The Overview
Nearly 1 billion people globally live with some form of mental illness, with estimated 90% requiring mental health treatment not receiving it. Uganda is one of the low-income countries discriminately and disproportionately affected with all form of mental illness. Women bear a particular burden, especially during the perinatal period. Majority of women experienced prenatal and postpartum depression, anxiety, and somatic disorders, contributing to most of the complications during pregnancy and childbirth. Hence, the critical need to address women mental health (WMH) and physical outcomes for women during pregnancy, childbirth, and the postpartum period, and in light of the increasing maternal mortalities in poverty affected communities.
Challenges
In Uganda, about 1 in 5 pregnant women experience a common mental disorder attributed to several factors including decade long scars from the civil wars, limited educational opportunities, stigma associated with unmarried status, gender-based Violence and poverty. Years of violence and armed conflict in northern Uganda have left thousands battling depression, anxiety and other serious conditions with women of child bearing and young people mostly affected. Yet, especially in rural communities where few services exist and mental health is regularly attached to stigma, most suffer in silence. Uganda is among the Low-income countries with high maternal mortality rate with an estimated 365 women dying for every 100,000 live births yearly. Unfortunately, women at underserved setting, have little say in determining family size and child spacing. The impact of the mental health treatment gap is all too evident. More specifically, lack of integrated care couple with severe shortage of mental health specialists, many women do not receive the care they require.
Approach
Advocacy for Action
PISCA Uganda advocates for action towards maternal mental health care for all mothers. Our advocacy efforts aim to address the significant information gap by translating evidence-based research, disseminating our findings to a wide range of stakeholders and engaging with local and international change agents. We aim to support and inform the design of health policies, guidelines and programmes by working with policy makers, governmental agencies and global networks. PICSA Uganda aim to lead and participate in strategic advocacy campaigns and to use social and traditional media to inform and empower vulnerable women to demand and take up mental health services.
Systems Strengthening
PICSA Uganda strengthens systems for integration of maternal mental health services at scale. We aim to strengthen systems in the health and social development sectors so that integrated maternal mental health services may be provided at scale. Our objectives are to demonstrate good practice through the provision of a comprehensive service model and to develop resources and guidelines to support systems strengthening. We engage with a wide range of service providers in other settings to promote our aim.
Our Women Mental Health model is based on a stepped care approach, which means that referrals are made to psychiatric services when necessary. We build partnerships with public services and civil society to promote outreach and sustainability of service delivery. Since inception, the Women Mental Health has provided the following service to pregnant and postnatal women.
Knowledge Generation
The Women Mental Health generates knowledge to strengthen maternal mental health systems in underserved and rural settings. The aim of the Knowledge Generation focus area is to conduct research or collaborate with others’ research to address critical information gaps and real-world service problems. We aim to translate research findings for a range of audiences and to disseminate this knowledge effectively. Our research work significantly informs, and is informed by, the other focus areas of our work.
Capacity Building
We build a critical mass of service providers capable of detecting and providing basic mental health support for mothers. We provide training in the public health and social development sectors as well as through academic institutions. We aim to empower, affirm and sustain providers, shift negative attitudes, reduce stigma and client abuse.
Our experiential approach enables us to prepare all cadres of service providers to integrate maternal mental health into their routine practice. We develop innovative, relevant and practical mental health training modules and multi-media resources for use in rural contexts.
Promoting maternal mental health has benefits across several sectors
Mental ill-health can compromise parental functioning and care-giving capacity which is central to child development. The ‘1000-day’ window from conception to two-years is a particularly sensitive period in child development and maternal mental health interventions are protective, preventative and promotive of optimal infant, child and maternal health outcomes. Mental wellness in the primary caregiver is associated with better development in children, as well as better nutrition. Under-nutrition is the single most deleterious determinant of poor child development, a factor also strongly linked to children diminished mental health. A mother with positive self-esteem and an ability to work towards a better future will better be able to negotiate the hardships in her life, care for herself and optimally nurture the development of her children.
Addressing HIV/AIDS
When women are listened to and validated in a safe and therapeutic environment, they begin to restore their self-esteem and locus of control. Women may be empowered to identify what actions they can realistically take to change their circumstances. We Prevent default and improves adherence to ARV (and TB) treatment regimens, Immune status improves when depression and anxiety is managed, promotes optimal PMTCT outcomes and Addressing gender-based violence
Impact To Date
OUR PARTNERS
Interested in partnering on our work in Uganda?
