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 and Bart Criel
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Nandini D. P. Sarkar: Health Systems and Equity Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
Azucena Bardaji: ISGlobal, Hospital Clínic—Universitat de Barcelona, Rosselló 132, 08036 Barcelona, Spain
Koen Peeters Grietens: Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
Joske Bunders-Aelen: Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
Florence Baingana: School of Public Health, Makerere University, Kampala PO Box 7072, Uganda
Bart Criel: Health Systems and Equity Unit, Department of Public Health, Institute of Tropical Medicine at Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium

IJERPH, 2018, vol. 15, issue 6, 1-16

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.

Keywords: Uganda; perinatal depression; mental health; illness representations; explanatory models; socio-cultural conceptualisations (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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