GHES LMIC Fellow 2016-2017
Fellowship Site: Public Health Research Institute of India, Mysore, Karnataka
U.S. Institution: Florida International University
Project Title: Influence of postnatal mental health on mother-infant relationship in rural India: a pilot exploratory study using mixed methods
Depression is one of the leading causes of the global burden of disease. In South Asia, the prevalence of postnatal depression is reported to be amongst the highest in the world, ranging from 18%-30% in urban areas and 28%-36% in rural areas. Postnatal depression is associated with adverse public health and social consequences for both mother and child. Over the past decades, postnatal depression has received increased attention both in rural and urban areas of many developing countries including India.
Poor maternal mental health is inversely associated with physical, social, emotional and behavioral development of an infant, independent of social background. Studies largely from high income settings indicate that maternal depression results in insecure attachment in infancy, leading to behavioral problems in childhood and poor mental health in adulthood. This may be mediated through sensitivity, bonding and emotional availability of mothers and affective response of the infant. Limited data from LMIC setting including India have restricted to examining the impact of maternal mental health on the physical, but not the psychological development of the infant. Studying mother-infant factors will provide newer insights into early life risk factors for adult mental health.
Public Health Research Institute of India has been providing maternal and child health services to rural areas of Mysore district for the past seven years. This program is following over 3000 mother-infant dyads in 144 villages. The program offers integrated antenatal services and HIV testing for pregnant women and follows up mother-infant dyads up into postnatal period for a period of two years. Therefore, this program provides a unique opportunity to examine the influence of postnatal depression on mother-infant relationship and on infant development, in a cultural context that is radically different to the west.