Optimizing Postpartum Depression Prevention in Primary Health Care Services
DOI:
https://doi.org/10.26630/jk.v15i2.4580Keywords:
Health services; Literature review; Public health issue.Abstract
Post-partum depression (PPD) is a post-natal disorder that not only impacts the mental health of the mother but also has long-term effects on the development and well-being of the child and family. PPD is a preventable disorder, starting from interventions at primary health care facilities. As one of the developing countries with a PPD incidence of 22% per 100,000 births, PPD is considered an urgent public health issue in Indonesia. In practice, evaluation, and improvement of services at primary health care facilities are needed. This study aims to identify and adapt international intervention strategies to reduce post-partum depression prevalence in Indonesian primary health care. A scoping review analysis method was used, involving previous studies on activities from pregnancy to post-partum that can prevent and reduce post-partum depression. The reviewed articles employed Randomized Controlled Trials or Randomized Clinical Trials (RCT) methods with specific inclusion and exclusion criteria. Data were collected from relevant sources, and a synthesis was conducted on 16 articles that met the inclusion criteria. The results show that direct psychological support activities (through health professionals or groups) and indirect support using digital platforms and applications are effective in reducing depression. Strategies such as digital technology, direct support programs, physical therapy, pharmacological therapy, community involvement, and strengthening health services, particularly post-partum psychological counseling, are recommended to enhance prevention. This research supports the expansion of evidence-based strategies that can be implemented in primary healthcare facilities to address post-partum depression.
References
Adli, F. K. (2022). Edinburgh Post-natal Depression Scale (EPDS): Deteksi Dini dan Skrining Depresi Post-partum. Jurnal Kesehatan, 13(2), 430. https://doi.org/10.26630/jk.v13i2.2741
Arakawa, Y., Haseda, M., Inoue, K., Nishioka, D., Kino, S., Nishi, D., Hashimoto, H., & Kondo, N. (2023). Effectiveness of mHealth consultation services for preventing post-partum depressive symptoms: A randomized clinical trial. BMC Medicine, 21(1), 221. https://doi.org/10.1186/s12916-023-02918-3
Broberg, L., Tabor, A., Rosthøj, S., Backhausen, M., Frokjaer, V. G., Damm, P., & Hegaard, H. K. (2021). Effect of supervised group exercise on psychological well-being among pregnant women with or at high risk of depression (the EWE Study): A randomized controlled trial. Acta Obstetricia Et Gynecologica Scandinavica, 100(1), 129–138. https://doi.org/10.1111/aogs.13982
Carvalho Hilje, C., Bauer, N. H., Reis, D., Kapp, C., Ostermann, T., Vöhler, F., & Längler, A. (2024). The role of breastfeeding and formula feeding regarding depressive symptoms and an impaired mother child bonding. Scientific Reports, 14(1), 11417. https://doi.org/10.1038/s41598-024-62168-y
Chaput, K. H., Freeman, M., McMorris, C., Metcalfe, A., Cameron, E. E., Jung, J., Tough, S., Hicks, L. M., Dimidjian, S., & Tomfohr-Madsen, L. M. (2023). Effect of Remote Peer-Counsellor- delivered Behavioral Activation and Peer-support for Antenatal Depression on Gestational Age at Delivery: A single-blind, randomized control trial. Trials, 24(1), 240. https://doi.org/10.1186/s13063-023-07077-7
Daudt, H. M., Van Mossel, C., & Scott, S. J. (2013). Enhancing the scoping study methodology: A large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Medical Research Methodology, 13(1), 48. https://doi.org/10.1186/1471-2288-13-48
Emalia, F. H., & Nilasari, P. (2021). Pengaruh Electronic Health Terhadap Penurunan Tingkat Depresi Postpartum: Tinjauan Sistematis. Jurnal Ilmu Keperawatan Maternitas, 4(2), 16–29. https://doi.org/10.32584/jikm.v4i2.1271
Felder, J. N., Epel, E. S., Neuhaus, J., Krystal, A. D., & Prather, A. A. (2022). Randomized controlled trial of digital cognitive behavior therapy for prenatal insomnia symptoms: Effects on post-partum insomnia and mental health. Sleep, 45(2), zsab280. https://doi.org/10.1093/sleep/zsab280
