
- Please, share with me your day-to-day management or handling of women who experience perinatal depression.
- -
- Are there tools available for you to screen for pre or post-partum depression?
- -
- How do perinatal women complain when they are depressed?
- -
- Are there some important things about the perinatal women you would be concerned about during routine antenatal or postnatal clinic?
- -
- How do you receive perinatal patients who have been referred from other facilities with depression?
- d.
- Please, what are the treatment options here in KATH for women with perinatal depression?
- e.
- What can keep a depressed mother from seeking help? (probe for the following)
- -
- Instrumental barriers
- -
- Attitude of staff
- -
- Stigma
- -
- Family obligations/Culture
- f.
- Can you please share with me the best way of informing mothers about the various treatment options?
- -
- Benefit to seeking treatment for PD? Are there any consequences too? (partner reaction, fear of impact on fetus/infant, criticism by others etc)
- g.
- Is there anything else you would like to share with me?
References
- Dagher, R.K.; Bruckheim, H.E.; Colpe, L.J.; Edwards, E.; White, D.B. Perinatal depression: Challenges and opportunities. J. Women’s Health 2021, 30, 154–159. [Google Scholar] [CrossRef]
- Legazpi, P.C.C.; Rodríguez-Muñoz, M.F.; Olivares-Crespo, M.E.; Izquierdo-Méndez, N. Review of suicidal ideation during pregnancy: Risk factors, prevalence, assessment instruments and consequences. Psicol. Reflexão E Crítica 2022, 35, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Sheeba, B.; Nath, A.; Metgud, C.S.; Krishna, M.; Venkatesh, S.; Vindhya, J.; Murthy, G.V.S. Prenatal depression and its associated risk factors among pregnant women in Bangalore: A hospital based prevalence study. Front. Public Health 2019, 7, 108. [Google Scholar] [CrossRef]
- Van Niel, M.S.; Payne, J.L. Perinatal depression: A review. Clevel. Clin. J. Med. 2020, 87, 273–277. [Google Scholar] [CrossRef] [PubMed]
- Tsai, A.C.; Scott, J.A.; Hung, K.J.; Zhu, J.Q.; Matthews, L.T.; Psaros, C.; Tomlinson, M. Reliability and Validity of Instruments for Assessing Perinatal Depression in African Settings: Systematic Review and Meta-Analysis. PLoS ONE 2013, 8, e82521. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- WHO. Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice; WHO: Geneva, Switzerland, 2015. [Google Scholar]
- Atif, M.; Halaki, M.; Raynes-Greenow, C.; Chow, C.M. Perinatal depression in Pakistan: A systematic review and meta-analysis. Birth 2021, 48, 149–163. [Google Scholar] [CrossRef] [PubMed]
- Carroll, M.; Downes, C.; Gill, A.; Monahan, M.; Nagle, U.; Madden, D.; Higgins, A. Knowledge, confidence, skills and practices among midwives in the republic of Ireland in relation to perinatal mental health care: The mind mothers study. Midwifery 2018, 64, 29–37. [Google Scholar] [CrossRef] [PubMed]
- Raman, S.; Srinivasan, K.; Kurpad, A.; Razee, H.; Ritchie, J. “Nothing Special, Everything Is Maamuli”: Socio-Cultural and Family Practices Influencing the Perinatal Period in Urban India. PLoS ONE 2014, 9, e111900. [Google Scholar] [CrossRef]
- Ng’Oma, M.; Meltzer-Brody, S.; Chirwa, E.; Stewart, R.C. “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. PLoS ONE 2019, 14, e0217102. [Google Scholar] [CrossRef] [Green Version]
- Barthel, D.; Kriston, L.; Barkmann, C.; Appiah-Poku, J.; Bonle, M.T.; Doris, K.Y.E.; Esther, B.K.C.; Armel, K.E.J.; Mohammed, Y.; Osei, Y.; et al. Longitudinal course of ante-and postpartum generalized anxiety symptoms and associated factors in West-African women from Ghana and Côte d’Ivoire. J. Affect. Disord. 2016, 197, 125–133. [Google Scholar] [CrossRef]
- Belay, S.; Astatkie, A.; Emmelin, M.; Hinderaker, S.G. Intimate partner violence and maternal depression during pregnancy: A community-based cross-sectional study in Ethiopia. PLoS ONE 2019, 14, e0220003. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chorwe-Sungani, G. Performance of the 3-item screener, the Edinburgh Postnatal Depression Scale, the Hopkins Symptoms Checklist-15 and the Self-Reporting Questionnaire and Pregnancy Risk Questionnaire, in screening of depression in antenatal clinics in the Blantyre district. Malawi Med. J. 2018, 30, 184. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Firouzan, V.; Noroozi, M.; Mirghafourvand, M.; Farajzadegan, Z. Participation of father in perinatal care: A qualitative study from the perspective of mothers, fathers, caregivers, managers and policymakers in Iran. BMC Pregnancy Childbirth 2018, 18, 297. [Google Scholar] [CrossRef] [Green Version]
- Singh, D.; Lample, M.; Earnest, J. The involvement of men in maternal health care: Cross-sectional, pilot case studies from Maligita and Kibibi, Uganda. Reprod. Health 2014, 11, 68. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alio, A.P.; Lewis, C.A.; Scarborough, K.; Harris, K.; Fiscella, K.A. Community perspective on the role of fathers during pregnancy: A qualitative study. BMC Pregnancy Childbirth 2013, 13, 60. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ghosh, J.K.C.; Wilhelm, M.H.; Dunkel-Schetter, C.; Lombardi, C.A.; Ritz, B.R. Paternal support and preterm birth, and the moderation of effects of chronic stress: A study in Los Angeles County mothers. Arch. Women’s Ment. Health 2010, 13, 327–338. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gelaye, B.; Rondon, M.B.; Araya, R.; Williams, M.A. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry 2016, 3, 973–982. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kugbey, N.; Ayanore, M.; Doegah, P.; Chirwa, M.; Bartels, S.A.; Davison, C.M.; Purkey, E. Prevalence and Correlates of Prenatal Depression, Anxiety and Suicidal Behaviours in the Volta Region of Ghana. Int. J. Environ. Res. Public Health 2021, 18, 5857. [Google Scholar] [CrossRef]
- Tabb, K.M.; Gavin, A.R.; Faisal-Cury, A.; Nidey, N.; Chan, Y.-F.; Malinga, T.; Meline, B.; Huang, H. Prevalence of antenatal suicidal ideation among racially and ethnically diverse WIC enrolled women receiving care in a Midwestern public health clinic. J. Affect. Disord. 2019, 256, 278–281. [Google Scholar] [CrossRef]
- Palfreyman, A. Addressing Psychosocial Vulnerabilities Through Antenatal Care—Depression, Suicidal Ideation, and Behavior: A Study Among Urban Sri Lankan Women. Front. Psychiatry 2021, 12, 554808. [Google Scholar] [CrossRef]
- World Health Organization. Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division; World Health Organization: Geneva, Switzerland, 2019. [Google Scholar]
- Noonan, M.; Doody, O.; Jomeen, J.; Galvin, R. Midwives’ perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review. Midwifery 2017, 45, 56–71. [Google Scholar] [CrossRef] [PubMed]
- Adjorlolo, S.; Aziato, L. Barriers to addressing mental health issues in childbearing women in Ghana. Nurs. Open 2020, 7, 1779–1786. [Google Scholar] [CrossRef] [PubMed]
- Jawed, M.; Pradhan, N.A.; Mistry, R.; Nazir, A.; Shekhani, S.; Ali, T.S. Management of maternal depression: Qualitative exploration of perceptions of healthcare professionals from a public tertiary care hospital, Karachi, Pakistan. PLoS ONE 2021, 16, e0254212. [Google Scholar] [CrossRef] [PubMed]
- Dzomeku, V.M.; Boamah Mensah, A.B.; Nakua, E.K.; Agbadi, P.; Lori, J.R.; Donkor, P. "I wouldn’t have hit you, but you would have killed your baby:" exploring midwives’ perspectives on disrespect and abusive Care in Ghana. BMC Pregnancy Childbirth 2020, 20, 15. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Balde, M.D.; Bangoura, A.; Diallo, B.A.; Sall, O.; Balde, H.; Niakate, A.S.; Vogel, J.P.; Bohren, M.A. A qualitative study of women’s and health providers’ attitudes and acceptability of mistreatment during childbirth in health facilities in Guinea. Reprod. Health 2017, 14, 4. [Google Scholar] [CrossRef] [Green Version]
- Sethi, R.; Gupta, S.; Oseni, L.; Mtimuni, A.; Rashidi, T.; Kachale, F. The prevalence of disrespect and abuse during facility-based maternity care in Malawi: Evidence from direct observations of labor and delivery. Reprod. Health 2017, 14, 111. [Google Scholar] [CrossRef] [Green Version]
- Minckas, N.; Gram, L.; Smith, C.; Mannell, J. Disrespect and abuse as a predictor of postnatal care utilisation and maternal-newborn well-being: A mixed-methods systematic review. BMJ Global Health 2021, 6, e004698. [Google Scholar] [CrossRef]
- Adeponle, A.; Groleau, D.; Kola, L.; Kirmayer, L.J.; Gureje, O. Perinatal depression in Nigeria: Perspectives of women, family caregivers and health care providers. Int. J. Ment. Health Syst. 2017, 11, 27. [Google Scholar] [CrossRef] [Green Version]
- Ayinde, O.O.; Oladeji, B.D.; Abdulmalik, J.; Jordan, K.; Kola, L.; Gureje, O. Quality of perinatal depression care in primary care setting in Nigeria. BMC Health Serv. Res. 2018, 18, 879. [Google Scholar] [CrossRef] [Green Version]
- Ayano, G.; Tesfaw, G.; Shumet, S. Prevalence and determinants of antenatal depression in Ethiopia: A systematic review and meta-analysis. PLoS ONE 2019, 14, e0211764. [Google Scholar] [CrossRef]
- Nakku, J.E.M.; Okello, E.S.; Kizza, D.; Honikman, S.; Ssebunnya, J.; Ndyanabangi, S.; Hanlon, C.; Kigozi, F. Perinatal mental health care in a rural African district, Uganda: A qualitative study of barriers, facilitators and needs. BMC Health Serv. Res. 2016, 16, 295. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van Heyningen, T.; Honikman, S.; Tomlinson, M.; Field, S.; Myer, L. Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women. PLoS ONE 2018, 13, e0193697. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Andersson, M.; Rubertsson, C.; Hansson, S. The experience of provided information and care during pregnancy and postpartum when diagnosed with preeclampsia: A qualitative study. Eur. J. Midwifery 2021, 5, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Sefogah, P.E.; Samba, A.; Mumuni, K.; Kudzi, W. Prevalence and key predictors of perinatal depression among postpartum women in Ghana. Int. J. Gynecol. Obstet. 2020, 149, 203–210. [Google Scholar] [CrossRef] [PubMed]
- Byatt, N.; Levin, L.L.; Ziedonis, D.; Moore Simas, T.A.; Allison, J. Enhancing Participation in Depression Care in Outpatient Perinatal Care Settings. Obstet. Gynecol. 2015, 126, 1048–1058. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- National Institute for Health and Care Excellence. Identifying and Assessing Mental Health Problems in Pregnancy and the Postnatal Period; National Institute for Health and Care Excellence: London, UK, 2018. [Google Scholar]
- Bayrampour, H.; McDonald, S.; Tough, S. Risk factors of transient and persistent anxiety during pregnancy. Midwifery 2015, 31, 582–589. [Google Scholar] [CrossRef]
- Chorwe-Sungani, G.; Chipps, J. A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi. S. Afr. J. Psychiatry 2018, 24, 1181. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fisher, J.; De Mello, M.C.; Patel, V.; Rahman, A.; Tran, T.; Holton, S.; Holmes, W. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: A systematic review. Bull World Health Organ 2012, 90, 139–149H. [Google Scholar] [CrossRef]
- Liu, Q.; Luo, D.; Haase, J.E.; Guo, Q.; Wang, X.Q.; Liu, S.; Xia, L.; Liu, Z.; Yang, J.; Yang, B.X. The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Global Health 2020, 8, e790–e798. [Google Scholar] [CrossRef]
- O’Brien, B.C.; Harris, I.B.; Beckman, T.J.; Reed, D.A.; Cook, D.A. Standards for reporting qualitative research: A synthesis of recommendations. Acad. Med. 2014, 89, 1245–1251. [Google Scholar] [CrossRef]
- Creswell, J.W.; Creswell, J.D. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches; Sage Publications: New York, NY, USA, 2017. [Google Scholar]
- Tong, A.; Sainsbury, P.; Craig, J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 2007, 19, 349–357. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- KATH. Obstetrics & Gynecological Report. Komfo Anokye Teaching Hospital. 2020. Available online: www.kathhsp.org (accessed on 18 August 2021).
- Doody, O.; Noonan, M. Nursing research ethics, guidance and application in practice. Br. J. Nurs. 2016, 25, 803–807. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Creswell, J.W.; Poth, C.N. Qualitative Inquiry and Research Design: Choosing among Five Approaches; Sage Publications: New York, NY, USA, 2016. [Google Scholar]
- Colaizzi, P.F. Psychological research as the phenomenologist views it. In Existential-Phenomenological Alternatives for Psychology; Valle, R.S., King, M., Eds.; Oxford University Press: Oxford, UK, 1978; pp. 48–71. [Google Scholar]
- Haase, J.E. Components of courage in chronically ill adolescents: A phenomenological study. ANS Adv. Nurs. Sci. 1987, 9, 64–80. [Google Scholar] [CrossRef]
- Guba, E.G.; Lincoln, Y.S. Fourth Generation Evaluation; Sage: New York, NY, USA, 1989. [Google Scholar]
- Dibaba, Y.; Fantahun, M.; Hindin, M.J. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: Evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth 2013, 13, 135. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Viveiros, C.J.; Darling, E.K. Perceptions of barriers to accessing perinatal mental health care in midwifery: A scoping review. Midwifery 2019, 70, 106–118. [Google Scholar] [CrossRef] [PubMed]
- Chorwe-Sungani, G. Screening for Antenatal Depression by Midwives in Low Resource Settings in Primary Care Settings in Malawi. In Healthcare Access; IntechOpen: London, UK, 2022. [Google Scholar]
- Noonan, M.; Doody, O.; Jomeen, J.; O’Regan, A.; Galvin, R. Family physicians perceived role in perinatal mental health: An integrative review. BMC Fam. Pract. 2018, 19, 154. [Google Scholar] [CrossRef]
- Stewart, R.C.; Umar, E.; Tomenson, B.; Creed, F. Validation of screening tools for antenatal depression in Malawi--a comparison of the Edinburgh Postnatal Depression Scale and Self Reporting Questionnaire. J. Affect Disord. 2013, 150, 1041–1047. [Google Scholar] [CrossRef]
- Ford, E.; Shakespeare, J.; Elias, F.; Ayers, S. Recognition and management of perinatal depression and anxiety by general practitioners: A systematic review. Fam. Pract. 2017, 34, 11–19. [Google Scholar] [CrossRef] [Green Version]
- Kotoh, A.M.; Boah, M. “No visible signs of pregnancy, no sickness, no antenatal care”: Initiation of antenatal care in a rural district in Northern Ghana. BMC Public Health 2019, 19, 1094. [Google Scholar] [CrossRef] [Green Version]
