Carol Graham’s recent guest blog is most helpful in drawing our attention to associations between maternal, or caregiver, wellbeing and certain child development outcomes.
Drawing on the Peru Young Lives data she mentions in particular, findings of associations between “maternal depression”, growth stunting, lower cognitive outcomes and adolescent behaviour problems that are particularly evident in the poorest women in the sample. Her findings corroborate those from other studies and have policy relevance. I would like follow-up and extend the discussion by addressing two issues:
- how we frame the relationship between poverty and maternal mental health, and
- how we interpret findings from the Self Reporting Questionnaire (SRQ20)[i], a screening tool for common mental disorders designed by the WHO for use in low income countries.
1. Framing poverty and maternal mental health
It is clear that over and above genetic predisposition, socio-cultural and economic pressures put the psychological wellbeing of women in low- and middle income- countries (LAMICs) at significant risk and that this compromises the quality of care they are able to provide to their children. However, in identifying the impact of living poor on the psychological wellbeing of women and mothers, and advocating for services and support to those affected (which is in their, and their children’s, interests), we must do all we can to avoid the (unintended) trap of extracting these women from their context and setting them up as responsible for providing “inadequate stimulation”, as showing “poor affectional care”, of “neglecting” their children’s health and development - as if these functions were under their individual control. They are not. We must recognize that as Brown and Harris showed in their research on women in Camberwell in London, many years ago, and others working in LAMICs more recently have confirmed, it is the conditions of their lived daily worlds, most evidently the strain of living poor (particularly when compounded by a high burden of child care and exposure to oppressive and violent partners), that increases women’s vulnerability to mental health problems that in turn impact the form of care they are able to provide their children.