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‘Good health means being mentally, socially, emotionally and physically fit’: women’s understanding of health and ill health during and after pregnancy in India and Pakistan: a qualitative study

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McCauley, Mary ORCID: https://orcid.org/0000-0003-1446-0625, Avais, Ayesha Rasheeda, Agrawal, Ritu, Saleem, Shumaila, Zafar, Shamsa and van den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2020) '‘Good health means being mentally, socially, emotionally and physically fit’: women’s understanding of health and ill health during and after pregnancy in India and Pakistan: a qualitative study'. BMJ Open, Vol 10, Issue 1, e028760.

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Abstract

Objective To explore what women consider health and ill health to be, in general, and during and after pregnancy. Women’s views on how to approach screening for mental ill health and social morbidities were also explored.

Settings Public hospitals in New Delhi, India and Islamabad, Pakistan.

Participants 130 women attending for routine antenatal or postnatal care at the study healthcare facilities.

Interventions Data collection was conducted using focus group discussions and key informant interviews. Transcribed interviews were coded by topic and grouped into categories. Thematic framework analysis identified emerging themes.

Results Women are aware that maternal health is multidimensional and linked to the health of the baby. Concepts of good health included: nutritious diet, ideal weight, absence of disease and a supportive family environment. Ill health consisted of physical symptoms and medical disease, stress/tension, domestic violence and alcohol abuse in the family. Reported barriers to routine enquiry regarding mental and social ill health included a small number of women’s perceptions that these issues are ‘personal’, that healthcare providers do not have the time and/or cannot provide further care, even if mental or social ill health is disclosed.

Conclusions Women have a good understanding of the comprehensive nature of health and ill health during and after pregnancy. Women report that enquiry regarding mental and social ill health is not part of routine maternity care, but most welcome such an assessment. Healthcare providers have a duty of care to deliver respectful care that meets the health needs of women in a comprehensive, integrated, holistic manner, including mental and social care. There is a need for further research to understand how to support healthcare providers to screen for all aspects of maternal morbidity (physical, mental and social); and for healthcare providers to be enabled to provide support and evidence-based care and/or referral for women if any ill health is disclosed.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 305 Mental health of special population groups
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjopen-2018-028760
Depositing User: Stacy Murtagh
Date Deposited: 09 Mar 2020 11:53
Last Modified: 09 Mar 2020 11:53
URI: https://archive.lstmed.ac.uk/id/eprint/13919

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