Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review
Summary: Background: Pregnant adolescent girls and young women (AGYW, aged 12–24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region. Methods: We performed a systematic review of mental health studies among pregnant AGYW in SSA published between...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022000190 |
| _version_ | 1828853426748915712 |
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| author | Joan Mutahi Anna Larsen Pim Cuijpers Stefan Swartling Peterson Jurgen Unutzer Mary McKay Grace John-Stewart Teresa Jewell John Kinuthia Fatima Gohar Joanna Lai Dalton Wamalwa Onesmus Gachuno Manasi Kumar |
| author_facet | Joan Mutahi Anna Larsen Pim Cuijpers Stefan Swartling Peterson Jurgen Unutzer Mary McKay Grace John-Stewart Teresa Jewell John Kinuthia Fatima Gohar Joanna Lai Dalton Wamalwa Onesmus Gachuno Manasi Kumar |
| author_sort | Joan Mutahi |
| collection | DOAJ |
| description | Summary: Background: Pregnant adolescent girls and young women (AGYW, aged 12–24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region. Methods: We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINAHL, PsycInfo, and Global Index Medicus following PRISMA guidelines (PROSPERO: CRD42021230980). We used Bronfenbrenner's bioecological model to frame and synthesize results from included studies. Findings: Our search yielded 945 articles from which 18 studies were included (N = 8 quantitative, N = 9 qualitative, N = 1 case report). The most frequently studied mental health problem was depression (N = 9 studies); the most frequently utilized measurement tool was the Edinburgh Postnatal Depression Scale (N = 3). Studies reported life course factors, individual, microsystem, exosystem, macrosystem, and chronosystem-level factors associated with mental health problems. Gaps in mental health service delivery for pregnant AGYW included lack of confidentiality, judgmental healthcare worker attitudes, and lack of services tailored to their unique needs. Interpretation: Gaps remain in research and services for mental health among pregnant AGYW in SSA. Integration of mental health services within school, community, and healthcare settings that are tailored to pregnant AGYW could strengthen health systems within SSA. Funding: Author contributions were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F31HD101149 to AL) and the Fogarty International Center (K43TW010716 to MK). The funding agencies had no role in the writing of the manuscript or the decision to submit it for publication. The project itself was not funded. |
| first_indexed | 2024-12-13T00:13:21Z |
| format | Article |
| id | doaj.art-f1e4f5b09a404d46984138109d5a0c11 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-13T00:13:21Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-f1e4f5b09a404d46984138109d5a0c112022-12-22T00:05:52ZengElsevierEClinicalMedicine2589-53702022-02-0144101289Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic reviewJoan Mutahi0Anna Larsen1Pim Cuijpers2Stefan Swartling Peterson3Jurgen Unutzer4Mary McKay5Grace John-Stewart6Teresa Jewell7John Kinuthia8Fatima Gohar9Joanna Lai10Dalton Wamalwa11Onesmus Gachuno12Manasi Kumar13Department of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, KenyaDepartment of Global Health, University of Washington, Seattle, WA, United StatesDepartment of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the NetherlandDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenDepartment of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United StatesBrown School of Social Work, Washington University in St. Louis, St. Louis, MO, United StatesDepartment of Global Health, University of Washington, Seattle, WA, United StatesUniversity of Washington Libraries, Seattle, WA, United StatesResearch and Programs, Kenyatta National Hospital, Nairobi, KenyaUnited Nations Children's Fund (UNICEF), New York, NY, United StatesUnited Nations Children's Fund (UNICEF), New York, NY, United StatesDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, KenyaDepartment of Obstetrics and Gynecology, University of Nairobi, Nairobi, KenyaDepartment of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, Kenya; Brain and Mind Institute, Aga Khan University, Kenya; Corresponding author.Summary: Background: Pregnant adolescent girls and young women (AGYW, aged 12–24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region. Methods: We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINAHL, PsycInfo, and Global Index Medicus following PRISMA guidelines (PROSPERO: CRD42021230980). We used Bronfenbrenner's bioecological model to frame and synthesize results from included studies. Findings: Our search yielded 945 articles from which 18 studies were included (N = 8 quantitative, N = 9 qualitative, N = 1 case report). The most frequently studied mental health problem was depression (N = 9 studies); the most frequently utilized measurement tool was the Edinburgh Postnatal Depression Scale (N = 3). Studies reported life course factors, individual, microsystem, exosystem, macrosystem, and chronosystem-level factors associated with mental health problems. Gaps in mental health service delivery for pregnant AGYW included lack of confidentiality, judgmental healthcare worker attitudes, and lack of services tailored to their unique needs. Interpretation: Gaps remain in research and services for mental health among pregnant AGYW in SSA. Integration of mental health services within school, community, and healthcare settings that are tailored to pregnant AGYW could strengthen health systems within SSA. Funding: Author contributions were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F31HD101149 to AL) and the Fogarty International Center (K43TW010716 to MK). The funding agencies had no role in the writing of the manuscript or the decision to submit it for publication. The project itself was not funded.http://www.sciencedirect.com/science/article/pii/S2589537022000190Mental healthPregnantAdolescentsYoung womenSub-Saharan Africa |
| spellingShingle | Joan Mutahi Anna Larsen Pim Cuijpers Stefan Swartling Peterson Jurgen Unutzer Mary McKay Grace John-Stewart Teresa Jewell John Kinuthia Fatima Gohar Joanna Lai Dalton Wamalwa Onesmus Gachuno Manasi Kumar Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review EClinicalMedicine Mental health Pregnant Adolescents Young women Sub-Saharan Africa |
| title | Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review |
| title_full | Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review |
| title_fullStr | Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review |
| title_full_unstemmed | Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review |
| title_short | Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review |
| title_sort | mental health problems and service gaps experienced by pregnant adolescents and young women in sub saharan africa a systematic review |
| topic | Mental health Pregnant Adolescents Young women Sub-Saharan Africa |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022000190 |
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