Introduction
Different studies report different prevalence rates of maternal mental health disorders. These include studies conducted in the same countries. In this post, I highlight several factors that drive the significant variations in the maternal mental health disorders.
1. Assessment/diagnostic tools used
In order to report a prevalence rate of maternal mental health disorder, an assessment or diagnostic tool must be used. Globally, there are several assessment and diagnostic tools that have been developed to measure maternal mental health illnesses. Unfortunately, majority of these tools have been developed in developed countries.
Studies using different assessment or diagnostic tools will report different prevalence rates of maternal mental health disorders.
Tools developed and used in developed countries’ context need to be contextualised and validated when using them in developing countries. However, very few studies conducted in developing countries contextualise or validate the tools.
2. Timeframe used for the assessment
Studies on maternal mental health focus on either the pregnancy period or the year after birth. However, the prevalence rate of different maternal mental health disorders will vary depending on the specific time the assessment or diagnosis was done, that is, during pregnancy, immediately after birth, between 4 weeks and 8 weeks after birth, 6 months or 12 months after birth.
The lack of uniformity with the timeframe used for the assessment leads to variations in the maternal mental health disorders’ prevalence rate.
3. Recruitment of the participants
The choice of participants for prevalence studies also has a role to play in the variations reported in such studies.
Studies recruit participants either from health facilities or within the community. Both are OK but the context matters.
In developed countries where majority of pregnant mothers attend antenatal care clinics and deliver in health facilities, it makes sense when the recruitment of study participants happens in health facilities.
In developing countries and low-resource settings, however, few mothers attend the recommended antenatal care clinics and even fewer deliver their babies in health facilities. Home-based deliveries are common in such contexts. Hence, when recruiting participants for prevalence studies, it is crucial to recruit from both health facilities and communities.
Other factors to consider include whether the recruitment is done in urban areas or rural areas or both settings, because the prevalence rates would differ between urban and rural settings. Additionally, the type of health facility selected matters. In developing countries, most facility-based deliveries happen in the primary-level facilities not tertiary facilities. Hence, a recruitment of participants from tertiary-level facilities would like underestimate the prevalence rates of maternal mental health disorders since majority of births take place in other facilities.
Conclusion
In summary, the prevalence rates of maternal mental health disorders reported in different studies will show variations depending on various factors including the assessment or diagnostic tools used, the timeframe used for the study, and the participants recruited for the studies. As a result, it is difficult to generalise the prevalence rates of maternal mental health disorders.
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