Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria

被引：24

作者：

Kola, Lola ^{[1
,2
,3
]}

Bennett, Ian M. ^{[4
,5
,6
,7
]}

Bhat, Amritha ^{[4
]}

Ayinde, Olatunde O. ^{[1
]}

Oladeji, Bibilola D. ^{[1
]}

Abiona, Dolapo ^{[1
]}

Abdumalik, Jibril ^{[1
]}

Faregh, Neda ^{[6
,7
]}

Collins, Pamela Y. ^{[5
]}

Gureje, Oye ^{[1
]}

机构：

[1] Univ Ibadan, Coll Med, Dept Psychiat, Ibadan, Nigeria

[2] Lead City Univ, Fac Social Sci, Dept Sociol & Psychol, Ibadan, Nigeria

[3] Univ Ibadan, WHO Collaborating Ctr Res & Training Mental Hlth, Coll Med, Dept Psychiat, Ibadan, Nigeria

[4] Univ Washington, Dept Family Med, Seattle, WA 98195 USA

[5] Univ Washington, Psychiat & Behav Sci, Seattle, WA 98195 USA

[6] Univ Washington, Global Hlth, Seattle, WA 98195 USA

[7] Carleton Univ, Dept Psychol, Ottawa, ON, Canada

来源：

BMC PREGNANCY AND CHILDBIRTH | 2020年 / 20卷 / 01期

基金：

芬兰科学院;

关键词：

Perinatal depression; Adolescent; Pregnancy; Stigma; Health care utilization; Resilience; Low- and middle-income country; MENTAL-HEALTH; MODEL;

D O I：

10.1186/s12884-020-02970-4

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

BackgroundDepression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression, in Nigeria to inform new strategies of care delivery.MethodsFocus Group Discussions (FGDs) were conducted among purposively selected low-income young mothers (with medical histories of adolescent perinatal depression), and separately with primary care clinicians treating this condition in Ibadan, Nigeria. Participants from this community-based study were from the database of respondents who participated in a previous randomized control trial (RCT) conducted between 2014 and 2016 in 28 primary health care facilities in the 11 Local government areas in Ibadan. Semi-structured interview guides, framed by themes of the Behavioral Model for Vulnerable Populations, was developed to obtain views of participants on the factors that promote or hinder help-seeking and engagement (see additional files 1 & 2). FGDs were conducted, and saturation of themes was achieved after discussions with six groups. Transcripts were analyzed using content analysis.ResultsA total of 42 participants, 17 mothers (who were adolescents at the time of the RCT), and 25 care providers participated in 6 FGDs. The availability of care for perinatal depression at the primary care level was an important enabling factor in healthcare utilization for the adolescents. Perceived health benefits of treatment received for perinatal depression were strong motivation for service use. Significant stigma and negative stereotypes expressed by care providers towards adolescent pregnancy and perinatal depression were obstacles to care. However, individual patient resilience was a major enabling factor, facilitating service engagement. Providers trained in the management of perinatal depression were perceived to deliver more tolerant and supportive care that adolescent mothers valued.ConclusionsParticipants identified unsupportive and stigmatizing clinic environments towards pregnant and parenting adolescents as significant barriers to accessing available care. Interventions to reduce stigma among healthcare providers may improve services for this vulnerable population.

引用

页数：8