The Karnataka government has taken a significant step in prioritising the mental health of pregnant women by introducing a new column in the “Thayi card”
The Thayi card is a document issued to Karnataka women that records their health status throughout pregnancy.
A champion for women’s mental health in India, professor of psychiatry at NIMHANS, Dr Prabha S Chandra, who also works in the field of perinatal health, has been advocating seriously for this inclusion for many years.
She appreciated the Department of Health’s move via a tweet on Sunday, 26 February.
“Music to my ears after years of advocacy! This year Thayi (Maternal Health) card comes with an additional entry as an innovative step towards protecting Maternal Mental Health in Karnataka. Mental health screening questions in page 35 of Thayi card,” she tweeted.
This will give us data regarding Maternal mental health conditions and ensure interventions as we strengthen referral pathways. Important now to train front line workers on how to ask these three key questions on mental health!
— Prabha Chandra (@globalpmh) February 26, 2023
How will this help?
The government recognised that mental health was a crucial aspect of maternal health, and that untreated mental health issues could have adverse effects on both the mother and the child.
According to the National Mental Health Survey of 2015-16, mental health problems affect around 15 percent of pregnant women in India.
Officials from the Karnataka Health and Family Welfare Department stated that the new column would enable healthcare providers to monitor the mental health status of pregnant women during their pregnancy.
This initiative is expected to help identify mental health problems among pregnant women and provide mental health support after delivery, especially in rural areas, where women are not comfortable discussing their mental health openly.
It has been noticed that expectant mothers are visibly stressed and panicked about the uncertainty of having access to healthcare when required.
This initiative is expected to bring to the fore such anxieties that can hamper the health of the mother.
Deputy Director (Maternal Health) Dr Rajkumar N is being praised by the state government for his efforts to reduce maternal mortality rates in Karnataka.
Speaking to South First, Department of Health and Family Welfare Commissioner Dr Randeep D said, “This year, we have incorporated various other things in the Thayi Card. Along with maternal mental health screening tools, we will also be recording haemoglobin levels of the patients during all the nine months.”
Other provisions & Thayi card benefits
The Karnataka government has been implementing various programmes to promote maternal and child health.
This initiative is a part of the larger strategy to improve maternal and child health in the state.
Randeep explained that there was also a provision to denote high-risk pregnancy status on the Thayi Card at the outset itself — a red colour flag for high-risk and green for low-risk or no risk on the cover page.
In case of mitigation of the risk factor, the green flag could be pasted over the red. “These measures will improve maternal health and reduce maternal deaths in the state,” he added.
Training still a need
The government is in the process of training healthcare workers and Accredited Social Health Activists (ASHAs) in rural areas to sensitively ask three questions under the mental health category and elicit answers from pregnant women.
The healthcare workers have been instructed to encourage pregnant women to open up about their mental health concerns and to provide them with appropriate treatment and support.
The government’s move has been welcomed by mental health professionals and women’s rights groups, who believe that it will help reduce the stigma surrounding mental health and improve access to mental health care for pregnant women.
Chandra tweeted, “This will give us data regarding mental health conditions and ensure interventions as we strengthen pathways. Important now to train frontline workers on how to ask these three key questions on mental health.”
Expressing appreciation for this move, the community health and maternal health doctor, who is serving amongst the tribal population of Soligas in the BR Hills in the Chamarajanagar district of Karnataka, told South First, “This will help the women. The Thayi Card has helped provide more and more comprehensive care to be provided and recorded over time for pregnant women and their children. This will ensure that health workers and doctors are trained to assess, record, and monitor the mental health of the mother both during and after pregnancy.”
She added that for the child, if developmental milestones could be added next, then both the mother and the child could get such assessments.
Meanwhile, public health activist Dr Sylvia Karpagam told South First that limiting the questions to only two focused ones was a good idea, and they could be followed up. But imparting proper training to assess them was very important, she added.
What are Thayi card questions added by Karnataka government?
The Thayi Card has two key questions to assess the mental health of the pregnant woman.
Question 1 seeks information about whether the person has had any history of mental health issues before pregnancy, and if they underwent any treatment for it.
Question 2 asks whether the mother has been going through any kind of worries, depression, anxiety, fear, sadness, or boredom.
If the answer to any of the two questions is a “yes”, the healthcare workers are expected to make note of it and ensure that they are taken for counselling and given help to seek treatment.
The officials have stated that the implementation process will be monitored closely.
The initiative is expected to have a positive impact on the health and well-being of pregnant women and their children, especially in rural areas where mental health issues often go unnoticed and untreated.