Gureje, O., Oladeji, B. D., Kola, L., Bello, T., Ayinde, O., Faregh, N., Bennett, I., & Zelkowitz, P. (2022). Effect of intervention delivered by frontline maternal care providers to improve outcome and parenting skills among adolescents with perinatal depression in Nigeria (the RAPiD study): A cluster randomized controlled trial. Journal of Affective Disorders, 312, 169–176. https://doi.org/10.1016/j.jad.2022.06.032
Hulsbosch, L. P., Nyklíček, I., Potharst, E. S., Meems, M., Boekhorst, M. G. B. M., & Pop, V. J. M. (2020). Online mindfulness-based intervention for women with pregnancy distress: Design of a randomized controlled trial. BMC Pregnancy and Childbirth, 20(1), 159. https://doi.org/10.1186/s12884-020-2843-0
Khodadad, M., Bahadoran, P., Kheirabadi, G. R., & Sabzghabaee, A. M. (2021). Can Vitamin B6 Help to Prevent Post-partum Depression? A Randomized Controlled Trial. International Journal of Preventive Medicine, 12, 136. https://doi.org/10.4103/ijpvm.IJPVM_240_19
Leis, J. A., Solomon, B. S., Wasserman, K. E., Carter, T. N., Mendelson, T., Perry, D. F., & Tandon, S. D. (2015). Preventing Post-partum Depression in a Pediatric Primary Care Clinic: A Pilot Study. Clinical Pediatrics, 54(5), 487–490. https://doi.org/10.1177/0009922814536775
Mak, S., & Thomas, A. (2022). Steps for Conducting a Scoping Review. Journal of Graduate Medical Education, 14(5), 565–567. https://doi.org/10.4300/JGME-D-22-00621.1
Marconcin, P., Peralta, M., Gouveia, É. R., Ferrari, G., Carraça, E., Ihle, A., & Marques, A. (2021). Effects of Exercise during Pregnancy on Post-partum Depression: A Systematic Review of Meta-Analyses. Biology, 10(12), 1331. https://doi.org/10.3390/biology10121331
Maryatun, Bangkit Ary Pratama, Indarwati Indarwati, Annisa Andriyani, Ratnawati Kusumaningsih, Sri Mulyani, Endang Sri Wahyuni, & Nur Wulan Agustina. (2023). Evaluation of a santun sejati web-based application: mother and baby care with cognitive behaviour therapy approach. International Journal of Public Health Excellence (IJPHE), 3(1), 38–44. https://doi.org/10.55299/ijphe.v3i1.411
McLeish, J., & Redshaw, M. (2018). A qualitative study of volunteer doulas working alongside midwives at births in England: Mothers’ and doulas’ experiences. Midwifery, pp. 56, 53–60. https://doi.org/10.1016/j.midw.2017.10.002
Modak, A., Ronghe, V., Gomase, K. P., Mahakalkar, M. G., & Taksande, V. (2023). A Comprehensive Review of Motherhood and Mental Health: Post-partum Mood Disorders in Focus. Cureus. https://doi.org/10.7759/cureus.46209
Murwati, M., & Suroso, S. (2017). Penerapan Cognitif Behavior Therapi (CBT) Pada Ibu Nifas Sebagai Upaya Pencegahan Depresi Post Partum Di Kabupaten Klaten. Jurnal Kebidanan Dan Kesehatan Tradisional, 2(2). https://doi.org/10.37341/jkkt.v2i2.91
Navas, A., Carrascosa, M. D. C., Artigues, C., Ortas, S., Portells, E., Soler, A., Yañez, A. M., Bennasar-Veny, M., & Leiva, A. (2021). Effectiveness of Moderate-Intensity Aerobic Water Exercise during Pregnancy on Quality of Life and Post-partum Depression: A Multi-Center, Randomized Controlled Trial. Journal of Clinical Medicine, 10(11), 2432. https://doi.org/10.3390/jcm10112432
Peterson, J., Pearce, P. F., Ferguson, L. A., & Langford, C. A. (2017). Understanding scoping reviews: Definition, purpose, and process. Journal of the American Association of Nurse Practitioners, 29(1), 12–16. https://doi.org/10.1002/2327-6924.12380
Putri, A. S., Wurisastuti, T., Suryaputri, I. Y., & Mubasyiroh, R. (2023). Post-partum Depression in Young Mothers in Urban and Rural Indonesia. Journal of Preventive Medicine and Public Health, 56(3), 272–281. https://doi.org/10.3961/jpmph.22.534
Rethlefsen, M. L., & Page, M. J. (2022). PRISMA 2020 and PRISMA-S: Common questions on tracking records and the flow diagram. Journal of the Medical Library Association : JMLA, 110(2), 253–257. https://doi.org/10.5195/jmla.2022.1449
Rodríguez-Gallego, I., Vila-Candel, R., Corrales-Gutierrez, I., Gomez-Baya, D., & Leon-Larios, F. (2024). Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Post-partum Depression: A Multicentre Randomised Clinical Trial. Nutrients, 16(2), 227. https://doi.org/10.3390/nu16020227
