Prevalence of Maternal Postpartum Depression, Health-Seeking Behavior and Out of Pocket Payment for Physical Illness and Cost Coping Mechanism of the Poor Families in Bangladesh: A Rural Community-Based Study

Abstract

<jats:p>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 &lt; 0.001) and violence against women (p &lt; 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 &lt; 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</jats:p>

Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal

“…It could be due to the reason that unplanned pregnancies are most often associated with poor maternal wellbeing that may develop long-term adverse psychological consequences [ 49 ]. Also, inadequate birth preparedness and poor stress coping mechanisms particularly among socio-economic disadvantaged women may exacerbate the mental health problems during the postpartum period [ 50 , 51 ]. Therefore, screening during ANC visits to identify high-risk groups would be crucial to prevent PPD.…”

Accuracy of Community Informant Led Detection of Maternal Depression in Rural Pakistan

“…The World Health Organization's (WHO's) mental health Gap Action Programme (mhGAP), reiterates that, in resource constrained settings, primary health care structures should be utilized for both detection and provision of mental health services as part of the task shifting agenda [8]. Research in low resource settings indicate that this raises an issue of women being missed in these primary care facilities as they have poorer health seeking behaviors and seldom access the facility to have themselves screened for depression [9,10].…”

The effect of acupuncture on condition being studied emotional disorders in patients with postpartum

“…[32] Traditional pharmacological treatments or psychological interventions can reduce the severity of PEDs, whereas the side effects of drugs and the high cost of psychotherapy may reduce the efficacy and hinder the application. [33,34] Acupuncture is becoming increasingly popular in western countries as a convenient, low-cost, safe, and superiorly effective treatment. In terms of reviews and meta-analyses were carried out to identify the efficacy of acupuncture in the treatment of PPD.…”