Maternal mental health and its determinants - A community-based cross-sectional study in Aligarh, Uttar Pradesh.

BACKGROUND: Maternal mental health problems are one of the major public health challenges. Globally, depression and anxiety cause immense suffering and disability among mothers who later contribute to compromise parenting practices and increased unmet needs of their newborn and young children. OBJECTIVES: The aim of this study is to determine the prevalence and determinants of maternal common mental disorders (CMDs) among the study population. METHODS: A community-based cross-sectional study was conducted in Aligarh, Uttar Pradesh, India, from July 2016 to June 2017, among 415 women of child-bearing age who had one or more children in the age group of 0-23 months. A World Health Organization prequalified questionnaire Self-Reporting Questionnaire 20 was used to assess the CMD of mothers. Binary logistic regression was used for finding out predictors of mental disorders. RESULTS: Overall prevalence of maternal CMDs was 38.8%. The prevalence of maternal CMD was significantly higher among mothers in a higher age group, belonging to low socioeconomic class, nuclear type of family, living in the urban locality, having lower or no education, being single mothers, housewives, and having higher parity. CONCLUSION: Substantially, high prevalence of CMD among mothers suggests for further research to explore the factors affecting the mental health of mothers. Measures for the early identification, treatment, and prevention of maternal mental disorders should be taken.

Psychological distress during pandemic Covid-19 among adult general population: Result across 13 countries.

The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.

All Slums are Not Equal: Maternal Health Conditions Among Two Urban Slum Dwellers.

BACKGROUND: Pregnant women inhabiting urban slums are a "high risk" group with limited access to health facilities. Hazardous maternal health practices are rampant in slum areas. Barriers to utilization of health services are well documented. Slums in the same city may differ from one another in their health indicators and service utilization rates. The study examines whether hazardous maternal care practices exist in and whether there are differences in the utilization rates of health services in two different slums. MATERIALS AND METHODS: A cross-sectional study was carried out in two urban slums of Aligarh city (Uttar Pradesh, India). House-to-house survey was conducted and 200 mothers having live births in the study period were interviewed. The outcome measures were utilization of antenatal care, natal care, postnatal care, and early infant feeding practices. Rates of hazardous health practices and reasons for these practices were elicited. RESULTS: Hazardous maternal health practices were common. At least one antenatal visit was accepted by a little more than half the mothers, but delivery was predominantly home based carried out under unsafe conditions. Important barriers to utilization included family tradition, financial constraints, and rude behavior of health personnel in hospitals. Significant differences existed between the two slums. CONCLUSION: The fact that barriers to utilization at a local level may differ significantly between slums must be recognized, identified, and addressed in the district level planning for health. Empowerment of slum communities as one of the stakeholders can lend them a stronger voice and help improve access to services.

Poor perinatal care practices in urban slums: possible role of social mobilization networks.

BACKGROUND: Making perinatal care accessible to women in marginalized periurban areas poses a public health problem. Many women do not utilize institutional care in spite of physical accessibility. Home-based care by traditional birth attendants (TBA) is hazardous. Inappropriate early neonatal feeding practices are common. Many barriers to perinatal care can be overcome by social mobilization and capacity building at the community level. OBJECTIVES: To determine the existing perinatal practices in an urban slum and to identify barriers to utilization of health services by mothers. STUDY DESIGN: This is a cross-sectional descriptive study. SETTING AND PARTICIPANTS: The high-risk periurban areas of Nabi Nagar, Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers (Community Mobilization Coordinators or CMCs) already working in an NGO in the area. A total of 92 mothers were interviewed at home. Current perinatal practices and reasons for utilizing or not utilizing health services were the topics of inquiry. STATISTICAL ANALYSIS: Data was tabulated and analyzed using SPSS 12. RESULTS: Analyses revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices as more than 60% of the women had home deliveries conducted by traditional untrained or trained birth attendants. Reasons for preferring home deliveries were mostly tradition (41.9%) or related to economics (30.7%). A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, the umbilical cord was cut using the edge of a broken cup. Although breast-feeding was universal, inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 hours in 8% of the cases. Several mothers had breastfeeding problems. CONCLUSION: Barriers to utilization of available services leads to hazardous perinatal practices in urban slums.