Monerdaktar

Like many other Low and Middle Income Countries, more than 90% of people in Bangladesh are deprived of any sort of mental health service (NIMH 2019) and the situation is more disappointing for women.  The poor pregnant women living in rural area are one of the most vulnerable population to mental disorders with minimum or no access to mental health care. Due to the lack of early identification and easy access to quality mental health care  pregnant woman, infant, family and community experiences an intergenerational negative consequence in multiple domains. To solve this  problem in Bangladesh and other low and middle Income Countries we stepped forward with an innovative solution "MonerDaktar"- a mobile application and web platform connecting professionals with the pregnant women, creating regular awareness and training program to reduce stigma. If we can scale up the platform in large scale it can reduce global mental health treatment gap.

Though upto 37% women during pregnancy encounter common mental Disorder (Jha et al 2018) and about 85% of the pregnant woman encounter postpartum blue. However, only 5% of people received the required mental health care in many least developed countries (WHO 2019). The situation is more  disappointing for pregnant women due to multiple sociocultural factors.   In addition to severe scarcity of mental health professionals (Patel et al 2007), the wide-spread stigma may be considered as key factors behind the wide treatment gap and the problem deepens in  women's mental health care. In a male dominant society, most women lack the decision making capacity even for healthcare access, to cross a long distance and visit professionals. Moreover, the financial constraints of  poor people is another barrier for them to seek mental health care. The COVID-19 outbreak made the situation more distressful for the pregnant women and new born babies   due to increased concerned and phobia being infected, safe delivery of the child, the upcoming insecurity and death of friends and family members.

We provide an integrated mental  health solution for pregnant women and new born babies starting from awareness and preparation to be pregnant, regular monitoring during pregnancy with regular consultation with mental health professionals  offer compact health services to pregnant women during perinatal period. In this integrated program at first we screen our patients. We also collect patient’s information throughout the pregnancy period based on biopsychological model. We collect information from patients through interview, self rating questionnaire and test results. In this process patients can upload their previous treatment prescriptions in our website. Here, the through digital information of a patient helps our health experts to make an idiosyncratic treatment plan and execute them accordingly.

Our service program also include regular mental and physical health checkup of pregnant women throughout their perinatal period. Pregnancy is a period of rapid change both physically and emotionally. The rapid change of hormones in the body creates heightened emotions especially mood swings that often interferes with healthy family relationships.

Sopnojatra serve the women at reproductive age, pregnant women. Infants, the family and community in a synchronous and integrated way.  

Pregnant women:  a) Awareness creating through different leaflets, posters and  audio video clips, with additional online and offline workshops,seminars  

                    b) regular monitoring their physical and mental health through  carefor me website

                    c) 6 online psychotherapy and counselling sessions during the pregnancy

                     d) Immediate access to Psychiatrist and Clinical Psychologist through Monerdaktar  https://monerdaktar.com/ whenever the mental health condition deteriorates                     

Child Development and wellbeing: We provide Online Parenting Programs for the parents to help acquire the knowledge and skill to maximise the chance for optimum development of each child.

The family: Considering the patriarchal norm of the society of our country, cultural resistance works as an obstacle for female patients to get proper antepartum and postpartum care. Our services for family engagement are designed to address these obstacles by providing family counseling and improvement of relations within the family.

Community: To solve maternal and child health issues, only family approach is not enough in the context of Bangladesh. As community outlook plays an important role in raising a child, the conventional and stigmatized ideas should be replaced with evidence-based and healthy ones. 

More than 4.57 billion people around the world now use the internet (https://datareportal.com/global-digital-overview). and World Psychiatric Association's Commission on the Future of Psychiatry considered ‘digital psychiatry as a major priority area for future practice, policy and research that could help ‘reach billions of people’ (Bhugra et al., 2017, p. 775). The efficacy and effectiveness of telepsychiatry has been documented in different context among different population including Bangladeshi population (Soron, 2017). Firth et al 2017 documented smartphone-based therapies yield the greatest benefits for depression. Considering the shortage of mental health professionals as well as barriers to access to mental health services, we have designed smart phone and computer based mental health apps and also an online platform to serve maximum number of people. We have already conducted different studies to findout the acceptance of mobile app for mental health care in Bangladesh (Soron 2019).   Our services have been highlighted in different electronic and print media. Every day we receive hundreds of positive feedbacks and response from our clients

Monerdaktar aims to be the complete mental health solution for all the pregnant women within one year. However, we consider the following key barriers that we need to address:

 1.       Poor Infrastructure and digital divide:

The lack of high-speed internet in most of the rural areas of the country is one of the key berries of ensuring access to our service Monerdaktar. Moreover, most of the pregnant women of low socioeconomic conditions don’t afford a smart phone or internet connection to take our services.

2.       Lack of Awareness:

 Most of the families in the country still believe they need physical health care and safe during pregnancy. However, the need of the mental health care during pregnancy and immediately after child birth is hardly considered as an important of the complete care.

• Lack of familiarity and confidence in online platform:

Though Telemedicine is in service in Bangladesh for more than a decade people are still not very familiar in online platform specially those living rural area and underprivileged group.

Government of Bangladesh

University of Dhaka

Bangladesh Clinical Psychology society

Bangladesh Child and Adolescent Society