The social nature of perceived Illness representations of perinatal depression in rural Uganda

Nandini D.P. Sarkar*, Azucena Bardaji, Koen Peeters Grietens, Joske Bunders-Aelen, Florence Baingana, Bart Criel

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

While the global health community advocates for greater integration of mental health into maternal health agendas, a more robust understanding of perinatal mental health, and its role in providing integrated maternal health care and service delivery, is required. The present study uses the Illness Representation Model, a theoretical cognitive framework for understanding illness conceptualisations, to qualitatively explore multiple stakeholder perspectives on perinatal depression in rural Uganda. A total of 70 in-depth interviews and 9 focus group discussions were conducted with various local health system stakeholders, followed by an emergent thematic analysis using NVivo 11. Local communities perceived perinatal depression as being both the fault of women, and not. It was perceived as having socio-economic and cultural causal factors, in particular, as being partner-related. In these communities, perinatal depression was thought to be a common occurrence, and its negative consequences for women, infants and the community at large were recognised. Coping and help-seeking behaviours prescribed by the participants were also primarily socio-cultural in nature. Placing the dynamics and mechanisms of these local conceptualisations of perinatal depression alongside existing gaps in social and health care systems highlights both the need of, and the opportunities for, growth and prioritisation of integrated perinatal biomedical, mental, and social health programs in resource-constrained settings.

Original languageEnglish
Article number1197
Pages (from-to)1-16
Number of pages16
JournalInternational Journal of Environmental Research and Public Health
Volume15
Issue number6
DOIs
Publication statusPublished - 7 Jun 2018

Funding

Individual sub-components of this study, such as translated data collection guides, as well as the larger research on the challenge of equitable mental health care at LHS-level in low-resource, rural Ugandan settings (2015–2017), of which this study is a part, received ethical approvals from the Institutional Review Boards of the Institute of Tropical Medicine in Antwerp, Belgium (No. 997/15), Makerere University, School of Public Health in Kampala, Uganda (No. 299), and the Ugandan National Council for Science and Technology (No. HS 1888). Acknowledgments: Nandini D. P. Sarkar is funded by an Erasmus Mundus Joint Doctorate Fellowship, Specific Grant Agreement 2014-0681, part of which was used to fund aspects of this study. We would like to acknowledge the Makerere University Center for Health and Population Research and the Iganga-Mayuge Health and Demographic Surveillance Site for their assistance in recruitment of study participants; our local field assistants and data collectors Sarah Namasuko, Betty Kyobe, and Rogers Mandu; and all the women and men who participated in this research.

FundersFunder number
Makerere University

    Keywords

    • Explanatory models
    • Illness representations
    • Mental health
    • Perinatal depression
    • Socio-cultural conceptualisations
    • Uganda

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