Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe.
Biomedical Research and Training Institute, Harare, Zimbabwe.
Glob Health Action. 2022 Dec 31;15(1):2040151. doi: 10.1080/16549716.2022.2040151.
BACKGROUND: Adolescents experiencing multiple vulnerabilities, including poverty, curtailed education, transactional sex and early childbearing, are at risk of poor mental health. In Zimbabwe, girls who are pregnant or new mothers and involved in selling sex struggle to cope with the combined pressures of parenthood, financial insecurity, and social stigma. A pilot intervention brought such girls together into self-help groups to increase peer support, resources and skills. OBJECTIVE: This study aimed to explore whether and how participation in a self-help group intervention affected vulnerable young mothers' experiences and perceptions of mental health stressors. METHODS: Self-help groups received 12 participatory sessions over 6 months. Eighteen semi-structured interviews and three focus group discussions were held with participants and drop-outs. Before and after the intervention, participants completed the locally validated 14-item Shona Symptom Questionnaire tool to indicate the probable prevalence of common mental health disorders. RESULTS: Adolescent girls described mutually reinforcing stressors in their lives and reported low self-esteem and anxiety. Key themes emerging from qualitative data centred around girls' struggles with adverse life events, the burden of new motherhood, social isolation related to sex work and self-help groups as a source of hope. Participants joined groups to obtain support and felt their mental well-being improved due to new social networks, feelings of solidarity with peers, and increased confidence for positive action, that is, seeking health services for themselves and their babies. Prior to enrolment 16% showed signs of possible common mental disorders falling to 2% at follow-up. CONCLUSIONS: Participants believed involvement in interactive self-help groups improved their mental health by strengthening peer support and engendering hope for the future. Although reduced mental distress cannot be attributed to the programme, the pilot intervention offers a low-cost approach that could be rigorously tested and adapted to a wide range of community settings.
背景:青少年面临多种脆弱性,包括贫困、教育中断、性交易和早育,他们的心理健康可能受到影响。在津巴布韦,怀孕或新成为母亲并从事性交易的女孩在应对生育、经济不安全和社会耻辱的双重压力时,难以应对。一项试点干预措施将这些女孩聚集在一起,组成自助小组,以增加同伴支持、资源和技能。 目的:本研究旨在探讨参与自助小组干预是否以及如何影响弱势年轻母亲对心理健康压力源的体验和看法。 方法:自助小组在 6 个月内接受了 12 次参与式会议。对参与者和辍学者进行了 18 次半结构化访谈和 3 次焦点小组讨论。在干预前后,参与者使用经过当地验证的 14 项绍纳症状问卷工具完成了调查,以表明常见精神障碍的可能流行率。 结果:青少年女孩描述了她们生活中相互加强的压力源,并报告了自尊心低和焦虑。定性数据中出现的主要主题围绕女孩与不利生活事件的斗争、新母亲的负担、与性工作相关的社会隔离以及自助小组作为希望的源泉。参与者加入小组是为了获得支持,并感到他们的心理健康状况因新的社交网络、与同龄人团结的感觉以及对积极行动的信心而得到改善,即他们自己和他们的婴儿寻求健康服务。在登记前,16%的人表现出可能存在常见精神障碍的迹象,随访时下降到 2%。 结论:参与者认为参与互动自助小组通过加强同伴支持和为未来带来希望,改善了他们的心理健康。虽然精神困扰的减少不能归因于该计划,但该试点干预措施提供了一种低成本方法,可以进行严格测试并适应广泛的社区环境。
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