Social Determinants of and Possible Intervention for Perinatal Depression in Nepal

- Prasansa Subba

Discussion Type: Research Seminar Series | Date: 14 Jul 2024 | Time: 03:00 PM


14 July 2024/३० असार २०८१ (आइतबार, दिउँसो ३ बजे)
Research Seminar Series
Social Determinants of and Possible Intervention for Perinatal Depression in Nepal
Prasansa Subba, PhD Fellow, University of Liverpool, UK

About Speaker:
Ms. Prasansa Subba holds a master’s degree in Sociology, MPhil in Public Mental Health and is currently enrolled as a PhD candidate at the University of Liverpool. She also works as a researcher for Transcultural Psychosocial Organization (TPO) Nepal. She holds more than a decade long experience researching on mental health especially focusing on the psychosocial aspects of mental health. Her current PhD research focuses on adaptation and pilot-testing of psychological intervention for perinatal depression called the "Thinking Healthy Programme" in Nepal.

Studies conducted in low- and middle-income countries (LMICs) show women are more vulnerable to depression than men and the risk is even higher during the perinatal period. In Nepal, postnatal depression affects 4.9-12% Nepali women, and suicide is the leading cause of death among women in reproductive age. We conducted a qualitative study to identify the risk factors and possible interventions to minimize perinatal depression. Methods: Twenty-six in-depth interviews (n=26) were conducted with perinatal women identified with depression in Edinburgh Postnatal Depression Scale (EPDS). Five focus group discussions were conducted with the health workers (n=13), psychosocial counselors (n=5) and lady community health workers (LCHWs) (n=16) in southern Nepal. Results: The qualitative findings identified lack of support, poverty, unsatisfying marital experience, unplanned pregnancy, previous experience of complications during and after pregnancy as probable determinants of perinatal depression. Socio-demographic differences in reported stressors were apparent in our study. Women with low education and low economic background cited economic burden, unplanned pregnancy, and family pressure to give birth to a son as stressors while women attending at least higher secondary education cited unsupportive in-laws, difficulty adapting to different culture after marriage, limited freedom to exercise their agency and ill health as major stressors. Family pressure to give birth to a son was higher in multigravida women with daughters than in primagravida women. Formation of peer support groups in the local communities, family level intervention, community sensitization programs, school education programs were recommended as possible interventions to support women with perinatal depression. In addition to general mental health facilities, a separate package for perinatal depression seemed essential at the health facility. Conclusion: A holistic approach is needed to treat perinatal depression. With the risk factors transcending to familial and community level, intervention should not limit to the health facility level but should expand to family and community level as well. 

- Prasansa Subba

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