Prenatal and Postnatal Practices of Healthcare Workers in Identifying Postpartum Psychosis: An Exploratory Study in First-Level Hospitals, Lusaka, Zambia

Introduction: Childbirth marks the beginning of motherhood, but women are at risk of developing psychiatric disorders like anxiety, depression, and postpartum psychosis (PPP) after delivery. PPP is a rare yet severe condition that can develop rapidly, putting both mother and child at risk. Due to lack of standard screening procedures, PPP is often underdiagnosed and underreported. This study explored healthcare workers’ practices in identifying postpartum psychosis in first-level hospitals. Methods: Data were collected through in-depth interviews and focus group discussions with 54 healthcare workers from 5 hospitals. Analysis revealed four main themes: 1. Healthcare workers’ prenatal and postnatal practices informed by knowledge levels. 2. Identification of PPP and referrals. 3. Training and support needs. 4. Barriers and facilitators to screening. Results: Healthcare workers have limited understanding of PPP, hindering effective screening. PPP screening is not standard in antenatal and postnatal care, leading to potential underdiagnosis. Overwhelming client numbers and inadequate staffing further hinder screening. Conclusion: This study highlights critical gaps in healthcare workers’ practices regarding PPP screening. Targeted interventions, including training and support, are needed to improve early detection and management, protecting the mental well-being of mothers and their children.