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

Journal article


Sah, L., Hatzidimitriadou, E., Wier, J. and Sah, R. 2024. Social determinants of the mental health of pregnant women in Nepal: Stakeholder perspectives. PLoS ONE. 19 (12), p. e0314736. https://doi.org/10.1371/journal.pone.0314736
AuthorsSah, L., Hatzidimitriadou, E., Wier, J. and Sah, R.
Abstract

Introduction
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.

Methods
This paper utilises eight stakeholder perspectives collected through open-ended in-depth interviews. All the interviews were analysed thematically using an inductive approach.

Results
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.

Conclusion
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.

KeywordsPregnant women; Nepal; Mental health; Social determinants
Year2024
JournalPLoS ONE
Journal citation19 (12), p. e0314736
PublisherPLoS
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0314736
Official URLhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0314736
Publication dates
Online03 Dec 2024
Publication process dates
Accepted14 Nov 2024
Deposited05 Dec 2024
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Open
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Cakir, S. and Hatzidimitriadou, E. 2012. Coping strategies of Turkish migrant women in the UK.
Continuing to care: the needs and roles of older carers of people with dementia
Milne, A., Hatzidimitriadou, E. and Chryssanthopoulou, C. 2005. Continuing to care: the needs and roles of older carers of people with dementia.
Forgone healthcare and intimate partner violence: a study in six European urban centres
Costa, D., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., Soares, J., Sundin, O., Toth, O. and Barros, H. 2014. Forgone healthcare and intimate partner violence: a study in six European urban centres.
Evaluation of the sleep project for unaccompanied asylum-seeking children in Kent
Carr, H., Hatzidimitriadou, E. and Sango, P. 2017. Evaluation of the sleep project for unaccompanied asylum-seeking children in Kent. Canterbury Canterbury Christ Church University.
Positive sexual health: an ethnographic exploration of social and cultural factors affecting sexual lifestyles and relationships of Nepalese young people in the UK
Sah, R. 2017. Positive sexual health: an ethnographic exploration of social and cultural factors affecting sexual lifestyles and relationships of Nepalese young people in the UK. PhD Thesis Canterbury Christ Church University Faculty of Health and Wellbeing
A qualitative analysis of migrant social workers’ work experiences and perceived prejudice from an empowering acculturative integration approach
Hatzidimitriadou, E. and Psoinos, M. 2017. A qualitative analysis of migrant social workers’ work experiences and perceived prejudice from an empowering acculturative integration approach. European Journal of Social Work. https://doi.org/10.1080/13691457.2017.1366299
Protecting the public: the current regulation of midwifery
Wier, J. 2015. Protecting the public: the current regulation of midwifery.
Protecting the public: the current regulation of midwifery
Wier, J. 2015. Protecting the public: the current regulation of midwifery.
Parental attitudes and beliefs towards childhood immunisations: exploring parental attitudes and beliefs which influence their decision-making towards childhood immunisations in UK
Sah, R. 2011. Parental attitudes and beliefs towards childhood immunisations: exploring parental attitudes and beliefs which influence their decision-making towards childhood immunisations in UK. VDM Verlag Dr. Müller.
Health and wellbeing of the Nepalese population: access and experiences of health and social care services in the UK
Simkhada, B., Sah, R., Mercel-Sanca, A., Teijlingen, E., Devkota, B. and Bhurtyal, Y. 2015. Health and wellbeing of the Nepalese population: access and experiences of health and social care services in the UK. UK
Post-migration wellbeing, community activism and empowerment: the case of Turkish-speaking women in London
Hatzidimitriadou, E. and Cakir, S. 2013. Post-migration wellbeing, community activism and empowerment: the case of Turkish-speaking women in London. in: Gideon, J. and Thomas, F. (ed.) Migration, Health and Inequality London Zed Books. pp. 180-197
Managing equality and diversity in health care: the case of ethnic monitoring at St George's NHS Trust
Butler, C., Hatzidimitriadou, E. and Psoinos, M. 2010. Managing equality and diversity in health care: the case of ethnic monitoring at St George's NHS Trust.
Socioeconomic inequalities in victims of intimate partner violence in Europe
Costa, D., Soares, J., Lindert, J., Hatzidimitriadou, E., Sundin, O., Toth, O., Ioannidi-Kapolou, E., Degomme, O., Cervilla, J. and Barros, H. 2013. Socioeconomic inequalities in victims of intimate partner violence in Europe. European Journal of Public Health. 23 (1), p. 120. https://doi.org/10.1093/eurpub/ckt126.296
