For Marie-Aimée Uwayo, the first weeks after giving birth were unexpectedly difficult. Instead of enjoying her new role as a mother, she struggled to bond with her baby. Her moods shifted constantly, and she withdrew from everyone around her. “I would shut myself in my room and cry,” she recalls. “I didn’t want to talk to anyone. I felt deeply low, yet I couldn’t understand why, because nothing was physically wrong.” According to Uwayo, the situation worsened when she began having frightening thoughts that signaled she was in serious distress. At the same time, her husband felt overwhelmed and was considering giving up on the marriage. Her older sister eventually stepped in, recognized that she needed urgent help, and connected her with a psychological clinical officer who provided proper care. Uwayo is one of many mothers facing post-partum mental health challenges and in need of support through available treatment programmes. At the fourth edition of the Africa Health Tech Summit, held at the Kigali Convention Centre from October 13 to 15, Maisha Mothers, a programme by Thalia Psychotherapy unveiled a proposal that could transform the way maternal mental healthcare is funded across Rwanda and the region. The initiative seeks to establish a public–private partnership (PPP) that would channel local pension funds into financing postpartum depression screening, therapy, and follow-up care. Thalia Psychotherapy is a digital mental health startup headquartered in Nairobi, Kenya, that integrates mental health services into primary healthcare systems across Africa. ALSO READ: Experts unsatisfied with new postpartum depression clauses Mercy Mwende, Thalia Psychotherapy co-founder and Head of Operations, said there is a need to build a new financing model, one that taps into local pension funds to sustainably support screenings, therapy, and follow-up care for mothers experiencing depression, anxiety, or trauma after childbirth. ALSO READ: Mother’s Day: Fighting postpartum depression The organisation which is seeking to operate in Rwanda said it is set to provide the systems, trained staff, and digital tools, while the Rwandan government would provide the enabling environment and integration into public clinics, as pension funds provide the capital, repaid through impact bonds and outcome-based agreements. Understanding postpartum depression According to clevelandclinic.org, postpartum depression is a type of depression that happens after having a baby. Postpartum depression involves emotional highs and lows, frequent crying, fatigue, guilt and anxiety. It affects up to 15% of women. ALSO READ: Fighting postpartum depression Understanding these risk factors can help individuals and families prepare for and recognise emotional changes after childbirth, allowing for earlier support and intervention when needed, according to experts. One major risk factor is having a personal or family history of depression, postpartum depression, or premenstrual dysphoric disorder (PMDD). Limited social support can also contribute to emotional difficulties. When new mothers feel isolated or lack help from friends, family, or community, it can intensify feelings of stress, loneliness, and overwhelm. Marital or relationship conflict may also increase emotional strain. When the partner relationship is tense or unstable, it can add emotional pressure during an already challenging transition to parenthood. Ambivalence about the pregnancy, whether due to unplanned circumstances or personal uncertainty can also play a role. These mixed feelings can lead to guilt or anxiety after the baby arrives, making it harder to cope emotionally. Pregnancy complications, such as maternal health issues, a difficult labour and delivery, or a premature birth, can be physically and emotionally traumatic. These experiences may increase vulnerability to mood swings or depression. Being under the age of 20 or a single parent presents additional challenges, such as financial stress, lack of experience, or limited access to support systems, all of which can contribute to emotional strain. Caring for a baby with special needs or one who cries frequently can be exhausting and emotionally taxing. It can lead to sleep deprivation, frustration, and feelings of helplessness, all of which may intensify postpartum emotional struggles. “Universal health coverage means nothing if mental health is left behind. We want every mother to be asked how she’s feeling—not just if the baby is okay, but if she is okay too,” Mercy Mwende, Thalia Psychotherapy co-founder stated. Postpartum depression affects at least 1 in 5 mothers in Rwanda, according to recent studies. Yet services are scarce, and cultural stigma makes it even harder to ask for help. What are the symptoms of postpartum depression? You may have postpartum depression if you experience feeling sad, worthless, hopeless or guilty, worrying excessively or feeling on edge, loss of interest in hobbies or things you once enjoyed, changes in appetite or not eating, loss of energy and motivation, trouble sleeping or wanting to sleep all the time, crying for no reason or excessively. The symptoms also include difficulty thinking or focusing, thoughts of suicide or wishing you were dead, lack of interest in your baby or feeling anxious around your baby, as well as thoughts of hurting your baby or feeling like you don't want your baby. Can postpartum depression affect a baby? Research suggests that post-partum depression can affect babies. The mother can have trouble bonding with her baby and may not establish a connection with them. The child may have behavioural or learning problems and the mother may skip appointments with the child's paediatrician. The child may have feeding and sleeping issues and may be at higher risk for obesity or developmental disorders. The mother may neglect their child's care or not recognise when they are ill. The baby may have impaired social skills. What should be done? “We can make changes by screening women during routine antenatal and postnatal visits, referring them to care early, and offering financial relief through discounted baby essentials like nappies and food,” explained Mercy Mwende, Thalia Psychotherapy co-founder. ALSO READ: How to deal with postpartum depression She said a public–private partnership (PPP) model could reduce suicide, improve infant bonding, and lead to healthier families. The approach, presented during the summit’s track on Universal Health Coverage, was aligned with the broader goal of building resilient systems that are locally funded, locally managed, and scalable. “If Rwanda adopts the PPP model, it would be among the first African countries to use pension-backed bonds to fund mental health services. Early discussions with government stakeholders are reportedly underway. In a country known for bold, systems-level reforms, Maisha Mothers may be Rwanda’s next big step,” She noted. Experts advise that you notify your healthcare provider right away if you have thoughts of harming yourself or your baby, recurrent thoughts of death or suicide, depressed mood for most of the day nearly every day for the last two weeks, feeling anxious, guilty, hopeless, scared, panicked or worthless, or loss of interest or pleasure in most activities nearly every day for the last two weeks. There isn't a specific test that diagnoses postpartum depression. Your healthcare provider will evaluate you at your postpartum visit. This visit may include discussing your health history, how you’ve felt since delivery, a physical exam, pelvic exam and lab tests.
