Postpartum depression: Prevention strategies and Replication. A study in Bangladesh, India, Pakistan and Nepal
Singh, M. (2016) Postpartum depression: Prevention strategies and Replication. A study in Bangladesh, India, Pakistan and Nepal, no. 47.
Post partum depression (PPD) (non-psychotic) is a considerable public health problem where nearly 10-15% of women are affected after child birth globally but the women with low socio-economic status are the most affected one especially in low and middle income countries. It is one of the most common complications of childbirth world-wide which usually arises within four to eight weeks of delivery that induces feelings of insignificance, agitation, anxiety or stress, hopelessness which ultimately affects a woman's ability to bond with her child and care for her baby. It is a major public health issue but it mostly goes undetected and underdiagnosed and is barely recognized during or after pregnancy in LMICs where almost 80% of women is believed to suffer from PPD but a very limited amount of research is done to understand how these countries have been working to address PPD especially in South Asian setting (Bangladesh, India and Pakistan). There are even evidence which shows south Asian countries (Pakistan) is one of the highest reported PPD countries. A rigorous literature review of published papers was done using different research data base including medline, pubmed, sciencedirect, google and google scholar, Plos, research gate, scopus. Grey literatures available from UN and WHO are also included in the study. The Socioecological model is used to structure the dissertation especially the literature review and the public health prevention model was used for analysis of different strategies practiced in the study countries to see the possibility of its replication in Nepal. The Findings from the study revealed that a very few work has been done in addressing PPD in these countries. Some of the strategies used such as cognitive behaviour therapy, education for girls, poverty alleviation program, participatory approach for empowerment and involvement of community health workers has shown to have a positive impact on reducing PPD. As the interventions used in these countries were simple and mostly conducted through community health workers, it showed a possibility to be imitated in Nepal as it already has a sufficient workforce working in Maternal and child health at community level. Above it, Nepal has been very progressive in education and is working on battling poverty. But, without strong political commitment and implementation of policies that recognize PPD, addressing the issue is impossible. Keywords: Depression, Post -partum depression , Post natal depression, Perinatal depression, Maternal depression, Maternal mental health , Strategies, Interventions , Prevention, LMICs, South Asia, Causes, Theories on PPD