Sah Lalita Kumari, Hatzidimitriadou Eleni, Wier Jacqueline, Sah Rajeeb Kumar
Faculty of Health Studies, University of Bradford, Bradford, United Kingdom.
Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, United Kingdom.
PLoS One. 2024 Dec 3;19(12):e0314736. doi: 10.1371/journal.pone.0314736. eCollection 2024.
Women during pregnancy are at a greater risk of experiencing poor mental health, which is one of the major global public health issues, and more so in many developing countries like Nepal, but limited evidence of research on this topic is evident. In this paper, we are focused on exploring the social determinants of the mental health of pregnant women in Nepal from the stakeholder perspectives.
This paper utilises eight stakeholder perspectives collected through open-ended in-depth interviews. All the interviews were analysed thematically using an inductive approach.
This paper presents three major findings: Inadequate social support, Limited availability and accessibility of maternal health services, and Restricted socioeconomic and cultural context. The inadequate social support from family/relatives, neighbours, community and national policies such as maternity leave, alongside the absence of NGOs/INGOs support, put women at risk of poor mental health. In addition to the inadequate support, limited availability and accessibility of maternal health services potentially cause immense distress among pregnant women. Furthermore, in the context of a patriarchal society, the impact of socioeconomic and cultural context on pregnant women's mental health is also presented as a major determinant of poor mental health among pregnant women.
Based on the findings, we conclude that pregnant women are at risk of poor mental health experiences in Nepal and recommend that promoting mental health among pregnant women needs a multifaceted approach that should be considered in all the policies and practices involved in promoting the mental health of pregnant women.
孕期女性心理健康状况不佳的风险更高,这是全球主要的公共卫生问题之一,在尼泊尔等许多发展中国家更是如此,但关于这一主题的研究证据有限。在本文中,我们聚焦于从利益相关者的角度探索尼泊尔孕妇心理健康的社会决定因素。
本文采用通过开放式深入访谈收集的八个利益相关者的观点。所有访谈均采用归纳法进行主题分析。
本文呈现了三个主要发现:社会支持不足、孕产妇保健服务的可获得性和可及性有限,以及社会经济和文化背景受限。来自家庭/亲属、邻居、社区和国家政策(如产假)的社会支持不足,再加上缺乏非政府组织/国际非政府组织的支持,使女性面临心理健康状况不佳的风险。除了支持不足外,孕产妇保健服务的可获得性和可及性有限可能会给孕妇带来巨大困扰。此外,在父权制社会背景下,社会经济和文化背景对孕妇心理健康的影响也被视为孕妇心理健康状况不佳的主要决定因素。
基于这些发现,我们得出结论,尼泊尔的孕妇存在心理健康状况不佳的风险,并建议促进孕妇心理健康需要采取多方面的方法,应在所有涉及促进孕妇心理健康的政策和实践中加以考虑。