Investigating Incidence and Association between Poverty and Maternal Common Mental Disorders, In a Populationbased Cohort of Pregnant Women, Cmamie Study, Butajira, Ethiopia: Retrospective Cohort Study
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Date
2014-06
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Addis Ababa University
Abstract
Background
Maternal Common Mental Disorders (CMD), including depression and anxiety, are recogniz ed
to have important public health consequences in lowand
middleincome
countries (LMICs). In
Ethiopia, maternal CMDs have been associated with increased infant diarrhea, impaired child
development and increased child mortality. Crosssectional
studies show associations between
poverty and maternal CMD in LMICs, but the temporal relationship is unclear.
Objectives: the aim of this study was to investigate the association between poverty and
maternal CMD, to assess incidence of poverty and maternal CMD.
Methods: a retrospective cohort study design was conducted. The CMaMiE
study recruited
pregnant women (aged 15 – 49 years). CMD has been measured using WHO’s SelfReporting
Q uestionnaire. Poverty was constructed using Mokken scaling procedure during pregnancy and
having two or more subjective poverty report at the follow up time. Poisson and binary logistic
regression analyses were performed.
Results: Incidence rates of poverty and CMD were 7 3 .3 9 (9 5 % CI: 5 1 .9 0 1
0 3 .7 9 ) and 3 5 .3 8
(9 5 % CI: 2 9 .1 1 4
2 .9 9 ) per 1 0 0 0 personyears
of observation respectively. However, this was
not statistically significant. This study revealed that there was no statistically significant (OR:
1.15, 95% CI: 0.68 – 1.95) effect of maternal CMD upon poverty but it was found effect of
poverty upon CMD (OR: 1.53, 95%CI: 1.02 – 2.31) . Husbands’ primary education school (OR:
0.64, 95% CI: 0.44 0.94)
and seconda ry and above (OR: 0.31 95% CI: 0.15 0.64)
and poor
social support (OR: 1.70, 95% CI: 1.06 2.75
) were predicators of poverty. Polygamous
marriage (OR: 0 .5 4 , 9 5 % CI: 0 .3 2 – 0 .9 2 ), age group of 2 4 – 3 4 years (OR: 1 .6 9 , 9 5 % CI: 1 .1 1 –
2 .5 7 ), and maternal health problem (OR: 2 .1 6 , 9 5 % CI: 1 .4 0 – 3 .3 3 ) were predicators of CMD.
Conclusion and Recommendations: there was no significant effect of CMD upon poverty. On
the other way round, there was statistically significant effect of poverty on CMD. Husbands’
educational level and poor social support were predicators of poverty. Polygamous marriage, age
and physicalill
health were predicators of CMD. The relationship among maternal mental
health, physicalill
health and poverty could be addressed, this linkage should be brought to the
attention of policy makers in the rural settings and further research is required to investigate
maternal CMD leads to poverty causality using standardiz ed and valid poverty measure
Description
Keywords
Maternal Common Mental Disorders (CMD)