Skip to main content
Top
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

The relationship between under-five child death and maternal mental distress in Gamo Gofa Zone, Southern Ethiopia: a community based comparative cross-sectional study

Authors: Girma Temam Shifa, Ahmed Ali Ahmed, Alemayehu Worku Yalew

Published in: BMC Women's Health | Issue 1/2018

Login to get access

Abstract

Background

Knowledge of the association between child death and maternal mental distress may help to understand the indirect impact of reduction of under-five mortality on maternal mental wellbeing. This will further have a positive impact on the development of the nation. Depression is associated substantially with reduced quality of life and functional capacity of women. Although studies in the country assessed the magnitude of Common Mental Disorders (CMD) among postpartum mothers, those assessing the association between child death and maternal mental distress are lacking. Therefore, this study examined the association between child death and maternal mental distress.

Methods

We conducted a comparative cross-sectional study in 2014 on a total of 356 mothers who lost their children and 712 mothers with alive children. We measured CMD symptoms using the World Health Organization’s (WHO’s) self-reporting questionnaire (SRQ-20). A cut-off score of ≥6 was taken as an indicator of mental distress. To determine the relationship between child death and maternal mental distress, we conducted weighted conditional logistic regression analysis with mental distress coded as a binary outcome.

Results

Mothers who lost children had significantly higher rate of mental distress (adjusted odds ratio (AOR) of 1.84(1.11–3.04) compared to their counterparts. Similarly, mothers with child loss reported a significantly higher rate of suicidal ideation (23.3%) than mothers without child death (16.3%), with p-value of 0.003. The effect of child loss on maternal mental distress was greater during earlier periods (within 6 months of child death) and it decreased through time. However, it was shown to be persistently high at least during the first three years after child death, relative to mothers with alive child.

