Social determinants of the mental health of pregnant women in Nepal: Stakeholder perspectives

• Published in: PloS one 2024-12, Vol.19 (12), p.e0314736
• Main Authors: Sah, Lalita Kumari, Hatzidimitriadou, Eleni, Wier, Jacqueline, Sah, Rajeeb Kumar
• Format: Article
• Language: English
• Subjects: Accessibility; Adult; Availability; Babies; Bilingualism; Care and treatment; Community; Context; Data analysis; Data collection; Developing countries; Ethics; Female; Gender; Health; Health aspects; Health services; Health Services Accessibility; Humans; Interviews; LDCs; Maternal Health Services; Maternity & paternity leaves; Medicine and Health Sciences; Mental disorders; Mental Health; Nepal - epidemiology; Newborn babies; People and Places; Policies; Pregnancy; Pregnant women; Pregnant Women - psychology; Psychological aspects; Public health; Reproductive health; Risk; Social aspects; Social Determinants of Health; Social interactions; Social Sciences; Social Support; Socioeconomic Factors; Socioeconomics; Stakeholders; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0314736

Women during pregnancy are at a greater risk of experiencing poor mental health, which is one of the major global public health issues, and more so in many developing countries like Nepal, but limited evidence of research on this topic is evident. In this paper, we are focused on exploring the social determinants of the mental health of pregnant women in Nepal from the stakeholder perspectives. This paper utilises eight stakeholder perspectives collected through open-ended in-depth interviews. All the interviews were analysed thematically using an inductive approach. This paper presents three major findings: Inadequate social support, Limited availability and accessibility of maternal health services, and Restricted socioeconomic and cultural context. The inadequate social support from family/relatives, neighbours, community and national policies such as maternity leave, alongside the absence of NGOs/INGOs support, put women at risk of poor mental health. In addition to the inadequate support, limited availability and accessibility of maternal health services potentially cause immense distress among pregnant women. Furthermore, in the context of a patriarchal society, the impact of socioeconomic and cultural context on pregnant women's mental health is also presented as a major determinant of poor mental health among pregnant women. Based on the findings, we conclude that pregnant women are at risk of poor mental health experiences in Nepal and recommend that promoting mental health among pregnant women needs a multifaceted approach that should be considered in all the policies and practices involved in promoting the mental health of pregnant women.