Enhancing Access to Mental Health Services for Antepartum and Postpartum Women Through Telemental Health Services at Wellbeing Centers in Selected Health Facilities in Bangladesh: Implementation Research

• DOI: 10.2196/65912
• Publication Date: 2024-10-26T10:55:17Z
• Authors: Aniqa Tasnim Hossain; Md Hafizur Rahman; Ridwana Maher Manna; Ema Akter; SM Hasibul Islam; Md Alamgir Hossain; Tasnu Ara; Nasimul Ghani Usmani; Pradip Chandra; Maruf Ahmed Khan; SM Mustafizur Rahman; Helal Uddin Ahmed; Muhammad Kamruzza...; Jesmin Mahmuda Juthi; Fatema Shahrin; Sadia Afrose Shams; Fahmida Afroze; Mukta Jahan Banu; Shafiqul Ameen; Sabrina Jabeen; Anisuddin Ahmed; Mohammad Robed Amin; Shams El Arifeen; Mohammad Sohel Sh...; Ahmed Ehsanur Rahman
• Keywords: Preprint

Background Globally, 10% of pregnant women and 13% postpartum experience mental disorders. In Bangladesh, nearly 50% mothers face common disorders, but health services trained professionals to serve their needs are scarce. To address this, the government Bangladesh’s Non-Communicable Disease Control program initiated “Wellbeing Centers,” telemental in selected public hospitals. Objective This study examines implementation outcomes, including adoption, accessibility, acceptability, feasibility, usefulness, need, experience, perception, expectations Wellbeing Centers, with a focus on antepartum women. Methods Between January 2023 August 2024, we interviewed 911 receiving 168 care providers at 6 Centers 4 districts Bangladesh. Data collection involved both quantitative qualitative methods. Implementation outcomes were measured following World Health Organization’s research framework. Depression anxiety symptoms assessed using Patient Questionnaire-9 Generalized Anxiety Disorder-7 questionnaires. Descriptive statistics adjusted odds ratios (aORs) 95% CIs used evaluate outcomes. Qualitative information was obtained through in-depth interviews key-informant interviews. Results Almost all (165/168, 98.2%) reported that feasible implement facilities; however, about half (84/168, 50%) felt staff operate them insufficient. agreed acceptable (906/911, 99.8%), useful (909/911, enhanced access 99.5%). Patients visiting district-level hospitals had higher (aOR 1.5, CI 1.1-2.0) Centers. Moreover, 77.4% (705/911) experienced depression symptoms, 76.7% (699/911) symptoms. About 51.8% (472/911) tiredness or lack energy, 50.9% (464/911) nervous, anxious, edge, 57.2% (521/911) worried, 3.8% (35/911) suicidal ideation almost every day. district 2.6, 1.8-3.78) compared patients subdistrict-level Decreasing trends scores (from mean 14.4, SD 0.47 12.9, 0.47) 13.3, 0.49 12.5, 0.48) between 2 counseling sessions indicated improved The Centers’ appreciated for privacy being free accessible. However, stigma, illness, long waiting times prevented some from these services. Conclusions our knowledge, this is first assessing facilities involving psychologists psychiatrists. Our highlighted increased utility supporting scale-up similar settings.