Conclusions

Significantly higher proportions of women with child loss experienced mental distress including suicidal ideation than those without. Screening for maternal mental health problems by incorporating simple common mental distress assessing tools, like WHO’s SRQ into the maternal and child health care programs of health facilities may have significant effect on reducing the impact of maternal mental health problems in the designated communities.
Literature
1.
go back to reference Patel V, Rahman A, Jacob KS, Hughes M. Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ. 2004;328:820–3.CrossRefPubMedPubMedCentral Patel V, Rahman A, Jacob KS, Hughes M. Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ. 2004;328:820–3.CrossRefPubMedPubMedCentral
2.
go back to reference Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R. Mothers mental health & infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2003;30:21–7.CrossRef Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R. Mothers mental health & infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2003;30:21–7.CrossRef
3.
go back to reference King-Hele S, Webb RT, Mortensen PB, Appleby L, Pickles A, Abel KM. Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):105–10.CrossRef King-Hele S, Webb RT, Mortensen PB, Appleby L, Pickles A, Abel KM. Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):105–10.CrossRef
4.
go back to reference Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;13(369):145–57.CrossRef Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;13(369):145–57.CrossRef
5.
go back to reference Cooper PJ, Murray L, Wilson A, Romaniuk H. Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression. Brit J Psychiat. 2003;182:412–9.CrossRefPubMed Cooper PJ, Murray L, Wilson A, Romaniuk H. Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression. Brit J Psychiat. 2003;182:412–9.CrossRefPubMed
7.
go back to reference Zisook S, Shuchter SR, Sledge PA, Paulus MP, Judd LL. The spectrum of depressive phenomena after spousal bereavement. J Clin Psyehiat. 1994;55(Suppl):29–36. Zisook S, Shuchter SR, Sledge PA, Paulus MP, Judd LL. The spectrum of depressive phenomena after spousal bereavement. J Clin Psyehiat. 1994;55(Suppl):29–36.
8.
go back to reference Stroebe W, Stroebe MS, Domittner G. Individual and situational differences in recovery from bereavement: a risk group identified. J Soc Iss. 1988;44(3):143–58.CrossRef Stroebe W, Stroebe MS, Domittner G. Individual and situational differences in recovery from bereavement: a risk group identified. J Soc Iss. 1988;44(3):143–58.CrossRef
10.
go back to reference Vance JC, Foster WJ, Najman JM, Embelton G, Thearle MJ, Hodgen FM. Early parental responses to sudden infant death, stillbirth or neonatal death. Med J Aust. 1991;155:292–7.PubMed Vance JC, Foster WJ, Najman JM, Embelton G, Thearle MJ, Hodgen FM. Early parental responses to sudden infant death, stillbirth or neonatal death. Med J Aust. 1991;155:292–7.PubMed
11.
go back to reference Boyle FM, Vance JC, Najman JM, Thearle MJ. The mental health impact of stillbirth, neonatal death or sudden infant death syndrome(SIDS): prevalence and patterns of distress among mothers. Soc Sci Med. 1996;43(8):1273–82.CrossRefPubMed Boyle FM, Vance JC, Najman JM, Thearle MJ. The mental health impact of stillbirth, neonatal death or sudden infant death syndrome(SIDS): prevalence and patterns of distress among mothers. Soc Sci Med. 1996;43(8):1273–82.CrossRefPubMed
12.
go back to reference Meert KL, Donaldson AE, Newth CJ, Harrison R, Berger J, Zimmerman J, Anand KJ, Carcillo J, Dean JM, Willson DF, et al. Complicated grief and associated risk factors among parents following a child's death in the pediatric intensive care unit. Archives of pediatrics & adolescent medicine. 2010;164(11):1045–51.CrossRef Meert KL, Donaldson AE, Newth CJ, Harrison R, Berger J, Zimmerman J, Anand KJ, Carcillo J, Dean JM, Willson DF, et al. Complicated grief and associated risk factors among parents following a child's death in the pediatric intensive care unit. Archives of pediatrics & adolescent medicine. 2010;164(11):1045–51.CrossRef
13.
