Evidence of mobile health integration into primary health care systems for better maternal mental health in LMICs during COVID-19 pandemic - Review.

Mental illnesses are prevalent worldwide, especially in the underdeveloped countries of the South Asian region, particularly in women, where they largely remain unaddressed. Evidence from the South Asian region indicates that there is a high burden of mental disorders in vulnerable populations such as pregnant women. Mental health problems during pregnancy and in the postpartum period are twice as common in LMICs as compared to HICs. Interventions delivered by community health workers (CHWs) in many health delivery and promotive initiatives have played a vital role in improving mental health. CHW-based interventions are cost-effective, efficient and acceptable for the local people and can strengthen the overall health system. This review aimed to explore integration of maternal mental health into existing maternal, newborn and child health (MNCH) programs so that delivery of mental health interventions can be done alongside MNCH interventions. Integrating maternal mental health programmes into existing MNCH programs and using digital platforms for expanding their delivery through CHWs, lay counsellors, and other frontline health workers can prove to be a promising strategy. Even though mHealth platforms for addressing a variety of health issues have been widely used during the COVID-19 pandemic, the use of digital platforms for addressing maternal mental health issues remains inadequate.

Knowledge, attitudes and practices towards COVID-19 among Pakistani residents: information access and low literacy vulnerabilities.

BACKGROUND: Coronavirus disease (COVID-19) has accentuated the need for speedy access to information. Digital divide and socio-demographic disparity create an information hiatus and therefore unhealthy practices with regard to dealing with COVID-19, particularly in low- and middle-income countries. AIMS: We assessed knowledge, attitudes, practices and their determinants regarding COVID-19 in Pakistan during March-April 2020. METHODS: 905 adults ≥18 years (males and females) participated: 403 from a web-based survey; 365 from an urban survey; and 137 from a rural survey. Frequency of adequate knowledge, attitudes and practices for the three populations was determined based on available global guidelines. Multivariable logistic regression analysis determined factors of adequacy of knowledge, attitudes, practices, and association of knowledge with attitudes and practices. RESULTS: Mean age of the participants was 33.5 (+ SD 11.1) years, 51% were females. More females and young adults (18-30 years) participated in the web-based survey. The urban survey and web-based survey participants had significantly higher adequate knowledge (2-7 times) and practices (4-5 times) towards COVID-19. Adequate knowledge had a significant influence on healthy attitudes and practices for COVID-19, after adjustment for covariates. Overall, two-thirds of the population had high levels of fear about COVID-19, which was highest among the rural survey population. CONCLUSION: Substantial gaps exist in adequate knowledge, attitudes and practices, particularly among rural populations, and underscores the variation in access to information according to level of education and access to the internet. Thus, a comprehensive, contextually congruent awareness raising strategy is urgently needed to confront COVID-19 among these populations.