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Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria

BACKGROUND: Depression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression, in Nigeria to inform new...

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Autores principales: Kola, Lola, Bennett, Ian M., Bhat, Amritha, Ayinde, Olatunde O., Oladeji, Bibilola D., Abiona, Dolapo, Abdumalik, Jibril, Faregh, Neda, Collins, Pamela Y., Gureje, Oye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226964/
https://www.ncbi.nlm.nih.gov/pubmed/32410586
http://dx.doi.org/10.1186/s12884-020-02970-4
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author Kola, Lola
Bennett, Ian M.
Bhat, Amritha
Ayinde, Olatunde O.
Oladeji, Bibilola D.
Abiona, Dolapo
Abdumalik, Jibril
Faregh, Neda
Collins, Pamela Y.
Gureje, Oye
author_facet Kola, Lola
Bennett, Ian M.
Bhat, Amritha
Ayinde, Olatunde O.
Oladeji, Bibilola D.
Abiona, Dolapo
Abdumalik, Jibril
Faregh, Neda
Collins, Pamela Y.
Gureje, Oye
author_sort Kola, Lola
collection PubMed
description BACKGROUND: Depression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression, in Nigeria to inform new strategies of care delivery. METHODS: Focus Group Discussions (FGDs) were conducted among purposively selected low-income young mothers (with medical histories of adolescent perinatal depression), and separately with primary care clinicians treating this condition in Ibadan, Nigeria. Participants from this community-based study were from the database of respondents who participated in a previous randomized control trial (RCT) conducted between 2014 and 2016 in 28 primary health care facilities in the 11 Local government areas in Ibadan. Semi-structured interview guides, framed by themes of the Behavioral Model for Vulnerable Populations, was developed to obtain views of participants on the factors that promote or hinder help-seeking and engagement (see additional files 1 & 2). FGDs were conducted, and saturation of themes was achieved after discussions with six groups. Transcripts were analyzed using content analysis. RESULTS: A total of 42 participants, 17 mothers (who were adolescents at the time of the RCT), and 25 care providers participated in 6 FGDs. The availability of care for perinatal depression at the primary care level was an important enabling factor in healthcare utilization for the adolescents. Perceived health benefits of treatment received for perinatal depression were strong motivation for service use. Significant stigma and negative stereotypes expressed by care providers towards adolescent pregnancy and perinatal depression were obstacles to care. However, individual patient resilience was a major enabling factor, facilitating service engagement. Providers trained in the management of perinatal depression were perceived to deliver more tolerant and supportive care that adolescent mothers valued. CONCLUSIONS: Participants identified unsupportive and stigmatizing clinic environments towards pregnant and parenting adolescents as significant barriers to accessing available care. Interventions to reduce stigma among healthcare providers may improve services for this vulnerable population.
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spelling pubmed-72269642020-05-27 Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria Kola, Lola Bennett, Ian M. Bhat, Amritha Ayinde, Olatunde O. Oladeji, Bibilola D. Abiona, Dolapo Abdumalik, Jibril Faregh, Neda Collins, Pamela Y. Gureje, Oye BMC Pregnancy Childbirth Research Article BACKGROUND: Depression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression, in Nigeria to inform new strategies of care delivery. METHODS: Focus Group Discussions (FGDs) were conducted among purposively selected low-income young mothers (with medical histories of adolescent perinatal depression), and separately with primary care clinicians treating this condition in Ibadan, Nigeria. Participants from this community-based study were from the database of respondents who participated in a previous randomized control trial (RCT) conducted between 2014 and 2016 in 28 primary health care facilities in the 11 Local government areas in Ibadan. Semi-structured interview guides, framed by themes of the Behavioral Model for Vulnerable Populations, was developed to obtain views of participants on the factors that promote or hinder help-seeking and engagement (see additional files 1 & 2). FGDs were conducted, and saturation of themes was achieved after discussions with six groups. Transcripts were analyzed using content analysis. RESULTS: A total of 42 participants, 17 mothers (who were adolescents at the time of the RCT), and 25 care providers participated in 6 FGDs. The availability of care for perinatal depression at the primary care level was an important enabling factor in healthcare utilization for the adolescents. Perceived health benefits of treatment received for perinatal depression were strong motivation for service use. Significant stigma and negative stereotypes expressed by care providers towards adolescent pregnancy and perinatal depression were obstacles to care. However, individual patient resilience was a major enabling factor, facilitating service engagement. Providers trained in the management of perinatal depression were perceived to deliver more tolerant and supportive care that adolescent mothers valued. CONCLUSIONS: Participants identified unsupportive and stigmatizing clinic environments towards pregnant and parenting adolescents as significant barriers to accessing available care. Interventions to reduce stigma among healthcare providers may improve services for this vulnerable population. BioMed Central 2020-05-14 /pmc/articles/PMC7226964/ /pubmed/32410586 http://dx.doi.org/10.1186/s12884-020-02970-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Kola, Lola
Bennett, Ian M.
Bhat, Amritha
Ayinde, Olatunde O.
Oladeji, Bibilola D.
Abiona, Dolapo
Abdumalik, Jibril
Faregh, Neda
Collins, Pamela Y.
Gureje, Oye
Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title_full Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title_fullStr Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title_full_unstemmed Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title_short Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
title_sort stigma and utilization of treatment for adolescent perinatal depression in ibadan nigeria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226964/
https://www.ncbi.nlm.nih.gov/pubmed/32410586
http://dx.doi.org/10.1186/s12884-020-02970-4
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