Examining the Research Gap in Maternal Mental Health Services Integration into Antenatal Care in Nigeria

Perinatal mental health disorders affect a substantial proportion of Nigerian women during and after pregnancy, yet maternal mental health services remain largely absent from antenatal care programmes, creating a documented gap that this study systematically examines and addresses. This study examined the research gap in the integration of maternal mental health services into antenatal care in Nigeria. A systematic review and gap analysis methodology was employed, searching eight databases for studies on perinatal mental health in Nigeria from 2015 to 2024. Parallel analysis examined existing national antenatal care protocols, FMOH maternal health guidelines, and global WHO mental health integration recommendations. Forty-seven eligible publications were identified and analysed for mental health condition studied, diagnostic tool used, prevalence estimates, service delivery findings, and integration recommendations. Results showed that perinatal depression was studied in 76.6 percent of publications, while anxiety (23.4 percent), post-traumatic stress disorder (12.8 percent), and perinatal psychosis (6.4 percent) were significantly underresearched. Prevalence estimates for perinatal depression ranged from 14.2 to 41.6 percent across studies. No study evaluated a tested model for mental health integration into routine antenatal care in Nigeria. Current FMOH ANC guidelines contain no mental health screening or referral provisions. The study identifies seven priority research gaps and proposes a Perinatal Mental Health Integration Framework for Nigeria specifying screening tools, referral pathways, and training requirements for ANC providers. This constitutes an original contribution to maternal health systems science in Nigeria.

Keywords: maternal mental health, perinatal depression, antenatal care integration, research gap, Nigeria