Table 1
Mother interview questions.
| All mothers | Separated mothers only | |
|---|---|---|
| Can you describe your home environment? | How much does maternal-child separation occur in your community? | Why did you separate from your child? |
| Can you describe your family’s circumstances at the time of your child’s birth? | Do you have any family or friends who have separated from their children? If yes: What do you think the decision to separate from their child was like? | How do you feel about the decision to separate from your child? |
| Can you describe your community’s opinion regarding your family’s situation? | What are factors that you think contribute to mothers separating from their children? Prompts: health (mother and child), finances, family/social support, religion? | How did you reach that decision? Were there outside factors? If so, what were they? |
| Can you tell me about your relationship with your parents? | Do you use birth control or contraceptives? Why or why not? | Did anyone help you make the decision? If so, who? |
| Were you separated from your mother as a child? | Was/were your pregnancy/pregnancies intentional or wanted? | Did the child’s health contribute to abandonment? |
| Can you describe your current emotional state? | Do you feel as though there has been any pressure in making decisions about child’s future? | Did the family’s financial situation contribute to abandonment? |
| Did social/family support contribute to abandonment? | ||
Table 2
Community leader interview questions.
| How much does child relinquishment occur in your community? | Can you describe their families’ circumstance at the time of the birth of their child? | Are you aware of whether or not the pregnancy was intentional/wanted? |
| What do you think the decision to separate from a child is like for the mother? | Can you describe the community’s opinion regarding the family’s situation? | Do you believe that there is access to family planning or contraceptives? |
| Do you feel you have the resources to impact this? | Can you describe the relationship with their family members (mother and father)? | Do you feel as though there was any pressure in making the decisions in regard to their child’s future? |
| What resources do you wish you had? | Do you know if they were separated from their mothers as a child? | What are factors that you think contribute to mothers relinquishing their children? |
| Please think of a member or members of your community who have separated from their children or child for the following questions: | Can you describe their home environment? |
Table 3
Individual, Interview, and Quantitative Information Types.
| Individuals | Interviews | Complete quantitative information | |
|---|---|---|---|
| Mothers | 56 | 52 | 49 |
| Separated | 8 | 8 | 8 |
| Non-separated | 48 | 44 | 41 |
| Community leaders | 23 | 18 | |
| Female | 11 | ||
| Male | 12 | ||
| NGO affiliated* | 13 | 11 | |
| Government affiliated | 6 | 5 | |
| Religious organization* | 6 | 4 | |
| Total | 79 | 70 | 49 |
[i] * Some interviewees were affiliated with a religion based NGO and as such are counted twice in this table.
Table 4
Maternal Characteristics.
| N (%) | Mean | |
|---|---|---|
| Age | 39.98 | |
| Number children | 3.22 | |
| Number prior births | 5.18 | |
| Marital status | ||
| Married | 13 (23.3%) | |
| Live with partner | 10 (17.8%) | |
| Single | 22 (39.3%) | |
| Separated | 5 (8.9%) | |
| Widowed | 6 (10.7%) | |
| Ever attended school | 47 (83.9%) | |
| Child with disability | 9 (16.1%) |
Table 5
Summary of themes.
| Economic means is the most commonly mentioned factor contributing towards maternal-child separation. | Education surrounding and use of family planning measures is sparse. |
| Means to provide education for the child is the next most commonly mentioned factor contributing towards maternal-child separation after economic means. | While not cited as a factor in maternal-child separation, having a disabled child was repeatedly mentioned as a source of additional pressures, both social and financial. |
| Lack of support from, absence of, or rejection by the partner/spouse is a contributing component to maternal-child separation. | Women reported fear of judgement from their communities. |
| Lack of support system contributes to maternal-child separation. | Maternal mental health is poor overall, particularly in mothers separated from their children. |
| There is a pervasive negative stigma towards maternal-child separation. |
Figure 1
MAPP-QOL Socioeconomic Satisfaction Distribution.
Socioeconomic status sum within the MAPP-QOL (Maternal Postpartum Quality of Life Survey) was not found to be significantly different between separated and non-separated mothers.
Figure 2
MAPP-QOL Partner Support Satisfaction Distribution.
The shaded box represents the interquartile range (IQR), the range from the 25th percentile (Q1) to the 75th percentile (Q4). Median and mean are indicated by solid line and diamond, respectively. Horizontal lines indicate minimum and maximum values when they fall outside of the IQR.
A greater score indicates a greater feeling of satisfaction. The partner scores were found to have a large difference between separated and non-separated mothers in terms of the magnitude of effect reported when utilizing a wilcoxon rank sum test, with a p-value of <0.01. (Figure 1). Thus, lack of partner support is associated with maternal-child separation.
Figure 3
PHQ-9 Distribution.
The shaded box represents the interquartile range (IQR), the range from the 25th percentile (Q1) to the 75th percentile (Q4). Median and mean are indicated by solid line and diamond, respectively. Horizontal lines indicate minimum and maximum values when they fall outside of the IQR. Open circles indicate outliers as defined by less than Q1–(1.5*IQR) or greater than Q3+(1.5*IQR).
PHQ-9 scores indicate mild-moderate depression in 76% of mothers. PHQ-9 scores were not found to be statistically different between those who were separated and those were not.
Figure 4
PCL-C Distribution.
The shaded box represents the interquartile range (IQR), the range from the 25th percentile (Q1) to the 75th percentile (Q4). Median and mean are indicated by solid line and diamond, respectively. Horizontal lines indicate minimum and maximum values when they fall outside of the IQR.
58.3% of mothers overall scored >44 on the PCL-C, indicating high potential of PTSD. PCL-C scores are significantly higher in separated mothers, with over 80% of separated mothers scoring >44.
Figure 5
MAPP-QOL Psychological Satisfaction Distribution.
The shaded box represents the interquartile range (IQR), the range from the 25th percentile (Q1) to the 75th percentile (Q4). Median and mean are indicated by solid line and diamond, respectively. Horizontal lines indicate minimum and maximum values when they fall outside of the IQR. Open circles indicate outliers as defined by less than Q1–(1.5*IQR) or greater than Q3+(1.5*IQR).
A greater score indicates a greater feeling of satisfaction. The psychological scores were significantly different between separated and non-separated mothers, however, this difference was relatively small.