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孕产妇心理健康与近期儿童疾病——来自尼日利亚吉加瓦州的横断面调查分析

Maternal mental well-being and recent child illnesses-A cross-sectional survey analysis from Jigawa State, Nigeria.

作者信息

Salako Julius, Bakare Damola, Colbourn Tim, Isah Adamu, Adams Osebi, Shittu Funmilayo, Uchendu Obioma, Bakare Ayobami A, Graham Hamish, McCollum Eric D, Falade Adegoke G, Burgess Rochelle A, King Carina

机构信息

Department of Health Promotion and Education, University College Hospital, Ibadan, Nigeria.

Department of Epidemiology and Medical Statistics, University College Hospital, Ibadan, Nigeria.

出版信息

PLOS Glob Public Health. 2023 Mar 2;3(3):e0001462. doi: 10.1371/journal.pgph.0001462. eCollection 2023.

Abstract

Child health indicators in Northern Nigeria remain low. The bidirectional association between child health and maternal well-being is also poorly understood. We aim to describe the association between recent child illness, socio-demographic factors and maternal mental well-being in Jigawa State, Nigeria. We analysed a cross-sectional household survey conducted in Kiyawa local government area, Jigawa State, from January 2020 to March 2020 amongst women aged 16-49 with at least one child under-5 years. We used two-stage random sampling. First, we used systematic random sampling of compounds, with the number of compounds based on the size of the community. The second stage used simple random sampling to select one eligible woman per compound. Mental well-being was assessed using the Short Warwick-Edinburgh Mental Wellbeing Score (SWEMWBS). We used linear regression to estimate associations between recent child illness, care-seeking and socio-demographic factors, and mental well-being. Overall 1,661 eligible women were surveyed, and 8.5% had high mental well-being (metric score of 25.0-35.0) and 29.5% had low mental well-being (metric score of 7.0-17.9). Increasing wealth quintile (adj coeff: 1.53; 95% CI: 0.91-2.15) not being a subsistence farmer (highest adj coeff: 3.23; 95% CI: 2.31-4.15) and having a sick child in the last 2-weeks (adj coeff: 1.25; 95% CI: 0.73-1.77) were significantly associated with higher mental well-being. Higher levels of education and increasing woman's age were significantly associated with lower mental well-being. Findings contradicted our working hypothesis that a recently sick child would be associated with lower mental well-being. We were surprised that education and late marriage, which are commonly attributed to women's empowerment and autonomy, were not linked to better well-being here. Future work could focus on locally defined tools to measure well-being reflecting the norms and values of communities, ensuring solutions that are culturally acceptable and desirable to women with low mental well-being are initiated.

摘要

尼日利亚北部的儿童健康指标仍然很低。儿童健康与母亲幸福之间的双向关联也未得到充分理解。我们旨在描述尼日利亚吉加瓦州近期儿童疾病、社会人口因素与母亲心理健康之间的关联。我们分析了2020年1月至2020年3月在吉加瓦州基瓦瓦地方政府辖区进行的一项横断面家庭调查,调查对象为16至49岁、至少有一个5岁以下子女的妇女。我们采用了两阶段随机抽样。首先,我们对住宅群进行系统随机抽样,住宅群数量根据社区规模确定。第二阶段采用简单随机抽样,从每个住宅群中选取一名符合条件的妇女。使用简短的沃里克 - 爱丁堡心理健康评分(SWEMWBS)评估心理健康状况。我们使用线性回归来估计近期儿童疾病、寻求医疗护理与社会人口因素和心理健康之间的关联。总共调查了1661名符合条件的妇女,其中8.5%心理健康状况良好(指标分数为25.0 - 35.0),29.5%心理健康状况较差(指标分数为7.0 - 17.9)。财富五分位数增加(调整系数:1.53;95%置信区间:0.91 - 2.15)、不是自给农民(最高调整系数:3.23;95%置信区间:2.31 - 4.15)以及在过去两周内有患病子女(调整系数:1.25;95%置信区间:0.73 - 1.77)与较高的心理健康状况显著相关。较高的教育水平和女性年龄增长与较低的心理健康状况显著相关。研究结果与我们的工作假设相矛盾,即近期患病的儿童会与较低的心理健康状况相关。我们感到惊讶的是,通常被认为与女性赋权和自主权相关的教育和晚婚,在此处并未与更好的幸福状况相关联。未来的工作可以侧重于当地定义的衡量幸福的工具,这些工具应反映社区的规范和价值观,确保启动对心理健康状况较差的女性在文化上可接受且合意的解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c755/10121178/55be430b61d2/pgph.0001462.g001.jpg

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