ANTENATAL MENTAL HEALTH SCREENING AMONG PREGNANT WOMEN IN ONE AMBULATORY OBSTETRIC UNIT: A BEST PRACTICE IMPLEMENTATION PROJECT

Abstract

Introduction: While the pregnancy is associated with the time of excitement, the emotional burden of it is often overlooked in many healthcare settings, affecting the mental health of a pregnant women. Antenatal depression, panic disorders, anxiety and other mental health disorders can have a lasting effect both on the health of mother and a fetus. Aim: The study aimed to promote antenatal mental health screening among pregnant women in one ambulatory obstetric unit in Kazakhstan. Methods: This study is a quality improvement project designed through the JBI Evidence Implementation process model guided by the JBI evidence-based healthcare (EBHC) framework. A baseline assessment of compliance with the best practice guidelines regarding the antenatal mental health screening was conducted. As a result, the identified gaps were addressed with the following strategies, targeted education of the healthcare workers, development of a clear algorithm of a mental health assessment and referral system, and a policy update for the sustainability of the introduced practices. Results: Baseline audit demonstrated low compliance with the best practice recommendations, especially inconsistencies were noticed in the lack of training for medical workers in women-centered communication and follow-up assessments of women who are at risk of antenatal depression. After the implementation of the strategies, a significant improvement was noted with Criterion 1 about training staff on women-centered communication and psychosocial assessment, increasing from 27.27% to 85.71% of compliance, and Criteria 6 and 7 achieving 100% compliance, which are about follow-up assessments in women scoring high on the Edinburgh Postnatal Depression Scale. Other criteria showed persistently high compliance with the best practice. Conclusions: The study promoted antenatal mental health screening among pregnant women in one ambulatory obstetric unit. The study successfully incorporated changes in the department's practices with the use of strategies focused on low compliance criteria, as well as considering interventions’ sustainability.