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. 2018 Feb 27;18(1):44.
doi: 10.1186/s12905-018-0537-9.

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

Girma Temam Shifa  1 , Ahmed Ali Ahmed  2 , Alemayehu Worku Yalew  2
Affiliations

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

Girma Temam Shifa et al. BMC Womens Health. .

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.

Keywords: Child loss; Child mortality; Common mental disorder; Ethiopia; Gamo Gofa; Maternal mental distress; Mental distress.

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Conflict of interest statement

Ethics approval and consent to participate

The study obtained ethical clearance and approval from the Institutional Review Board (IRB) of the College of Health Sciences at Addis Ababa University. Letters were written to the Gamo Gofa Zone Health Department, Woreda Health Offices of Arba Minch Zuria and Arba Minch Town and to administrator of each kebele and we secured permissions at all levels. After explaining about the purpose of the study, confidentiality of the data and voluntariness of participation, verbal informed consent was obtained from each respondent. In case of minors (under 16), verbal consent was also obtained from their legal guardians (parents/partners). A trained interviewer sat down with each respondent/guardian who was willing and available to participate and went over the consent form in a private space. The interviewer answered any questions the respondent might have and secured his/her consent. We sought and secured a waiver of written consent from the IRB, since this might be the only form of identifier. The main risk to participants might be breach of confidentiality. We assured the confidentiality of the information through anonymous interviews and securing the collected data in a locked cabinet. Besides, we only reported aggregated data so that no information could be linked to individuals.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Proportion of mothers who had mental distress, by time since child death, Gamo Gofa Zone, Ethiopia, 2014
Fig. 2
Fig. 2
Proportion of mothers who had mental distress, by age of the child at death, Gamo Gofa Zone, Ethiopia, 2014
See this image and copyright information in PMC

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