Validation of City Birth Trauma Scale in postnatal clinics in Lilongwe District, Malawi,
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Date
2022-04-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Executive Summary
Study type
This will be a cross-sectional study that will collect quantitative data at one point in time.
The Problem
Different studies and systematic reviews that were conducted in High Income Countries (HIC) and
Low to Middle Income Countries (LMIC) found Post-Traumatic Stress Disorder (PTSD) to be
prevalent among women after childbirth and postnatal mothers experience elevated levels of PostTraumatic Stress symptoms. For instance, it was found that the prevalence of PTSD among women
after childbirth ranges from 1.7%-9% related to low partner support and postpartum depressive
symptoms (Beck et al., 2011; Donadon et al., 2018). It is also evident from other studies that 3.17%
of women report PTSD after childbirth (Abdollanpour et al., 2019; Ayers et al., 2018; CaparrosGonzalez et al., 2021; Donadon et al., 2018; Gankanda et al., 2021). This is the comparable with
global prevalence of Postpartum PTSD. The studies demonstrated that postnatal mothers with low
stress coping score and lack of social support had a high sensitivity and specificity for predicting
a traumatic childbirth leading to Postpartum PTSD. A systematic review and cross-section surveys
which were conducted on maternal post-traumatic stress during perinatal period found 4% of
women having Postpartum PTSD (Cook et al., 2018; Garthus-Niegel et al., 2018; Yildiz et al.,
2017). In France and Nigeria, studies that were conducted found that 5.7% and 5.9% respectively,
women develop Postpartum PTSD mothers and associated risk factors were hospital admission
due to pregnancy complication, instrumental delivery, manual removal of placenta and maternal
experiences of control during childbirth (Adewuya, 2016; (Sentilhes et al., 2017).
In Malawi, a study was done on childbirth fear and related factors among pregnant and postpartum
women. It was found that demographic and obstetrical characteristics of women are associated
with childbirth fear (Kwepeya et al., 2019). Furhermore, there is no published literature located
for the prevalence of Postpartum PTSD in Malawi. However, majority of patients with mental
health problems present in Primary Health Care (PHC) centers and one study found that 28% of
patients had common mental disorders including PTSD (Kauye et al., 2014; Udedi, 2016). Despite
of this high rate of mental health problems at PHC, there is no available validated instrument to
11-Apr-2022
Validation of Chichewa Version of City Birth Trauma Scale in Postnatal clinics in Lilongwe, Malawi
Version 2, 18th March, 2022.
2 | P a g e
assess PTSD associated with childbirth. Therefore, there is a need for use of validated scale to
assess Postpartum PTSD in Postnatal clinics.
Broad objective of the study
The broad objective of this study is to assess diagnostic accuracy of Chichewa Version of City
Birth Trauma Scale among postnatal mothers in Postnatal clinics in Lilongwe, Malawi.
Specific objectives of the study
The specific objectives of this study are to;
1. Determine the prevalence of Post-Traumatic Stress Disorder among postnatal mothers in
Lilongwe, Malawi. (This is a supporting objective of assessing the diagnostic accuracy)
2. Eestablish psychometric properties Chichewa Version of the City Birth Trauma Scale
among postnatal mothers in Postnatal clinics in Lilongwe, Malawi.
Methodology
The type of this study will be a cross-sectional study that will use a random sampling with sample
size of 384 participants and study population will be postnatal mothers. Data will be collected by
the Principal Investigator and the research assistants with the use of data collection questionnaires.
Data will be analysed by use of Confirmatory Factor Analysis and SPSS version 23.
Expected Findings
The study will document the prevalence of Postpartum PTSD and psychometric properties of
Chichewa Version of City Birth Trauma Scale among postnatal mothers at postnatal clinics in
Lilongwe, Malawi.
Dissemination of Findings
The report of this study is going to be submitted to Lilongwe District Health Office, Kamuzu
University of Health Sciences, College of Medicine Research and Ethics Committee secretariat
and INTERSECT Malawi Maternal Mental Health secretariat. The findings will be published in
reputable peer reviewed journals and will be presented at conferences.