go back to reference Meert KL, Shear K, Newth CJ, Harrison R, Berger J, Zimmerman J, Anand KJ, Carcillo J, Donaldson AE, Dean JM, et al. Follow-up study of complicated grief among parents eighteen months after a child's death in the pediatric intensive care unit. J Palliat Med. 2011;14(2):207–14.CrossRefPubMedPubMedCentral Meert KL, Shear K, Newth CJ, Harrison R, Berger J, Zimmerman J, Anand KJ, Carcillo J, Donaldson AE, Dean JM, et al. Follow-up study of complicated grief among parents eighteen months after a child's death in the pediatric intensive care unit. J Palliat Med. 2011;14(2):207–14.CrossRefPubMedPubMedCentral
15.
go back to reference Forrest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. BMJ. 1982;285:1475–9.CrossRefPubMedPubMedCentral Forrest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. BMJ. 1982;285:1475–9.CrossRefPubMedPubMedCentral
17.
go back to reference Vachon MLS, Rogers J, Lyall WAL, Lancee WJ, Sheldon AR, Freeman SJJ. Predictors and correlates of adaptation to conjugal bereavement. Am J Psychiatr. 1982;139(8):998–1002.CrossRefPubMed Vachon MLS, Rogers J, Lyall WAL, Lancee WJ, Sheldon AR, Freeman SJJ. Predictors and correlates of adaptation to conjugal bereavement. Am J Psychiatr. 1982;139(8):998–1002.CrossRefPubMed
18.
go back to reference Lindemann E. Symptomatology and management of acute grief. Am J Psychiatr. 1944;101(2):141–8.CrossRef Lindemann E. Symptomatology and management of acute grief. Am J Psychiatr. 1944;101(2):141–8.CrossRef
20.
22.
go back to reference Shifa GT, Ahmed AA, Yalew AW. Early days of life are crucial for child survival in Gamo Gofa zone, southern Ethiopia: a community based study. BMC Pediatr. 2016;16(1):30.CrossRefPubMedPubMedCentral Shifa GT, Ahmed AA, Yalew AW. Early days of life are crucial for child survival in Gamo Gofa zone, southern Ethiopia: a community based study. BMC Pediatr. 2016;16(1):30.CrossRefPubMedPubMedCentral
23.
go back to reference Baumgartner JN, Parcesepe A, Mekuria YG, Abitew DB, Gebeyehu W, Okello F, Shattuck D. Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey. Global health, science and practice. 2014;2(4):482–6.CrossRefPubMedPubMedCentral Baumgartner JN, Parcesepe A, Mekuria YG, Abitew DB, Gebeyehu W, Okello F, Shattuck D. Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey. Global health, science and practice. 2014;2(4):482–6.CrossRefPubMedPubMedCentral
25.
go back to reference Alem A, Kebede D, Woldesemiat G, Jacobsson L, Kullgren G. The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia. Acta Psychiatr Scand. 1999;397:48–55.CrossRef Alem A, Kebede D, Woldesemiat G, Jacobsson L, Kullgren G. The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia. Acta Psychiatr Scand. 1999;397:48–55.CrossRef
26.
go back to reference Senturk V, Hanlon C, Medhin G, Dewey M, Araya M, Alem A, Prince M, Stewart R. Impact of perinatal somatic and common mental disorder symptoms on functioning in Ethiopian women: the P-MaMiE population-based cohort study. J Affect Disord. 2012;136(3):340–9.CrossRefPubMedPubMedCentral Senturk V, Hanlon C, Medhin G, Dewey M, Araya M, Alem A, Prince M, Stewart R. Impact of perinatal somatic and common mental disorder symptoms on functioning in Ethiopian women: the P-MaMiE population-based cohort study. J Affect Disord. 2012;136(3):340–9.CrossRefPubMedPubMedCentral
27.
go back to reference Damena T, Mossie A, Tesfaye M. Khat chewing and mental distress: a community based study, in Jimma City, southwestern Ethiopia. Ethiop J Health Sci. 2011;21(1):37–45.CrossRefPubMedPubMedCentral Damena T, Mossie A, Tesfaye M. Khat chewing and mental distress: a community based study, in Jimma City, southwestern Ethiopia. Ethiop J Health Sci. 2011;21(1):37–45.CrossRefPubMedPubMedCentral
28.
go back to reference Gelaye B, Lemma S, Deyassa N, Bahretibeb Y, Tesfaye M, Berhane Y, Williams MA. Prevalence and correlates of mental distress among working adults in Ethiopia. Clin Pract Epidemiol Ment Health. 2012;8:126–33.CrossRefPubMedPubMedCentral Gelaye B, Lemma S, Deyassa N, Bahretibeb Y, Tesfaye M, Berhane Y, Williams MA. Prevalence and correlates of mental distress among working adults in Ethiopia. Clin Pract Epidemiol Ment Health. 2012;8:126–33.CrossRefPubMedPubMedCentral
29.