Schytt, E., Wahlberg, A., Eltayb, A., Tsekhmestruk, N., Small, R., & Lindgren, H. (2022). Community-based bilingual doula support during labour and birth to improve migrant women’s intrapartum care experiences and emotional well-being-Findings from a randomised controlled trial in Stockholm, Sweden [NCT03461640]. PloS One, 17(11), e0277533. https://doi.org/10.1371/journal.pone.0277533
Suharwardy, S., Ramachandran, M., Leonard, S. A., Gunaseelan, A., Lyell, D. J., Darcy, A., Robinson, A., & Judy, A. (2023). Feasibility and impact of a mental health chatbot on post-partum mental health: A randomized controlled trial. AJOG Global Reports, 3(3), 100165. https://doi.org/10.1016/j.xagr.2023.100165
Sukmawati, S. T., Anshori, R. O., Pinem, L. H., Wardhani, M. A. K., Mega, M., Safitri, M. Z., Pratama, P. W. Y., & Sholeha, W. (2021). Pemanfaatan Aplikasi Digital dalam Mencegah Depresi Postpartum: Literature Review. Jurnal Kesehatan Holistic, 5(2), 31–39. https://doi.org/10.33377/jkh.v5i2.99
Sun, Y., Li, Y., Wang, J., Chen, Q., Bazzano, A. N., & Cao, F. (2021). Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. Journal of Medical Internet Research, 23(1), e23410. https://doi.org/10.2196/23410
Sun, Y., Park, S., Malik, A., Atif, N., Zaidi, A., Rahman, A., & Surkan, P. J. (2024). Pregnancy stressors and post-partum symptoms of depression and anxiety: The moderating role of a cognitive-behavioural therapy (CBT) intervention. General Psychiatry, 37(1), e101136. https://doi.org/10.1136/gpsych-2023-101136
Surkan, P. J., Hamdani, S. U., Huma, Z.-E., Nazir, H., Atif, N., Rowther, A. A., Chaudhri, R., Zafar, S., Mullany, L. C., Malik, A., & Rahman, A. (2020). Cognitive-behavioral therapy-based intervention to treat symptoms of anxiety in pregnancy in a prenatal clinic using non-specialist providers in Pakistan: Design of a randomised trial. BMJ Open, 10(4), e037590. https://doi.org/10.1136/bmjopen-2020-037590
Tricco, A. C., Langlois, Etienne. V., Straus, S. E., Alliance for Health Policy and Systems Research, & World Health Organization. (2017). Rapid reviews to strengthen health policy and systems: A practical guide. World Health Organization. https://iris.who.int/handle/10665/258698
Truong, S., Foley, O. W., Fallah, P., Lalla, A. T., Osterbur Badhey, M., Boatin, A. A., Mitchell, C. M., Bryant, A. S., & Molina, R. L. (2023). Transcending Language Barriers in Obstetrics and Gynecology: A Critical Dimension for Health Equity. Obstetrics & Gynecology, 142(4), 809–817. https://doi.org/10.1097/AOG.0000000000005334
Van Lieshout, R. J., Layton, H., Savoy, C. D., Brown, J. S. L., Ferro, M. A., Streiner, D. L., Bieling, P. J., Feller, A., & Hanna, S. (2021). Effect of Online 1-Day Cognitive Behavioral Therapy-Based Workshops Plus Usual Care vs Usual Care Alone for Post-partum Depression: A Randomized Clinical Trial. JAMA Psychiatry, 78(11), 1200–1207. https://doi.org/10.1001/jamapsychiatry.2021.2488
Van Lieshout, R. J., Layton, H., Savoy, C. D., Xie, F., Brown, J. S. L., Huh, K., Bieling, P. J., Streiner, D. L., Ferro, M. A., & Haber-Evans, E. (2023). In-person 1-day cognitive behavioral therapy-based workshops for post-partum depression: A randomized controlled trial. Psychological Medicine, 53(14), 6888–6898. https://doi.org/10.1017/S0033291723000454
Vigod, S. N., Slyfield Cook, G., Macdonald, K., Hussain-Shamsy, N., Brown, H. K., de Oliveira, C., Torshizi, K., Benipal, P. K., Grigoriadis, S., Classen, C. C., & Dennis, C.-L. (2021). Mother Matters: Pilot randomized wait-list controlled trial of an online therapist-facilitated discussion board and support group for post-partum depression symptoms. Depression and Anxiety, 38(8), 816–825. https://doi.org/10.1002/da.23163
Wang, J., Carru, C., Sedda, S., Fiori, P. L., Li, Z., & Chen, Z. (2024). Comparative impact of exercise‐based interventions for post-partum depression: A Bayesian network meta‐analysis. International Journal of Gynecology & Obstetrics, 165(1), 67–75. https://doi.org/10.1002/ijgo.15091
Widiasih, R., Susanti, R. D., Sari, C. W. M., & Hendrawati, S. (2020). Menyusun Protokol Penelitian dengan Pendekatan SETPRO: Scoping Review. Journal of Nursing Care, 3(3), Article 3. https://doi.org/10.24198/jnc.v3i3.28831
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