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Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Research

Psychosocial challenges and individual strategies for coping with mental stress among pregnant and postpartum adolescents in Nairobi informal settlements: a qualitative investigation

Authors: Caroline W. Wainaina, Estelle Monique Sidze, Beatrice W. Maina, Icoquih Badillo-Amberg, Hazel Odhiambo Anyango, Faith Kathoka, Dorcas Khasowa, Collins E. M. Okoror

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

This study was part of a project funded under the Grand Challenges Explorations initiative to engage adolescent girls living in the main slums of Nairobi. This involved an innovative co-creation initiative through jointly designing and testing the feasibility of a toolkit of information, skill, and confidence-building, and coping mechanisms that can effectively shield them and their peers against the risks of mental stress during pregnancy and early motherhood.

Methods

Qualitative interviews and discussions from visual methodologies including Photovoice, digital storytelling, and public service announcements were conducted with 30 pregnant and adolescent mothers aged 14–19 years in four informal settlements either pregnant or having a child less than 2 years. The aims included; to generate an inventory of mental stressors during pregnancy and early motherhood; understand how mental stress affects the ability to seek care for themselves and their child, and understand individual coping strategies.

Results

The psychosocial challenges identified in order of importance included: chased from home by the parents; economic hardship; neglect and abandonment by the person responsible for the pregnancy; stigmatization by family, friends, and the community; feelings of shattered dreams; and daily stress related to living in poor and unhygienic conditions. During the pregnancy and early motherhood, the participants experienced feelings of embarrassment, shame, hopelessness, and to the extreme, suicidal thoughts clouded their minds. Main coping strategies included social isolation for some, socializing with other pregnant and adolescent mothers, and negative behaviors like the uptake of illicit drugs and alcohol and risky sexual relationships.

Conclusion

The unpreparedness for early motherhood infused with inadequate psychosocial support led to increased mental stress and risk of depression. The interconnection between the triggers to mental stress showed the need to focus on a multifaceted approach to address the wellbeing of pregnant and adolescent mothers.
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Literature
1.
go back to reference Department of Economic and Social Affairs. World population prospects, vol. 141; 2019. p. 2019. Department of Economic and Social Affairs. World population prospects, vol. 141; 2019. p. 2019.
3.
go back to reference UN-Habitat, Enhancing Urban Safety and Security : Global Report on Human Settlements, no. 2006. 2007. UN-Habitat, Enhancing Urban Safety and Security : Global Report on Human Settlements, no. 2006. 2007.
6.
go back to reference APHRC, “NUHDSS indicators 2003–2012. Nairobi: African Population & Health Research Centre (APHRC).,” 2012. APHRC, “NUHDSS indicators 2003–2012. Nairobi: African Population & Health Research Centre (APHRC).,” 2012.
8.
go back to reference African Population and Health Research Center (APHRC). Population and Health Dynamics in Nairobi’s Informal Settlements: Report of the Nairobi Cross-Sectional Slums Survey (NCSS) 2012. Nairobi: APHRC; 2014. p. 1–185. African Population and Health Research Center (APHRC). Population and Health Dynamics in Nairobi’s Informal Settlements: Report of the Nairobi Cross-Sectional Slums Survey (NCSS) 2012. Nairobi: APHRC; 2014. p. 1–185.
14.
go back to reference Beguy D, Mumah J, Wawire S, Muindi K, Gottschalk L, Kabiru CW. Status report on the sexual and reproductive health of adolescents living in urban slums in Kenya; 2013.CrossRef Beguy D, Mumah J, Wawire S, Muindi K, Gottschalk L, Kabiru CW. Status report on the sexual and reproductive health of adolescents living in urban slums in Kenya; 2013.CrossRef
16.
go back to reference Jenkins R, Kiima D, Okonji M, Njenga F, Kingora J, Lock S. Integration of mental health into primary care and community health working in Kenya: context, rationale, coverage, and sustainability. Ment Health Fam Med. 2010;7(1):37–47.PubMedPubMedCentral Jenkins R, Kiima D, Okonji M, Njenga F, Kingora J, Lock S. Integration of mental health into primary care and community health working in Kenya: context, rationale, coverage, and sustainability. Ment Health Fam Med. 2010;7(1):37–47.PubMedPubMedCentral
18.
go back to reference World Health Organization, “The WHO Mental Atlas 2011,” 2011. World Health Organization, “The WHO Mental Atlas 2011,” 2011.
19.
go back to reference 2017 WHO, “World Health Organization,” Who, pp. 1–10, 2017. 2017 WHO, “World Health Organization,” Who, pp. 1–10, 2017.
22.
24.
go back to reference Wang CC. 1999_Wang_Women_Health_Photovoice.Pdf. J Women's Health. 1999;8(2):185–92.CrossRef Wang CC. 1999_Wang_Women_Health_Photovoice.Pdf. J Women's Health. 1999;8(2):185–92.CrossRef
25.
go back to reference Lambert J. The digital storytelling cookbook; 2010. Lambert J. The digital storytelling cookbook; 2010.
27.
go back to reference Rachier A. Understanding the ethical and legal framework in Kenya; 2016. Rachier A. Understanding the ethical and legal framework in Kenya; 2016.
31.
go back to reference C. W, Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet. 2016;389(10068):547–58. C. W, Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet. 2016;389(10068):547–58.
32.
go back to reference UNFPA, “Motherhood in childhood: facing the challenge of adolescent pregnancy,” 2013. UNFPA, “Motherhood in childhood: facing the challenge of adolescent pregnancy,” 2013.
Metadata
Title
Psychosocial challenges and individual strategies for coping with mental stress among pregnant and postpartum adolescents in Nairobi informal settlements: a qualitative investigation
Authors
Caroline W. Wainaina
Estelle Monique Sidze
Beatrice W. Maina
Icoquih Badillo-Amberg
Hazel Odhiambo Anyango
Faith Kathoka
Dorcas Khasowa
Collins E. M. Okoror
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04128-2

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