TY - JOUR
T1 - Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study
AU - Keynejad, Roxanne
AU - Bitew, Tesera
AU - Mulushoa, Adiyam
AU - Howard, Louise
AU - Hanlon, Charlotte
N1 - Funding Information: RK is supported by a King’s IoPPN Clinician Investigator Scholarship for her PhD. RK and CH are supported by the National Institute of Health and Care Research (NIHR) Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa (ASSET), King’s College London (GHRU 16/136/54) using UK aid from the UK Government. Funding Information: LH is supported by UK Research and Innovation ((ES/S004424/1) and received salary support from the NIHR Applied Research Collaboration South London and the South London and Maudsley NHS Foundation Trust Biomedical Research Centre. Funding Information: TB is supported by the DELTAS Africa Initiative [DEL-15-01], an independent funding scheme of the African Academy of Sciences’ Alliance for Accelerating Excellence in Science in Africa, with support from the New Partnership for Africa’s Development Planning and Coordinating Agency with funding from the Wellcome Trust and UK government. TB is also supported by Injibara University and Debre Markos University. Funding Information: CH also receives support from NIHR through grant NIHR200842 and the Wellcome Trust through grant 222154/Z20/Z. Publisher Copyright: © 2023, The Author(s).
M1 - 78
PY - 2023/1/28
Y1 - 2023/1/28
N2 - 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.
AB - 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.
U2 - 10.1186/s12884-023-05352-8
DO - 10.1186/s12884-023-05352-8
M3 - Article
SN - 1471-2393
VL - 23
JO - BMC pregnancy and childbirth
JF - BMC pregnancy and childbirth
IS - 1
ER -