Impact of perinatal and repeated maternal common mental disorders on educational outcomes of primary school children in rural Ethiopia: population-based cohort study

Habtamu Mekonnen, Girmay Medhin, Mark Tomlinson, Atalay Alem, Martin Prince, Charlotte Hanlon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
44 Downloads (Pure)

Abstract

Background: There have been no studies from low- or middle-income countries to investigate the long-term impact of perinatal common mental disorders (CMD) on child educational outcomes.

Aims: To test the hypothesis that exposure to antenatal and postnatal maternal CMD would be associated independently with adverse child educational outcomes in a rural Ethiopian.

Method: A population-based birth cohort was established in 2005/2006. Inclusion criteria were: age between 15 and 49 years, ability to speak Amharic, in the third trimester of pregnancy and resident of the health demographic surveillance site. One antenatal and nine postnatal maternal CMD assessments were conducted using a self-reporting questionnaire, validated for the local use. Child educational outcomes were obtained from the mother at T1 (2013/2014 academic year; mean age 8.5 years) and from school records at T2 (2014/2015 academic year; mean age 9.3 years).

Results: Antenatal CMD (risk ratio (RR) = 1.06, 95% CI 1.05-1.07) and postnatal CMD (RR = 1.07, 95% CI 1.06-1.09) were significantly associated with child absenteeism at T2. Exposure to repeatedly high maternal CMD scores in the preschool period was not associated with absenteeism after adjusting for antenatal and postnatal CMD. Non-enrolment at T1 (odds ratio 0.75, 95% CI 0.62-0.92) was significantly but inversely associated with postnatal maternal CMD. There was no association between maternal CMD and child academic achievement or drop-out.

Conclusions: Our findings support the hypothesis of a critical period for exposure to maternal CMD for adverse child outcomes and indicate that programmes to enhance regular school attendance in low-income countries need to address perinatal maternal CMD.

Original languageEnglish
Article numbere87
JournalBJPsych Open
Volume5
Issue number6
DOIs
Publication statusPublished - 01 Nov 2019
Externally publishedYes

Bibliographical note

Funding Information:
The study was supported by the Wellcome Trust (project grant: 093559). H.M. is supported through a post-doctoral fellowship awarded as part of the Africa Mental Health Research Initiative (AMARI) within the DELTAS Africa Initiative [DEL-15-01]. C.H. receives salary support from the same DELTAS Africa Initiative [DEL-15-01]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government. C.H. is funded by the National Institute of Health Research (NIHR)

Funding Information:
The publication of this paper is supported by a grant from The Royal College of Psychiatrists Academic Freedom Fund established by Kenneth R. Kaufman, MDFRCPsych. For further details about the fund please visit: https://www.cambridge.org/core/journals/bjpsych-open/ information/instructions-contributors.

Publisher Copyright:
© 2019 The Author(s).

Keywords

  • absenteeism
  • Education
  • mental health
  • postnatal depression
  • sub-Saharan Africa

ASJC Scopus subject areas

  • Psychiatry and Mental health

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