Impact of village health volunteer support on postnatal depressive symptoms in the remote rural areas of Lao People’s Democratic Republic: a cross-sectional study

• Published in: Tropical Medicine and Health
• Main Authors: Noriko Toyama, Inthanomchanh Vongphoumy, Manami Uehara, Chika Sato, Futoshi Nishimoto, Kazuhiko Moji, Tiengkham Pongvongsa, Kokoro Shirai, Tomomi Takayama, Misuzu Takahara, Yoko Tamashiro, Yumiko Endo, Sengchanh Kounnavong, Jun Kobayashi
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2021
• Subjects: Postnatal depressive symptoms; Village health volunteer; Social support; Cross-sectional study; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-021-00316-0; https://doaj.org/article/7ae30cb9060043fbbcdfc5fc9da2ddda

Abstract Background Village health volunteers (VHVs) are responsible for providing primary care in the communities of Laos. Unlike other districts, in Xepon more than 90% of VHVs are male and therefore experience difficulties interacting with pregnant women. To improve outreach to pregnant women, especially among ethnic minorities, a new project was implemented by local municipalities in 2017: newly selected female VHVs were paired to work with existing male VHVs. The objective of this study was to compare the postnatal depressive symptoms of ethnic minority mothers supported by pair-VHVs and single-VHVs in remote rural areas of Lao People’s Democratic Republic (PDR). Methods A cross-sectional study was conducted in March 2019. Mothers who had delivered a baby within 1 year preceding the study were recruited from 36 villages. Of the 305 mothers, 227 responded. The questionnaires included (1) demographic characteristics such as age, economic status, and birth experience; (2) self-decision to go to a health center/hospital to receive antenatal care; (3) type of VHVs (pair or single), support, and information from VHVs during pregnancy, support from husband and relationship with husband; (4) the Edinburgh Postnatal Depression Scale (EPDS). A Mann-Whitney U test, chi-square test, and multiple linear regression analysis were performed. Ethical approval was obtained from the University of the Ryukyus and National Ethics Committee for Health Research of Lao PDR. Results The average total EPDS score was 5.5 among mothers supported by pair-VHV and 7.0 among mothers supported by single-VHV. Results of the multiple linear regression analysis showed that the EPDS score was significantly lower among mothers supported by pair-VHV (β=−1.18, p <0.05) even after adjusting for economic and biological factors. Conclusions Mothers supported by pair-VHV had a significantly lower EPDS score than those supported by single-VHVs in this study area, suggesting that the support of male and female VHV pairs contributed to improving ...