Improving Postpartum Mental Health Services in Nigeria: Perspectives of Postpartum Mothers on Healthcare Support and Service Needs

Postpartum depression (PPD) and other postpartum mental health conditions are major contributors to maternal morbidity and adverse child health outcomes worldwide. Despite the substantial burden of maternal mental health disorders in Nigeria, postpartum mental health remains inadequately integrated into routine maternal healthcare. Limited screening, insufficient counselling services, and weak referral systems continue to hinder early identification and management of women experiencing psychological distress during the postpartum period. Understanding mothers' perspectives on healthcare support and service needs is essential for informing contextually appropriate service improvements. This study explored postpartum mothers' perspectives on healthcare support and maternal mental health service needs in Southeast Nigeria, with the aim of identifying gaps in service delivery and informing recommendations for strengthening postpartum mental healthcare. A qualitative descriptive study was conducted in 2024 among 36 postpartum mothers attending a private hospital in Awka, Southeast Nigeria. Participants were recruited purposively and participated in four focus group discussions. Discussions were conducted in English or Igbo according to participants' preference, audio-recorded with consent, transcribed verbatim, and analysed using thematic analysis following Braun and Clarke's framework. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Administrative approval was obtained from the hospital management, and written informed consent was obtained from all participants before data collection. Three interconnected themes emerged. First, participants described healthcare neglect, where routine postnatal care focused primarily on infant wellbeing and maternal physical recovery while emotional wellbeing received little attention. Second, mothers identified significant service gaps, including the absence of routine mental health screening, limited access to counselling services, and inadequate referral pathways for women experiencing psychological distress. Third, participants expressed a need for improved healthcare support, emphasizing empathetic communication from healthcare providers, family-inclusive counselling, community-based peer support groups, and greater public awareness of maternal mental health. Collectively, these findings highlight important gaps in postpartum mental healthcare delivery and opportunities for service improvement. Postpartum mothers identified substantial deficiencies in maternal mental healthcare services and proposed practical, culturally relevant strategies for improving care. Integrating routine mental health screening, counselling services, referral pathways, and family-centred support into postnatal care could strengthen maternal mental healthcare delivery in Nigeria. These findings provide context-specific evidence to inform policy, healthcare planning, and future interventions aimed at improving maternal wellbeing and reducing inequities in postpartum mental healthcare.