Effectiveness of a brief psychoeducational intervention on postnatal depression in the slums, Nairobi: a longitudinal st
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ORIGINAL ARTICLE
Effectiveness of a brief psychoeducational intervention on postnatal depression in the slums, Nairobi: a longitudinal study Esther W. Kariuki 1 & Mary W. Kuria 1 & Fredrick N. Were 1 & David M. Ndetei 1,2 Received: 13 February 2020 / Accepted: 30 October 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Research has shown that postnatal depression (PND) is higher in low- and middle-income countries as compared to higherincome countries. Despite this, little is known about practical interventions in these poorly resourced countries. This research investigated the effectiveness of a brief, prophylactic and therapeutic psychoeducational intervention in a low-resourced community in Nairobi. Two closely similar Maternal and Child Health (MCH) clinics in urban slums in Nairobi were identified and randomly selected. A total of 567 mothers formed the study population. The experimental group (284) mothers received the intervention, which included psychoeducation on PND, coping skills, healthy way of mother/child interaction and infant stimulation in addition to routine treatment, while the control group (283) mothers received treatment as usual. Data was collected using a social-demographic questionnaire and the English version of Becks Depression Inventory (BDI) at baseline. At 6 months, we reassessed both groups using BDI only. Within group comparison, the percentage reduction of depression was 35.6% among the experimental as compared to 2.3% in the control group. Between group comparison, the mean BDI depression score was significantly low in the experimental arm compared to the control arm at endline (p = 0.025). When all variables were adjusted, using a generalized linear model, BDI depression score reduction among the participants was significantly associated with the intervention (p = 0.040). A brief, psychoeducational intervention that targets the mother and her infant may reduce PND even in poorly resourced environments. Therefore, it can be integrated into existing MCH services. Keywords Postnatal depression . Psychosocial intervention . Psychoeducation . Low- and middle-income countries
Introduction Postnatal depression (PND) is a worldwide health problem (Almond 2009). It is prevalent in both developing and developed countries and across cultures (Arifin et al. 2018). Postnatal depression negatively affects the mother (Kabakian-Khasholian et al. 2015; Woolhouse et al. 2014) and her infant (Murray 1992; Ueda et al. 2006). Research has shown that PND prevalence rates range between 1.9 and 82.1% in developing countries compared to 5.2% and 74.0% in developed countries using a self-reported questionnaire (Norhayati 2015). A research study that searched five * Esther W. Kariuki [email protected] 1
Department of Psychiatry, School of Medicine, The University of Nairobi, P.O. Box 30197, Nairobi 00100, Kenya
2
Africa Mental Health Research and Training Foundation, Nairobi, Kenya
databases found a higher (31.3%) PND prevalence rates among women in developing countrie
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