A qualitative study exploring the role of community health workers in promoting maternal postpartum mental health in Nicaragua

Abstract

# Background The objectives of this qualitative study were to examine perceptions of maternal postpartum distress among community health workers and mothers living in rural Nicaragua; and to identify the role of community health workers (CHWs) in implementing locally relevant strategies to reduce maternal postpartum distress. # Methods The study was conducted between May and July 2015 with a small, rural community in the central highlands of Nicaragua. Primary data sources included two focus group interviews with 10 community health workers, and individual interviews with 12 mothers who had delivered their most recent child within roughly the previous year. # Results Both community health workers and mothers identified maternal distress following childbirth as a community concern. Identified factors that contributed to postpartum distress were lack of people to confide in, experiences of intimate partner violence, and exposure to household poverty. Participants felt that community health workers might play an important role in ameliorating postpartum distress by providing social support to mothers and engaging intimate partners to offer assistance. However, results indicated that any community health worker interventions must also prioritize the well-being of CHWs. # Conclusions Community health workers have the potential to address gaps in postpartum services for mothers living in rural Nicaraguan communities. However, such programs must consider the well-being of CHWs, and should be developed along with interventions and policies that address major social factors, such as poverty and interpersonal violence, to promote the mental health of mothers in rural Nicaragua.