Supplementary Material

Focus Group Discussion topic guide (English)

PREGNANCY

1. When a woman becomes pregnant, what thoughts and feelings might she have? What happy thoughts? What worries?

  • When a woman is pregnant what kind of help does she get from her husband, parents, relatives and community?
  • Are there particualr rituals, beliefs or taboos about what a woman, her family and community should do/say when pregnant? Are these practices helpful or can they cause stress?

What are the specific stresses faced by women when they become pregnant?

  • Probe: husband leaving her, physical health problems, worry of delivery, pain, risk of serious problem, stress of having HIV test, pregnancy being unwanted, Not being able to support another baby due to poverty, worries of witchcraft vulnerability, domestic violence(emotional, physical)
  • Probe: witchcraft(meaning of it, ,what does it entail..... i.e. magic, evil eye, envy, curse and its link to pregnancy)

POSTPARTUM PERIOD

When a woman has given birth and in the first 6 months, what thoughts and feelings might she have? What happy thoughts? What worries?

What are the good positive things experienced between a mum and her baby?

What are the times when caring for the baby becomes difficult and hard?

  • When a woman has a young baby what kind of help does she get from her husband, parents, relatives and community?
  • Are there particualr rituals, beliefs or taboos about what a woman, her family and community should do/say ? Are these practices helpful or can they cause stress?

What are the specific stresses face by women when they have delivered and in the first months of caring for a new baby?

  • Probe: Child being sick, Poverty, Problems breastfeeding, Burden of extra work, worry if HIV+ re infecting child, Husband/family not supporting her, Husband infidelity? worries of witchcraft vulnerability? domestic violence(emotional, physical)

MENTAL HEALTH

If a woman has a lot of stresses in pregancy and in the postnatal period how might it affect her emotionally? Might she be “thinking too much? How will she feel and behave if she has this?

How does it affect the mum looking after the baby i.e. feeding, hygiene, playing?

Will family/community members recognize if a woman is struggling and is depressed? (How)? How would they help?

Are women able to discuss worries with someone, who – family, husband, and friends?

Other mental health problems?

How does “Manunu” present? How will a woman feel and behave?

Are there other sorts of emotional problems that can affect a woman soon after giving birth? What about “going mad”? How will a woman feel and behave in this case? What causes this? Is it different from thinking too much? What would the family/community do?