Closing the Gap: An Integrated Maternal and Mental Health Care Delivery Platform to Improve Mother and Daughter Health Outcomes

Women suffering from mental health disorders are at higher risk of pregnancy-related illness and death, including postpartum suicide. Further, their children suffer from low birth weight, under-nutrition due to early cessation of breastfeeding, and increased rates of diarrheal diseases and neonatal mortality. This is especially true in rural India, where estimates show a higher burden of perinatal mental illness than in other contexts, and where structural violence related to fetal sex-preference is linked to poor health outcomes and impaired economic development. Government programs have upgraded health facilities and incentivized hospital-based childbirth, but there has not been a concomitant improvement in maternal and child health outcomes, especially for girls. Mounting evidence suggests that the ignored issue of mental health is a major reason for this failure, as vulnerable women burdened by perinatal mental illness and associated stigma continue to fall through the cracks of the healthcare system. Our project integrates task shifting, guided support groups, reproductive clinical care, and mental health services to identify and streamline care to these vulnerable pregnant women. We will target mothers with daughters to address the wide-ranging health effects of fetal-sex preference. We will utilize existing human resource infrastructure to implement the project in 30 communities in a manner that allows for effective scale-up across the district upon proof of concept.