Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol

Elizabeth Awini; Irene Akua Agyepong; David Owiredu; Leveana Gyimah; Mary Eyram Ashinyo; Linda Lucy Yevoo; Sorre Grace Emmanuelle Victoire Aye; Shazra Abbas; Anna Cronin de Chavez; Sumit Kane; Tolib Mirzoev; Anthony Danso-Appiah

doi:10.1136/bmjopen-2022-069545

Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol

BMJ Open. 2023 Jun 7;13(6):e069545. doi: 10.1136/bmjopen-2022-069545.

Authors

Affiliations

¹ Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana.
² Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana.
³ Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana.
⁴ Department of Psychiatry, Pantang Hospital, Accra, Ghana.
⁵ Faculty of Psychiatry, Ghana College of Physicians and Surgeons, Accra, Ghana.
⁶ Institutional Care Division, Ghana Health Service, Accra, Ghana.
⁷ Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia.
⁸ Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
⁹ Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana adanso-appiah@ug.edu.gh.
¹⁰ Centre for Evidence Synthesis and Policy, University of Ghana, Legon, Accra, Ghana.

Abstract

Introduction: Pregnancy and postpartum-related mental health problems pose serious public health threat to the society, but worryingly, neglected in sub-Saharan Africa (SSA). This review will assess the burden and distribution of maternal mental health (MMH) problems in SSA, with the aim to inform the implementation of context sensitive interventions and policies.

Methods and analysis: All relevant databases, grey literature and non-database sources will be searched. PubMed, LILAC, CINAHL, SCOPUS and PsycINFO, Google Scholar, African Index Medicus, HINARI, African Journals Online and IMSEAR will be searched from inception to 31 May 2023, without language restriction. The reference lists of articles will be reviewed, and experts contacted for additional studies missed by our searches. Study selection, data extraction and risk of bias assessment will be done independently by at least two reviewers and any discrepancies will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence) of MMH problems will be assessed using pooled proportions, OR or risk ratio and mean difference for continuous outcomes; all will be presented with their 95% CIs. Heterogeneity will be investigated graphically for overlapping CIs and statistically using the I² statistic and where necessary subgroup analyses will be performed. Random-effects model meta-analysis will be conducted when heterogeneity is appreciable, otherwise fixed-effect model will be used. The overall level of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation.

Ethics and dissemination: Although no ethical clearance or exemption is needed for a systematic review, this review is part of a larger study on maternal mental health which has received ethical clearance from the Ethics Review Committee of the Ghana Health Service (GHS-ERC 012/03/20). Findings of this study will be disseminated through stakeholder forums, conferences and peer review publications.

Prospero registration number: CRD42021269528.

Keywords: MENTAL HEALTH; Maternal medicine; PSYCHIATRY.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Ghana
Humans
Mental Health*
Meta-Analysis as Topic
Postpartum Period*
Pregnancy
Systematic Reviews as Topic

Grants and funding

MR/T023481/2/MRC_/Medical Research Council/United Kingdom