go back to reference Hanlon C, Medhin G, Alem A, Araya M, Abdulahi A, Hughes M, Tesfaye M, Wondimagegn D, Patel V, Prince M. Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh postnatal depression scale. J Affect Disord. 2008;108:251–62.CrossRefPubMed Hanlon C, Medhin G, Alem A, Araya M, Abdulahi A, Hughes M, Tesfaye M, Wondimagegn D, Patel V, Prince M. Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh postnatal depression scale. J Affect Disord. 2008;108:251–62.CrossRefPubMed
31.
go back to reference Ross J, Hanlon C, Medhin G, Alem A, Tesfaye F, Worku B, Dewey M, Patel V, Prince M. Perinatal mental distress and infant morbidity in Ethiopia: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2011;96:59–64.CrossRef Ross J, Hanlon C, Medhin G, Alem A, Tesfaye F, Worku B, Dewey M, Patel V, Prince M. Perinatal mental distress and infant morbidity in Ethiopia: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2011;96:59–64.CrossRef
32.
go back to reference Medhin G, Hanlon C, Dewey M, Alem A, Tesfaye F, Lakew Z, Worku B, Aray M, Abdulahi A, Tomlinson M, et al. The effect of maternal common mental disorders on infant undernutrition in Butajira, Ethiopia: the P-MaMiE study. BMC Psychiatry. 2010;10:32.CrossRefPubMedPubMedCentral Medhin G, Hanlon C, Dewey M, Alem A, Tesfaye F, Lakew Z, Worku B, Aray M, Abdulahi A, Tomlinson M, et al. The effect of maternal common mental disorders on infant undernutrition in Butajira, Ethiopia: the P-MaMiE study. BMC Psychiatry. 2010;10:32.CrossRefPubMedPubMedCentral
33.
go back to reference Kwakye KO, Otupiri E, Dabo EO, Browne ENL, Adjuik M. Determinants of under-five mortality in Builsa District, upper east region, Ghana. J Sci Technol. 2010;30(1):145–53. Kwakye KO, Otupiri E, Dabo EO, Browne ENL, Adjuik M. Determinants of under-five mortality in Builsa District, upper east region, Ghana. J Sci Technol. 2010;30(1):145–53.
34.
go back to reference Abir T, Agho KE, Page AN, Milton AH, Dibley MJ. Risk factors for under-5 mortality: evidence from Bangladesh demographic and health survey, 2004-2011. BMJ Open. 2015;5(8):e006722.CrossRefPubMedPubMedCentral Abir T, Agho KE, Page AN, Milton AH, Dibley MJ. Risk factors for under-5 mortality: evidence from Bangladesh demographic and health survey, 2004-2011. BMJ Open. 2015;5(8):e006722.CrossRefPubMedPubMedCentral
35.
go back to reference Kyei KA. Determinants of childhood mortality in South Africa: using categorical data modeling. J Hum Ecol. 2012;37(1):47–56.CrossRef Kyei KA. Determinants of childhood mortality in South Africa: using categorical data modeling. J Hum Ecol. 2012;37(1):47–56.CrossRef
36.
go back to reference Pollock JI, Manaseki-Holland S, Patel V. Depression in Mongolian women over the first 2 months after childbirth: prevalence and risk factors. J Affect Disord. 2009;116(1–2):126–33.CrossRefPubMed Pollock JI, Manaseki-Holland S, Patel V. Depression in Mongolian women over the first 2 months after childbirth: prevalence and risk factors. J Affect Disord. 2009;116(1–2):126–33.CrossRefPubMed
37.
go back to reference Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry J Ment Sci. 2002;181:499–504.CrossRef Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry J Ment Sci. 2002;181:499–504.CrossRef
38.
go back to reference Patel V, Kirkwood BR, Pednekar S, Weiss H, Mabey D. Risk factors for common mental disorders in women. Population-based longitudinal study. Br J Psychiatry J Ment Sci. 2006;189:547–55.CrossRef Patel V, Kirkwood BR, Pednekar S, Weiss H, Mabey D. Risk factors for common mental disorders in women. Population-based longitudinal study. Br J Psychiatry J Ment Sci. 2006;189:547–55.CrossRef
39.
go back to reference Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Krishnan KR, Nemeroff CB, Bremner JD, Carney RM, Coyne JC, et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;58(3):175–89.CrossRefPubMed Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Krishnan KR, Nemeroff CB, Bremner JD, Carney RM, Coyne JC, et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;58(3):175–89.CrossRefPubMed
Metadata
Title
The relationship between under-five child death and maternal mental distress in Gamo Gofa Zone, Southern Ethiopia: a community based comparative cross-sectional study
Authors
Girma Temam Shifa
Ahmed Ali Ahmed
Alemayehu Worku Yalew
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0537-9

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue