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Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study
BACKGROUND: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality. OB...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411280/ https://www.ncbi.nlm.nih.gov/pubmed/37551659 http://dx.doi.org/10.1177/17455057231189547 |
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author | Gribbin, Catherine Achieng, Florence K’Oloo, Alloys Barsosio, Hellen C Kwobah, Edith Kariuki, Simon Nabwera, Helen M |
author_facet | Gribbin, Catherine Achieng, Florence K’Oloo, Alloys Barsosio, Hellen C Kwobah, Edith Kariuki, Simon Nabwera, Helen M |
author_sort | Gribbin, Catherine |
collection | PubMed |
description | BACKGROUND: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality. OBJECTIVES: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya. DESIGN: A cross-sectional study. METHODS: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale. RESULTS: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to perceived insufficient breastmilk were a particular challenge for mothers with features of PND, who were more likely to introduce complementary feeds. Maternal health-seeking decisions were influenced by high financial cost, long waiting times and poor interactions with health care providers that induced stress and fear among mothers. Maternal caregiving capacity was influenced by her ability to juggle other household duties, which was difficult for mothers with features suggestive of PND. Support from friends and relatives positively impacted maternal mood and caregiving ability. CONCLUSION: Mothers experienced many stress-inducing events in the perinatal period which potentially exacerbated features of PND in the immediate postnatal period. Women with features of PND were particularly vulnerable to these stressors that influenced infant caregiving practices. Addressing the socio-economic challenges and health system gaps that include scale up of compassionate and respectful care for women during pregnancy and childbirth, as well as early screening and intervention of PND, through enhanced referral pathways between health facilities and community support structures, could mitigate against the impact of PND on neonatal caregiving. |
format | Online Article Text |
id | pubmed-10411280 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-104112802023-08-10 Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study Gribbin, Catherine Achieng, Florence K’Oloo, Alloys Barsosio, Hellen C Kwobah, Edith Kariuki, Simon Nabwera, Helen M Womens Health (Lond) Original Research Article BACKGROUND: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality. OBJECTIVES: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya. DESIGN: A cross-sectional study. METHODS: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale. RESULTS: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to perceived insufficient breastmilk were a particular challenge for mothers with features of PND, who were more likely to introduce complementary feeds. Maternal health-seeking decisions were influenced by high financial cost, long waiting times and poor interactions with health care providers that induced stress and fear among mothers. Maternal caregiving capacity was influenced by her ability to juggle other household duties, which was difficult for mothers with features suggestive of PND. Support from friends and relatives positively impacted maternal mood and caregiving ability. CONCLUSION: Mothers experienced many stress-inducing events in the perinatal period which potentially exacerbated features of PND in the immediate postnatal period. Women with features of PND were particularly vulnerable to these stressors that influenced infant caregiving practices. Addressing the socio-economic challenges and health system gaps that include scale up of compassionate and respectful care for women during pregnancy and childbirth, as well as early screening and intervention of PND, through enhanced referral pathways between health facilities and community support structures, could mitigate against the impact of PND on neonatal caregiving. SAGE Publications 2023-08-08 /pmc/articles/PMC10411280/ /pubmed/37551659 http://dx.doi.org/10.1177/17455057231189547 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Gribbin, Catherine Achieng, Florence K’Oloo, Alloys Barsosio, Hellen C Kwobah, Edith Kariuki, Simon Nabwera, Helen M Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title | Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title_full | Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title_fullStr | Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title_full_unstemmed | Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title_short | Exploring the influence of postnatal depression on neonatal care practices among mothers in Western Kenya: A qualitative study |
title_sort | exploring the influence of postnatal depression on neonatal care practices among mothers in western kenya: a qualitative study |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411280/ https://www.ncbi.nlm.nih.gov/pubmed/37551659 http://dx.doi.org/10.1177/17455057231189547 |
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