The burden of depression is high globally. Maternal depression affects the mother, the child, and other family members. We aimed to measure the prevalence of maternal postpartum depressive (PPD) symptoms having a child aged 6–16 months, health-seeking behavior for general illness of all family members, out of pocket (OOP) payments for health care and cost coping mechanisms. We conducted a cross sectional study with 591 poor families in rural Bangladesh. The survey was conducted between August and October, 2017. Information was collected on maternal depressive symptoms using the Self Reporting Questionnaire (SRQ-20), health-seeking behavior, and related costs using a structured, pretested questionnaire. The prevalence of depressive symptoms was 51.7%. Multiple logistic regression analysis showed that PPD symptoms were independently associated with maternal age (p = 0.044), family food insecurity (p < 0.001) and violence against women (p < 0.001). Most (60%) ill persons sought health care from informal health providers. Out of pocket (OOP) expenditure was significantly higher (p = 0.03) in the families of depressed mothers, who had to take loan or sell their valuables to cope with expenditures (p < 0.001). Our results suggest that postpartum depressive symptoms are prevalent in the poor rural mothers. Community-based interventions including prevention of violence and income generation activities for these economically disadvantaged mothers should be designed to address risk factors. Health financing options should also be explored for the mothers with depressive symptoms
Background
There is sufficient evidence that psychosocial stimulation (PS) benefits children’s neurocognitive behavior, however, there is no information on how it works when delivered through an Unconditional Cash Transfer (UCT) platform for poor rural population in developing countries. The objective of this study is to measure effects of adding PS for children of lactating mothers enrolled to receive UCT with health education (HE) on neurocognitive behavior of children in rural Bangladesh.
Methods
The study will be conducted at 11 unions of Ullapara sub-district in Bangladesh. The study is a cluster randomized controlled trial with three-arms; (i) PS and UCT with HE (ii) UCT with HE and iii) Comparison arm. The cluster will be considered as an old
Ward
of a
Union
, the lowest tier of local government system in rural Bangladesh. There are three old
Wards
in a
union
. These three clusters will be randomized to one of the three arms. Similarly, randomization will be done for each 11 Unions and then 11 clusters will be assigned to an arm. Eighteen participants will be recruited from each cluster randomly (
n
= 196 in each arm). The intervention designed for one year includes UCT with HE for the poor as a safety net program in rural Bangladesh with or without PS. An age-based curriculum of PS is already available for Bangladeshi children and this will be administered by trained local women; play leaders (PL) in intervention clusters. The government of Bangladesh is providing UCT of taka 500 ($6.25) as maternity allowance per month with HE. The primary outcomes will be cognitive, motor and language composite scores measured by Bayley-III and behavior using Wolke’s behavior rating scale. The secondary outcomes will be children and mothers’ growth, family food security status, health seeking behavior, mothers’ depressive symptoms and self-esteem and violence against mothers.
Discussion
The study will provide a unique opportunity to assess an integrated early childhood development intervention using UCT platform to mitigate developmental delays in poor vulnerable children of rural Bangladesh.
Trial registration number
ClinicalTrials.gov
NCT03281980, registered on September 13, 2017.
Fertility is considered as a marital responsibility in most the communities and a kind of social respectability for couples. The societal and parental pressures for propagation of the family name can also place a psychological burden on the infertile couple and may significantly affect quality of life. The present study aimed to investigate the gender differences in fertility related quality of life in primary infertility. 30 couples with primary infertility were recruited for the study after a written informed consent. Hindi version of FertiQoL was applied to all participants. Males had significantly better emotional, relational, social and global quality of life (QoL) as compared to females. Tolerability to infertility related problems was significantly better in females compared to males. This study found that primary infertility has extensive negative repercussions on the QOL of women as compared to males.
In the present study, an effort has been made to study the impact of age and marital status on the degree of Thanatophobia (Death Anxiety) of adult women of Ranchi town in Jharkhand, India. A total of 120, married and single (unmarried / divorcee / widow) adult women in the age range of 45 to 70 years were selected by incidental non probability method from Ranchi town. The Death Anxiety Scale by Thakur and Thakur was administered on the sample and it was found that age has no impact on the degree of Death Anxiety whereas marital status has significant impact on Death Anxiety. Combined impact of age and marital status is also significant.
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