Continuing carers: developing a conceptual framework to explore their status & identity
Milne, A. and Hatzidimitriadou, E. 2014. Continuing carers: developing a conceptual framework to explore their status & identity.
‘Care for me at home’ A qualitative exploration of experiences of people receiving domiciliary (home) care in the London Borough of Bexley.
Palmer, D., Williams, L., Hatzidimitriadou, E., Hossain, R., Ball, C., Rigby, N., Hackett, L. and Hinds-Murray, A. 2015. ‘Care for me at home’ A qualitative exploration of experiences of people receiving domiciliary (home) care in the London Borough of Bexley. Bexley London Borough of Bexley.
Cultural capital and professional development experiences of migrant health and social care professionals
Hatzidimitriadou, E. and Psoinos, M. 2010. Cultural capital and professional development experiences of migrant health and social care professionals.
Review of domestic violence policies in England & Wales
Matczak, A., Hatzidimitriadou, E. and Lindsay, J. 2011. Review of domestic violence policies in England & Wales. London, U.K. Kingston University and St George's, University of London.
An exploration of cultural capital, labour market position and work experiences of migrant and refugee doctors in the UK
Hatzidimitriadou, E. and Psoinos, M. 2011. An exploration of cultural capital, labour market position and work experiences of migrant and refugee doctors in the UK.
Ethnic monitoring in healthcare services in the UK as a mechanism to address health disparities: a narrative review
Psoinos, M., Hatzidimitriadou, E., Butler, C. and Barn, R. 2011. Ethnic monitoring in healthcare services in the UK as a mechanism to address health disparities: a narrative review. London Swan IPI.
Informing the development of cultural and ethical competence in social work education
Gupta, A., Fook, J., Bhatti-Sinclair, K., Hatzidimitriadou, E. and Lee, Y. 2011. Informing the development of cultural and ethical competence in social work education. London, U.K. Social Policy and Social Work Subject Centre (SWAP).
Exploring how to optimise the professional contribution and enhance the psychosocial well-being of migrant and refugee healthcare professionals in the UK
Hatzidimitriadou, E. and Psoinos, M. 2012. Exploring how to optimise the professional contribution and enhance the psychosocial well-being of migrant and refugee healthcare professionals in the UK.
Transferability of locally collected research results: employing theoretical triangulation in a study on migrant social workers in the UK
Hatzidimitriadou, E. and Psoinos, M. 2012. Transferability of locally collected research results: employing theoretical triangulation in a study on migrant social workers in the UK.
Evidence of a gender effect in the impact of Intimate Partner Violence victimisation on health-related quality of life
Costa, D., Soares, J., Lindert, J., Hatzidimitriadou, E., Sundin, O., Toth, O., Ioannidi-Kapolou, E., Degomme, O., Cervilla, J. and Barros, H. 2012. Evidence of a gender effect in the impact of Intimate Partner Violence victimisation on health-related quality of life.
Evaluation of the totally touchable arts intervention project for sight impaired adults
Manship, S. and Hatzidimitriadou, E. 2015. Evaluation of the totally touchable arts intervention project for sight impaired adults. Canterbury Christ Church University.
Cultural capital during migration: findings from narrative interviews with academically and vocationally skilled adults with immigrant background in the UK - final report
Hatzidimitriadou, E. 2008. Cultural capital during migration: findings from narrative interviews with academically and vocationally skilled adults with immigrant background in the UK - final report. Canterbury European Centre for the Study of Migration and Social Care, University of Kent.
Cultural capital of second generation migrant women in the UK: reconstructing gendered experiences through biographical narratives
Hatzidimitriadou, E. 2008. Cultural capital of second generation migrant women in the UK: reconstructing gendered experiences through biographical narratives.
Domestic violence in Europe: study on determinants and characteristics of domestic violence in England
Lindsay, J. and Hatzidimitriadou, E. 2012. Domestic violence in Europe: study on determinants and characteristics of domestic violence in England.
Male and female physical intimate partner violence and socioeconomic position: a cross-sectional international multicentre study in Europe
Costa, D., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., Soares, J., Sundin, O., Toth, O. and Barros, H. 2016. Male and female physical intimate partner violence and socioeconomic position: a cross-sectional international multicentre study in Europe. Public Health. 139, pp. 44-52. https://doi.org/10.1016/j.puhe.2016.05.001
A qualitative evaluation of psychosocial outcomes of the Creative Communications pilot project for people with dementia
Manship, S. and Hatzidimitriadou, E. 2015. A qualitative evaluation of psychosocial outcomes of the Creative Communications pilot project for people with dementia.
Editorial: User involvement and empowerment in health care practices with ethnic minority and migrant groups: a community approach
Garcia-Ramirez, M. and Hatzidimitriadou, E. 2009. Editorial: User involvement and empowerment in health care practices with ethnic minority and migrant groups: a community approach. International Journal of Migration, Health and Social Care. 5 (1), pp. 2-4. https://doi.org/10.1108/17479894200900001
'No one knows like we do' - the narratives of mental health service users trained as researchers
Palmer, D., Williams, L., White, S., Chenga, C., Calabria, V., Branch, D., Arundal, S., Storer, L., Ash, C., Cuthill, C., Bezuayehu, H. and Hatzidimitriadou, E. 2009. 'No one knows like we do' - the narratives of mental health service users trained as researchers. Journal of Public Mental Health. 8 (4), pp. 18-28. https://doi.org/10.1108/17465729200900024
Sozialraumliche Koordinaten beruflicher Orientierung. Hochqualifizierte der zweiten Generation in Deutschland und Grossbritannien
Schittenhelm, K. and Hatzidimitriadou, E. 2010. Sozialraumliche Koordinaten beruflicher Orientierung. Hochqualifizierte der zweiten Generation in Deutschland und Grossbritannien. in: Nohl, A., Schittenhelm, K., Schmidtke, O. and Weiss, A. (ed.) Kulturelles Kapital in der Migration: Hochqualifizierte Einwanderer und Einwanderinnen auf dem Arbeitsmarkt Wiesbaden, Germany VS Verlag. pp. 301-314
"Isn't he wonderful?" Exploring the contribution and conceptualization of older husbands as carers
Milne, A. and Hatzidimitriadou, E. 2003. "Isn't he wonderful?" Exploring the contribution and conceptualization of older husbands as carers. Ageing International. 28 (4), pp. 389-407. https://doi.org/10.1007/s12126-003-1011-y
Carers of older relatives in long term care: support needs and services
Milne, A., Hatzidimitriadou, E. and Chryssanthopoulou, C. 2004. Carers of older relatives in long term care: support needs and services. Generations Review. 14 (3), pp. 4-9.
Carers of older relatives in long term care: support needs and services
Milne, A., Hatzidimitriadou, E. and Chryssanthopoulou, C. 2004. Carers of older relatives in long term care: support needs and services. Generations Review.
Planning ahead: meeting the needs of older people with intellectual disabilities in the United Kingdom
Hatzidimitriadou, E. and Milne, A. 2005. Planning ahead: meeting the needs of older people with intellectual disabilities in the United Kingdom. Dementia: The International Journal for Social Research and Practice. 4 (3), pp. 341-359. https://doi.org/10.1177/1471301205055027
GP attitudes to early diagnosis of dementia: evidence of improvement
Hatzidimitriadou, E., Milne, A. and Hamilton-West, K. 2005. GP attitudes to early diagnosis of dementia: evidence of improvement. Aging & Mental Health. 9 (5), pp. 449-455. https://doi.org/10.1080/13607860500142762
Providing care for older people with learning disabilities
Hatzidimitriadou, E. and Milne, A. 2006. Providing care for older people with learning disabilities. in: Carnaby, S. (ed.) Intimate and Personal Care for People with Learning Disabilties London Jessica Kingsley. pp. 160-180
Learning in the real world? Exploring widening participation student views concerning the 'fit' between knowledge learnt and work practices
Forrester-Jones, R. and Hatzidimitriadou, E. 2007. Learning in the real world? Exploring widening participation student views concerning the 'fit' between knowledge learnt and work practices. Assessment & Evaluation in Higher Education. 31 (6), pp. 611-624. https://doi.org/10.1080/02602930600760181
Migrant women and welfare issues: diversity of experiences, challenges and opportunities
Hatzidimitriadou, E. 2007. Migrant women and welfare issues: diversity of experiences, challenges and opportunities. International Journal of Migration, Health and Social Care. 3 (3), pp. 2-5. https://doi.org/10.1108/17479894200700014
Community activism and empowerment of Turkish-speaking migrant women in London
Hatzidimitriadou, E. and Cakir, S. 2009. Community activism and empowerment of Turkish-speaking migrant women in London. International Journal of Migration, Health and Social Care. 5 (1), pp. 34-46. https://doi.org/10.1108/17479894200900005
Migration and ageing: settlement experiences and emerging care needs of older refugees in developed countries
Hatzidimitriadou, E. 2010. Migration and ageing: settlement experiences and emerging care needs of older refugees in developed countries. Hellenic Journal of Psychology. 7 (1), pp. 1-20.
Intimate partner violence in Europe: design and methods of a multinational study
Costa, D., Soares, J., Lindert, J., Hatzidimitriadou, E., Karlsson, A., Sundin, O., Toth, O., Ioannidi-Kapolou, E., Degomme, O., Cervilla, J. and Barros, H. 2013. Intimate partner violence in Europe: design and methods of a multinational study. Gaceta Sanitaria. 27 (6), pp. 558-561. https://doi.org/10.1016/j.gaceta.2013.03.001
From the asylum to the community: a longitudinal study of staff involved in the transition from Tone Vale Hospital to community-based services
Carpenter, J., Ring, C., Sangster, A., Cambridge, P. and Hatzidimitriadou, E. 2000. From the asylum to the community: a longitudinal study of staff involved in the transition from Tone Vale Hospital to community-based services. Journal of Mental Health. 9 (2), pp. 211-230. https://doi.org/10.1080/09638230050009203
Early diagnosis of dementia by GPs: an exploratory study of attitudes
Milne, A., Woolford, H., Mason, J. and Hatzidimitriadou, E. 2000. Early diagnosis of dementia by GPs: an exploratory study of attitudes. Aging & Mental Health. 4 (4), pp. 292-300. https://doi.org/10.1080/713649958
Caring in later life: reviewing the role of older carers
Milne, A., Hatzidimitriadou, E., Chryssanthopoulou, C. and Owen, T. 2001. Caring in later life: reviewing the role of older carers. London Help the Aged.
Political ideology, helping mechanisms and empowerment of mental health self-help/mutual aid groups
Hatzidimitriadou, E. 2002. Political ideology, helping mechanisms and empowerment of mental health self-help/mutual aid groups. Journal of Community & Applied Social Psychology. 12 (4), pp. 271-285. https://doi.org/10.1002/casp.681
The caring in later life report: a secondary analysis of the 1995 General Household Survey
Milne, A. and Hatzidimitriadou, E. 2002. The caring in later life report: a secondary analysis of the 1995 General Household Survey. Quality in Ageing and Older Adults. 3 (3), pp. 3-15. https://doi.org/10.1108/14717794200200017
Gaining access to and working with self-help groups in mental health
Hatzidimitriadou, E. 2003. Gaining access to and working with self-help groups in mental health. in: Cochrane, S. (ed.) Where You Stand Affects Your Point of View: Emancipatory Approaches to Mental Health Research: Notes from SPN Study Day 12 June 2003 UK Social Perspectives Network.
Intimate partner violence and health-related quality of life in European men and women: findings from the DOVE study
Costa, D., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., Soares, J., Sundin, O., Toth, O. and Barros, H. 2015. Intimate partner violence and health-related quality of life in European men and women: findings from the DOVE study. Quality of Life Research. 24 (2), pp. 463-471.
Current perceptions of statutory supervision of midwifery: time for change
Wier, J. 2015. Current perceptions of statutory supervision of midwifery: time for change. British Journal of Midwifery. 23 (4), pp. 288-295. https://doi.org/10.12968/bjom.2015.23.4.288
Physical intimate partner violence in Europe: results from a population-based multi-center study in six countries
Costa, D., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., Soares, J., Sundin, O., Toth, O. and Barros, H. 2015. Physical intimate partner violence in Europe: results from a population-based multi-center study in six countries. International Journal of Epidemiology. 44 (S1), p. 264. https://doi.org/10.1093/ije/dyv096.500
"Tangled wires in the head": older migrant Chinese's perception of mental illness in Britain
Li, S., Hatzidimitriadou, E. and Psoinos, M. 2014. "Tangled wires in the head": older migrant Chinese's perception of mental illness in Britain. Journal of Aging Studies. 30 (1), pp. 73-86. https://doi.org/10.1016/j.jaging.2014.04.001
Cultural health capital and professional experiences of overseas doctors and nurses in the UK
Hatzidimitriadou, E. and Psoinos, M. 2014. Cultural health capital and professional experiences of overseas doctors and nurses in the UK. Diversity and Equality in Health and Care. 11 (1), pp. 35-47.
Evaluation of co-production processes in a community-based mental health project in Wandsworth
Hatzidimitriadou, E., Mantovani, N. and Keating, F. 2012. Evaluation of co-production processes in a community-based mental health project in Wandsworth. Kingston upon Thames Kingston University and St George's, University of London.
Ageing in the English countryside: is it good for your health?
Milne, A., Hatzidimitriadou, E. and Wiseman, J. 2004. Ageing in the English countryside: is it good for your health?
Health and quality of life among older people in rural England: exploring the impact and efficacy of policy
Milne, A., Hatzidimitriadou, E. and Wiseman, J. 2007. Health and quality of life among older people in rural England: exploring the impact and efficacy of policy. Journal of Social Policy. 36 (3), pp. 477-495. https://doi.org/10.1017/S0047279407001055
Informed consent and the birth plan
Wier, J. 2008. Informed consent and the birth plan. The Practising Midwife. 11 (7), pp. 17-18.