It is always said that the road to motherhood is the most rewarding. On social media, there are pictures of beaming mothers with their newborn babies, further setting this notion of motherhood as pure bliss. But the reality of motherhood could not be farther from ideal for many women. Every year in West Africa, thousands of women silently suffer from postpartum depression, anxiety, and psychosis, all highly misconceived and often totally dismissed in the public health system.
Indeed, these are some of the most poorly studied and ill-funded health concerns anywhere in the world; it is against such a general trend that West Africa continues to make the world worry. Cultural stigma, gaps in healthcare, and weak policy responses continue to make this crisis a silent burden carried by many mothers.
The Silent Crisis: A Regional Overview
According to the World Health Organization, mental disorders, majorly depression affect 10% of pregnant women and 13% of those who have just delivered. WHO indicates that 1 in every 5 women throughout the world suffers from maternal mental health disorders. These figures are even higher in Sub-Saharan Africa, where as high as 25% of mothers may exhibit symptoms of postpartum depression (PPD).
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An approximation of the rates of new mothers with depression within Nigeria stands around 14 to 20%, while estimates for other Western African countries are set at approximately 7-32%.
PPD is the most common maternal mental health disorder characterized by feelings of sadness, tiredness, and hopelessness that are overwhelming. The rarer ones include postpartum psychosis, which affects 1 in every 1,000 mothers, possibly manifested through hallucinations, delusions, or suicidal thoughts. And yet, despite these shocking statistics, maternal mental health takes a huge backseat to physical health, leaving millions not to get the help they desperately need.
A Comparative Study of Osun and Kwara States of Nigeria
The current burden of maternal mental disorders, however, demonstrates wide disparities in prevalence across different geographical regions in the country. In Osun State, for instance, cultural norms that emphasize traditional postpartum care often delay medical intervention for mental health issues. Many women rely on family elders or traditional birth attendants, who may dismiss symptoms of postpartum depression as mood swings or spiritual weakness.
In contrast, Kwara State has made modest progress in integrating mental health services into primary healthcare. Some health centers offer screening for depression during antenatal visits, although these services remain limited to urban areas. The disparity between the two states highlights how access to care, community attitudes, and healthcare infrastructure shape maternal mental health outcomes.
Cultural and Structural Drivers of the Crisis
The cultural stigma represents one of the major impediments to addressing maternal mental health in West Africa. The societal expectations often place mothers as resilient caregivers who should suppress personal struggles. To admit feelings of sadness or inadequacy is often looked upon as a failure, and so many women suffer in silence.
Health systems are not helpful either. For instance, in Nigeria, less than 300 psychiatrists attend to over 200 million citizens. Often, services are concentrated in urban centers and leave rural areas with a deficiency. The situation is also dire in Ghana, with the WHO recording 20 psychiatrists per 1 million people.
Consequences on Family and Society
Untreated maternal mental health disorders have far-reaching implications. Children of depressed mothers are likely to experience developmental delays, behavioral problems, and school difficulties; these factors are frequently self-perpetuating and may result in a cycle of disadvantage and poverty.
Marital relationships also suffer. Partners may feel helpless or frustrated, leading to increased conflict and, in some cases, family breakdowns. Beyond the home, the economic impact is staggering. A 2021 study published in The Lancet estimated that, left unaddressed, mental health disorders cost more than $1 trillion every year in lost productivity. In West Africa, these costs, though less documented, are straining already fragile economies.
Such disparities highlight the urgency of region-specific interventions to mitigate the economic impact of untreated maternal mental health disorders.
Existing Interventions: What’s Working?
Against this background, some promising initiatives emerge to address the issues of maternal mental health in this region:
- Community-Based Models: The Friendship Bench program has been training lay health workers in problem-solving therapy in Zimbabwe. Adapting this model to rural Nigerian communities could bridge the care gap.
- Digital Innovations: Ghana’s mHealth programs, which use SMS to provide health education, can be expanded to include maternal mental health support. Similarly, Nigeria’s Hello Mama platform could incorporate tools like the MomMoodBooster app to offer cognitive behavioral therapy.
- Policy Efforts: Some countries are beginning to integrate mental health into broader health strategies. Ghana’s 2012 Mental Health Act offers a framework for scaling up, but its actual implementation has been very slow.
Recommendations for a Holistic Approach
Some key steps that would help address the maternal mental health challenges with efficacy in West Africa include:
- Awareness Campaigns: The governments, NGOs, and the media need to de-stigmatize maternal mental health through awareness campaigns that normalize seeking help and stress the importance of well-being.
- Integrated Healthcare: Mental health services should be embedded in antenatal and postnatal care. Training community health workers to screen for depression can make care more accessible.
- Sustainable Funding: There should be specific commitments from governments toward the cause of maternal mental health. Partnerships with NGOs, private sector partners, could give additional funding, along with expertize.
- Digital Tools: Engage in telehealth and mobile apps that will bridge the gaps in order to reach the rural areas.
- Policy Implementation: Existing mental health policies must be fully enacted, with accountability mechanisms to ensure progress.
Conclusion: Breaking the Silence
This study represents the reflections upon a very critical and at the same time immensely ignored aspect of public health: disorders related to maternal mental health, enveloped by stigma. Additionally, cultural norms and an extremely meager system for health with deficiencies in policies ensure that many are left without care.
Now is the time to act. We call for governments, health providers, NGOs, and communities to break the silence on maternal mental health. Let us break the stigma, invest in accessible care, and put a greater focus on mental well-being as part of building healthier families and societies. Every mother deserves the right to be able to face motherhood not in silent struggle but in a journey nurtured by compassion and care.
Azeezat Modesola Abereijo is a passionate and dedicated researcher with a strong academic background in Public Health (M.A., Nottingham Trent University) and Health Education (B.Sc., Lagos State University). Her primary area of interest is Maternal and Child Health, where she strives to improve health outcomes for vulnerable populations through evidence-based research and innovative interventions. Her professional experience includes working with the Lagos State Ministry of Health on impactful programs, such as the “Saving One Million Lives” initiative, where she contributed to health campaigns, vaccination drives, and welfare distribution for underserved communities. She also has hands-on experience in providing emotional support and compassionate care in her roles as a Health Care Worker in the UK.
Azeezat is deeply committed to advancing public health initiatives that foster societal growth. Outside of her professional pursuits, she enjoys mentoring, traveling, and exploring innovative trends in global health.