- Atif, N.; Nazir, H.; Zafar, S.; Chaudhri, R.; Atiq, M.; Mullany, L.C.; Rowther, A.A.; Malik, A.; Surkan, P.J.; Rahman, A. Development of a Psychological Intervention to Address Anxiety During Pregnancy in a Low-Income Country. Front. Psychiatry 2020, 10, 927. [Google Scholar] [CrossRef]
- Lasater, M.E.; Murray, S.M.; Keita, M.; Souko, F.; Surkan, P.J.; Warren, N.E.; Winch, P.J.; Ba, A.; Doumbia, S.; Bass, J.K. Integrating Mental Health into Maternal Health Care in Rural Mali: A Qualitative Study. J. Midwifery Womens Health 2021, 66, 233–239. [Google Scholar] [CrossRef] [PubMed]
- Byatt, N.; Xu, W.; Levin, L.L.; Moore Simas, T.A. Perinatal depression care pathway for obstetric settings. Int. Rev. Psychiatry 2019, 31, 210–228. [Google Scholar] [CrossRef] [PubMed]
- Webb, R.; Uddin, N.; Ford, E.; Easter, A.; Shakespeare, J.; Roberts, N.; Alderdice, F.; Coates, R.; Hogg, S.; Cheyne, H.; et al. Barriers and facilitators to implementing perinatal mental health care in health and social care settings: A systematic review. Lancet Psychiatry 2021, 8, 521–534. [Google Scholar] [CrossRef] [PubMed]
- GSS. 2021 Population and Housing Census Ghana Statistical Service. 2021. Available online: https://census2021.statsghana.gov.gh (accessed on 20 July 2021).
- Weobong, B.; Soremekun, S.; Asbroek, A.H.T.; Amenga-Etego, S.; Danso, S.; Owusu-Agyei, S.; Prince, M.; Kirkwood, B.R. Prevalence and determinants of antenatal depression among pregnant women in a predominantly rural population in Ghana: The DON population-based study. J. Affect. Disord. 2014, 165, 1–7. [Google Scholar] [CrossRef] [PubMed]
- Leddy, M.; Haaga, D.; Gray, J.; Schulkin, J. Postpartum mental health screening and diagnosis by obstetrician–gynecologists. J. Psychosom. Obstet. Gynecol. 2011, 32, 27–34. [Google Scholar] [CrossRef] [PubMed]
- Surjaningrum, E.R.; Jorm, A.F.; Minas, H.; Kakuma, R. Personal attributes and competencies required by community health workers for a role in integrated mental health care for perinatal depression: Voices of primary health care stakeholders from Surabaya, Indonesia. nt. J. Ment. Health Syst. 2018, 12, 46. [Google Scholar] [CrossRef] [PubMed]
- WHO. mhGAP operations manual; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- Rompala, K.S.; Cirino, N.; Rosenberg, K.D.; Fu, R.; Lambert, W.E. Prenatal depression screening by certified nurse-midwives, Oregon. J. Midwifery Women’s Health 2016, 61, 599–605. [Google Scholar] [CrossRef]
Themes | Sub-Themes |
---|---|
Ineffective communication | Referral lapses. Long waiting time Lack of confidentiality |
Poor attitude towards patients | Low level of knowledge No screening tools |
Workload | Insufficient staff to meet perinatal women’s need. Time constraints |
Reaction to patients symptoms | Identifying client’s symptoms Assessment through patient’s centeredness Education and counselling |
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Asare, S.F.; Rodriguez-Muñoz, M.F. Understanding Healthcare Professionals’ Knowledge on Perinatal Depression among Women in a Tertiary Hospital in Ghana: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 15960. https://doi.org/10.3390/ijerph192315960
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(23):15960. https://doi.org/10.3390/ijerph192315960
Chicago/Turabian StyleAsare, Sandra Fremah, and Maria F. Rodriguez-Muñoz. 2022. "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 19, no. 23: 15960. https://doi.org/10.3390/ijerph192315960