Dataset Information

Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study.

ABSTRACT:

Background

There have been no studies from low- or middle-income countries to investigate the long-term impact of perinatal common mental disorders (CMD) on child educational outcomes.

Aims

To test the hypothesis that exposure to antenatal and postnatal maternal CMD would be associated independently with adverse child educational outcomes in a rural Ethiopian.

Method

A population-based birth cohort was established in 2005/2006. Inclusion criteria were: age between 15 and 49 years, ability to speak Amharic, in the third trimester of pregnancy and resident of the health demographic surveillance site. One antenatal and nine postnatal maternal CMD assessments were conducted using a self-reporting questionnaire, validated for the local use. Child educational outcomes were obtained from the mother at T1 (2013/2014 academic year; mean age 8.5 years) and from school records at T2 (2014/2015 academic year; mean age 9.3 years).

Results

Antenatal CMD (risk ratio (RR) = 1.06, 95% CI 1.05-1.07) and postnatal CMD (RR = 1.07, 95% CI 1.06-1.09) were significantly associated with child absenteeism at T2. Exposure to repeatedly high maternal CMD scores in the preschool period was not associated with absenteeism after adjusting for antenatal and postnatal CMD. Non-enrolment at T1 (odds ratio 0.75, 95% CI 0.62-0.92) was significantly but inversely associated with postnatal maternal CMD. There was no association between maternal CMD and child academic achievement or drop-out.

Conclusions

Our findings support the hypothesis of a critical period for exposure to maternal CMD for adverse child outcomes and indicate that programmes to enhance regular school attendance in low-income countries need to address perinatal maternal CMD.

Declaration of interest

None.

SUBMITTER: Mekonnen H

PROVIDER: S-EPMC6788221 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study.

Mekonnen Habtamu H Medhin Girmay G Tomlinson Mark M Alem Atalay A Prince Martin M Hanlon Charlotte C

BJPsych open 20191007 6

<h4>Background</h4>There have been no studies from low- or middle-income countries to investigate the long-term impact of perinatal common mental disorders (CMD) on child educational outcomes.<h4>Aims</h4>To test the hypothesis that exposure to antenatal and postnatal maternal CMD would be associated independently with adverse child educational outcomes in a rural Ethiopian.<h4>Method</h4>A population-based birth cohort was established in 2005/2006. Inclusion criteria were: age between 15 and 49 ...[more]

PMID: 31588890

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Project description:BackgroundSeasonal migrant farmworkers in Ethiopia are a vulnerable segment of the population facing numerous threats to their mental health. This research aimed to determine the magnitude of common mental disorders (CMDs) and its associated factors among seasonal migrant farmworkers in the northwest of Ethiopia.MethodsA cross-sectional study was conducted. A total of 950 seasonal migrant farmworkers were selected randomly. CMDs were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect the associated characteristics of socio-demographic data. Data were analyzed using descriptive statistics, bivariate, and multivariable binary logistic regression. The adjusted odds ratio (AOR) with a 95% confidence level was used to declare a statistically significant association with CMDs.ResultsThe prevalence of CMDs was found to be 23.05% (219/950; 95% CI 20.47-25.84) among seasonal migrant farmworkers. The prevalence of psychological stress was 74.53% (708/950; 95% CI 71.65-77.20). Having a daily income below USD 5 (AOR = 1.53, 95% CI: 1.10-2.15), moderate perceived stress (AOR = 3.18, 95% CI: 1.18, 5.36), severe perceived stress (AOR = 16.15, 95% CI: 8.96, 29.11), and heat-related illness (AOR = 1.60, 95% CI: 1.11, 2.30) were associated with a higher likelihood of experiencing CMD. On the other hand, those seasonal migrant farmworkers who migrated for the first time (AOR = 0.38, 95% CI: 0.23-0.65) and those who received health related information (AOR = 0.60, 95% CI: 0.42, 0.85) were less likely to have CMDs.ConclusionIn this study, CMDs were found to be prevalent among seasonal migrant farmworkers. These findings highlight the importance of systematic development of community-based mental health services in combination with rural primary health care centers and an integrated approach to the health care of farmworkers such as screening, early identification, and treatment of CMDs of seasonal migrant farmworkers.

Project description:BackgroundMental health conditions are common during the perinatal period and associated with maternal, foetal, and neonatal morbidity and mortality. There is an established bidirectional relationship between mental health conditions and intimate partner violence (IPV), including during and after pregnancy. Mean lifetime prevalence of physical, sexual or emotional IPV exposure among women in rural Ethiopia is estimated to be 61% and may be even higher during the perinatal period. We aimed to explore the perspectives of women and antenatal care (ANC) health workers on the relationship between all types of IPV and perinatal mental health, to inform the adaptation of a psychological intervention for pregnant women experiencing IPV in rural Ethiopia.MethodsWe conducted in-depth qualitative interviews with 16 pregnant women and 12 health workers in the Gurage zone of the Southern Nations, Nationalities and People's Region of Ethiopia, between December 2018 and December 2019. We conducted thematic analysis of English-translated transcripts of audio-recorded Amharic-language interviews.ResultsParticipants contextualised IPV as the primary form of abusive treatment women experienced, connected by multiple pathways to emotional and bodily distress. Patriarchal norms explained how the actions of neighbours, family, community leaders, law enforcement, and government agents in response to IPV often reinforced women's experiences of abuse. This created a sense of powerlessness, exacerbated by the tension between high cultural expectations of reciprocal generosity and severe deprivation. Women and health workers advocated a psychological intervention to address women's powerlessness over the range of difficulties they faced in their daily lives.ConclusionsWomen and health workers in rural Ethiopia perceive multiple, interconnected pathways between IPV and perinatal emotional difficulties. Contrary to expectations of sensitivity, women and health workers were comfortable discussing the impact of IPV on perinatal mental health, and supported the need for brief mental health interventions integrated into ANC.

Dataset Information

Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study.

Background

Aims

Method

Results

Conclusions

Declaration of interest

Publications

Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study.

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