Existing practices, gaps and strategies to promote perinatal mental health in Ghana.

BACKGROUND: Perinatal mental health (PMH) is a critical component of overall maternal well-being, yet the provision of PMH services remains challenging in Ghana and other settings. More crucially, there is limited data on healthcare providers' perspectives on PMH care delivery to inform efforts to improve service provision and mental health outcomes. OBJECTIVE: This study explored healthcare providers' perspectives on current practices, gaps, and strategies to improve PMH care delivery in Ghana, a West African country. METHODS: An exploratory qualitative design with a needs assessment orientation was adopted, and data were collected from focus group discussions with 32 nurses and midwives involved in perinatal healthcare service delivery in the Greater Accra Region of Ghana. Data were analysed using the six steps of reflexive thematic analysis. FINDINGS: Four main themes were developed: Providers' Understandings of Perinatal Mental Health and its Intersection with Reproductive Health; Integrated Approaches to Perinatal Mental Health Care; Barriers and Challenges in Perinatal Mental Health Care; and Enhancing/Strengthening Perinatal Mental Health. Participants demonstrated knowledge of PMH and had adopted task-shifting and collaborative care approaches to provide PMH services. Key barriers to service provision include healthcare provider factors (e.g., stigma, inadequate training) and institutional challenges (lack of standardised tools, limited private consultation spaces, increased workload). Proposals to improve PMH outcomes include enhanced training, provision of resources and tools, and strengthened collaborative efforts. CONCLUSION: The findings highlight the need for comprehensive system reforms in PMH care delivery, including the provision of training and assessment tools and coordinated action across policy, institutional, and individual levels, supported by appropriate resource allocation and infrastructure development.