No maternal health without mental health: suggested indicators to monitor perinatal mental health globally

Perinatal mental health refers to the psychological wellbeing of women during pregnancy and up to one year postpartum. Perinatal mental health conditions as depression significantly affect maternal, newborn health, and child development worldwide. However, the absence of standardized indicators limits effective monitoring and evaluation. This paper introduces a framework with indicators for global perinatal mental health monitoring. The framework development involved a scoping review, expert consultations, and stakeholder surveys. A global expert group, guided by evidence and the World Health Organization (WHO), identified an initial set of indicators. Two rounds of online surveys were conducted, allowing stakeholders to rank these indicators and suggest additional ones. Indicators were chosen based on their validity, reliability, relevance, feasibility, and potential impact for advocacy purposes on perinatal mental health. The WHO expert working group finalized the set of indicators. Six perinatal mental health indicators were identified for future testing. These include three primary indicators: policy presence, screening coverage, and prevalence of perinatal mental health conditions. Three secondary indicators cover mental health expenditure, healthcare professional training, and provision of care. Challenges to implementing standardized monitoring include resource limitations and data collection methods. Strengthening health workers and facility capacity to measure, report, and interpret perinatal mental health data, including the use of screening tools, is crucial. The integration of these indicators into existing systems, such as health information management systems (HIMS) and national surveys, will be key. Monitoring perinatal mental health is essential for improving maternal and newborn outcomes. The proposed framework offers a means to enhance global monitoring and guide policy interventions. Global stakeholders are encouraged to integrate perinatal mental health into their policy, program, and monitoring agendas.