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Impact of Maternal Mental Health Education on Postnatal Mental Health Screening Uptake among Mothers in Nigeria

Abstract

Maternal mental health is an important component of maternal and child health because emotional and psychological difficulties may occur during pregnancy and the postnatal period and can affect mothers' wellbeing, functioning, and ability to care for their infants. Postnatal mental health screening provides an opportunity for the early identification of mothers who may require further assessment, counselling, psychosocial support, or appropriate clinical care. Maternal mental health education provides mothers with information about common postnatal mental health concerns, warning signs, risk factors, available screening services, the importance of early identification, treatment and support options, confidentiality, and appropriate healthcare-seeking. Postnatal mental health screening uptake refers to the utilization of recommended mental health screening services by mothers during the postnatal period. In Nigeria, limited uptake of postnatal mental health screening may be associated with inadequate awareness, misconceptions about mental health, stigma, fear of diagnosis, lack of knowledge about available services, concerns about confidentiality, limited integration of mental health services into maternal healthcare, and poor access to appropriate screening facilities. Effective maternal mental health education may improve mothers' understanding of postnatal mental health and encourage timely utilization of screening services. Against this background, this study investigates the impact of maternal mental health education on postnatal mental health screening uptake among mothers in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Theory of Planned Behavior. The Health Belief Model provides a framework for understanding mothers' decisions to utilize postnatal mental health screening through perceived susceptibility to mental health difficulties, perceived severity of possible consequences, perceived benefits of early screening, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the influence of knowledge, self-efficacy, social support, observational learning, healthcare environments, and access to services on health-seeking behaviour. The Theory of Planned Behavior explains how mothers' attitudes toward mental health screening, perceived social expectations, and perceived behavioural control may influence their intention and decision to utilize screening services. Collectively, these theoretical perspectives provide a suitable framework for explaining how maternal mental health education may influence postnatal mental health screening uptake among mothers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers attending selected postnatal clinics, immunization clinics, primary healthcare centres, hospitals, and other appropriate maternal and child health facilities in Nigeria using a structured interviewer-administered questionnaire and postnatal mental health screening uptake assessment tool. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, postnatal clinics, and eligible mothers. Where feasible, selected healthcare facilities or participant groups will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured maternal mental health education through individual counselling, group education sessions, audiovisual materials, printed resources, and healthcare-provider-led discussions. The education will cover common postnatal mental health concerns, warning signs requiring attention, risk factors, the importance of screening, available screening services, confidentiality, appropriate healthcare-seeking, available support systems, and the benefits of early identification and intervention. Postnatal mental health screening uptake will be assessed using indicators such as awareness of available screening services, acceptance of screening, attendance for recommended screening, completion of an appropriate validated screening assessment, and referral for further assessment where indicated. Where feasible, screening uptake will be verified through appropriate healthcare records while maintaining participant confidentiality. Descriptive statistics will be used to summarize participants' sociodemographic and obstetric characteristics, previous exposure to mental health information, knowledge of postnatal mental health, awareness of screening services, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the impact of maternal mental health education on postnatal mental health screening uptake. Where appropriate, screening uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that maternal mental health education has a significant positive impact on postnatal mental health screening uptake among mothers in Nigeria. Mothers exposed to structured mental health education are expected to demonstrate improved knowledge of postnatal mental health concerns, greater awareness of screening services, and increased willingness to participate in recommended screening. Education is expected to reduce misconceptions and stigma surrounding maternal mental health, improve recognition of possible warning signs, and encourage mothers to seek professional support when necessary. Education that emphasizes confidentiality, normalizes mental health screening as part of routine postnatal care, and clearly explains where and how screening can be accessed is expected to be particularly effective. However, education alone may not guarantee screening uptake because mothers may continue to face barriers such as stigma, fear of being judged, lack of privacy, limited availability of trained providers, financial constraints, transportation difficulties, competing childcare responsibilities, and inadequate integration of mental health screening into routine maternal healthcare. Consequently, maternal mental health education may be most effective when supported by accessible and confidential screening services, trained healthcare providers, clear referral pathways, psychosocial support, and integration of mental health screening into routine postnatal care. The study is expected to contribute to the literature on maternal mental health education, postnatal mental health screening, maternal healthcare utilization, health education, mental health promotion, maternal and child health, and public health in Nigeria by providing empirical evidence on the impact of mental health education on screening uptake among mothers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, primary healthcare development agencies, hospitals, maternal and child health programmes, mental health professionals, midwives, nurses, community health workers, public health practitioners, health educators, development partners, and policymakers regarding strategies for improving early identification of postnatal mental health concerns. The study will also provide evidence-based recommendations for integrating maternal mental health education and routine screening into postnatal services, strengthening healthcare-provider capacity, improving referral systems, reducing mental health stigma, protecting confidentiality, expanding access to appropriate psychosocial support, and promoting timely postnatal mental health screening among mothers in Nigeria.

Keywords: Maternal mental health education, postnatal mental health screening, screening uptake, mothers, Nigeria, maternal mental health, postnatal care, mental health education, mental health screening, maternal healthcare, health education, mental health promotion, maternal health, public health.