National dialogue on maternal mental health policy in Nigeria

Abstract

This National dialogue on Maternal Mental Health (MMH) was organized by the Federal Ministry of Health (FMOH) with the support of the USAID Momentum Country Global Leadership (MCGL). Mental health has lagged behind physical health for a long time in terms of attention, funding and action. This is in tandem with the inclusion of mental health as a fundamental aspect of overall health and one of the Sustainable Development Goals (SDG) by the World Health Organization. Mental disorders are among the most common morbidities of pregnancy and the postnatal period and can have adverse effects on the mother, her child and family. Anxiety and depression are common, and women with pre-existing major mental disorders, such as schizophrenia, are at greater risk of compromised maternity care, delivery complications and relapse in pregnancy and the postpartum period. Globally, depression and anxiety are the most common mental health problems during pregnancy, with around 12% of women experiencing depression and 13% experiencing anxiety at some point; many women will experience both. Depression and anxiety also affect 15-20% of women in the first year after childbirth. Though pregnancy and childbirth are physiologic processes, they can be associated with risks for a number of women. These risk factors are multifactorial and may differ between antenatal and postnatal disorders. Globally recognized risk factors include: Poverty, gender discrimination/GBV, relationship with intimate partner, low educational opportunities, physical health conditions, poor nutrition, unwanted or adolescent pregnancy, difficult birth experiences, conflict and natural disasters. Perinatal common mental disorders (PCMDs) are a leading cause of years lived with disability in women of childbearing age and are associated with substantial human and economic costs. MMH problems are not only detrimental to a woman’s health; they have also been linked to reduced sensitivity and responsiveness in caregiving and to higher rates of behavioural problems in young children. Research into effective strategies for promoting MMH have recommended that mental health service integration is the most viable option. For most Low- and Medium-Income Countries (LMICs), the constraint of human resource makes service integration imperative. Against this background of huge burden of PCMDs in Nigeria, the inadequate Human Resource for Health (HRH) across all cadre of Health Care Workers (HCW), dearth in Specialists, inadequate funding for health and a large treatment gap of almost 90%, it becomes imperative to raise awareness on its burden on health in Nigeria. This will also help in developing/implementing evidence-based initiatives to ensure better mental health for women of reproductive age in Nigeria. Participants were drawn from the FMOH, National Primary Health Care Development Agency (NPHCDA), other Ministries, Departments, & Agencies (MDAs), Medical Experts, Implementing Partners, Civil Society Organizations, Media and relevant State Government representatives. Details of participants are contained in the list of participants (Appendix I). The sessions were interactive with suggestions and recommendations on the process of developing a maternal mental health policy for Nigeria.