Maternal mental health of adolescent mothers: a cross-sectional mixed-method study protocol to determine cultural and social factors and mental health needs in Lilongwe, Malawi

Abstract

IntroductionAdolescence marks a transition of life from childhood to adulthood. Becoming a mother during adolescence presents unique challenges that have a significant mental and physical burden and may increase the likelihood of developing common mental disorders (CMDs). Untreated CMDs have serious effects on both the mother and her child. Culture constitutes an important context for most experiences, and affects how individuals seek help. However, there is limited research that has investigated how culture and social factors influence the adolescent mother’s mental health during the postpartum period in Malawi.Methods/designA cross-sectional sequential mixed methods design will be carried out in four phases. Phase one will include the preparatory phase and scoping review. The second phase will comprise a survey with adolescent mothers. The sample for the survey consists of adolescent postpartum mothers aged 14–19 years (with infants of up to 6 months of age) who have the capacity to consent for the study. Phase three will be a qualitative study in which in-depth interviews and focus group discussions will be employed to collect data from health workers and informal healthcare providers in the community (eg, traditional healers, traditional birth attendants). The fourth phase will involve developing recommendations for policy and practiceEthics and disseminationThis study will provide an understanding of the impact of culture and social factors that influence adolescent mother’s mental health and well-being, including the identification of potential risk and protective factors. The findings will inform recommendations for an appropriate, culturally accepted spectrum of interventions, including universal, selective and indicated prevention strategies. The findings will be disseminated to stakeholders working in maternal health in Malawi. Ethical approval was received from the Curtin University Human Research Ethics Committee (HRE2021-0223) and (P.05/21/575) Malawian Ethics Board National Committee on Research Ethics in the Social Sciences and Humanities.

Postnatal depression and its social-cultural influences among adolescent mothers: A cross sectional study

“…This paper describes the prevalence and social and cultural influences of depression among adolescent mothers attending community clinics at Mitundu in Lilongwe, Malawi. These findings are part of a broader mixed-methods study [34]. The results inform the policymakers to consider screening adolescent mothers for mental health disorders during the postnatal period as part of a possible appropriate intervention to improve identification and management.…”

“…The research is governed by the principles of beneficence, justice, and respect and is in accordance with the ethical principles of the Declaration of Helsinki [34]. Ethics approval was granted, recognizing adolescent mothers as emancipated minors; with participants under the age of 18 being asked additional questions to ensure they understood their potential involvement in the study.…”

“…All participants provided informed consent. Where necessary, legal guardians witnessed the adolescent mother's consent [34], and ethical approval was received from the Curtin University Human Research Ethics Committee [HRE2021-0223] and the Malawian Ethics Board National Committee on Research Ethics in the Social Sciences and Humanities [P.05/21/575]. Any woman who reported suicidal ideation was counselled and offered a referral for clinical mental health assessment and treatment.…”