Utilization of Perinatal Depression and Anxiety Assessment Tools in Routine Perinatal Care: a Call for the Integration and Implementation of Maternal Mental Health Services into Perinatal Care in Ghana

Background: This study intends to stimulate critical thinking and generate impactful discussions on the provision of holistic perinatal care. The rationale is to promote the exchange of ideas and collaboration among stakeholders to ensure that the training and practice of midwifery in Ghana become more robust and meet global standards. Additionally, it is meant to inform, prepare competent, resourceful, knowledgeable, and most importantly adaptable midwives who can contribute to and promote the overall health of the women in their care. Objective: To explore midwives’ knowledge and understanding on soliciting the requisite information that impacts the psychological health of the perinatal women in their care during the perinatal period using globally validated and reliable assessment tools for depression and anxiety. Methods: A structured questionnaire was used to collect data from the participants (midwives). The study was conducted in selected hospitals across all 16 regions in Ghana. A total of 319 midwives with varying degrees and experience working at different levels (teaching, municipal, regional and district hospitals) of the health care system in Ghana participated in the study. Basic descriptive quantitative analysis was used based on frequency tables, pie chart and graphical illustration to interpret the data. Results: The participants have adequate knowledge on the impact of perinatal anxiety and depression on birth and maternal outcomes. However, the remains a huge deficit in their ability to use the validated and reliable assessment tools in recognizing clinical cues related to anxiety and depression among perinatal women. Surprisingly, over 50% of the midwives were unfamiliar with the commonly used assessment tools for depression and anxiety such as the EPDS and PHQ-9. Additionally, nearly 40% of the participants lack the requisite assessment skills for assessing perinatal anxiety and depression. Conclusion: Perinatal mental health should be made a critical component of perinatal care, with midwives being well situated to recognize the manifestations of deteriorating mental health among the perinatal women in their care and provide the needed support and required level of supervision. It is therefore imperative to train midwives on basic mental health assessment skills and encourage them to incorporate mental health care into the delivery of routine perinatal care and services.