Qualitative studies evaluating maternal mental health services are lacking in Ethiopia, and the available evidence targets severe mental illnesses in the general population. We conducted a qualitative study to explore barriers to, enablers of, or opportunities for perinatal depression health services implementations in Ethiopia. We conducted a total of 13 face to face interviews with mental and maternal health service administrators from different levels of the Ethiopian healthcare system. We interviewed in Amharic (a local language), transcribed and translated into English, and imported into NVivo. We analysed the translated interviews inductively using thematic framework analysis. The study identified: (i) health administrators’ low literacy about perinatal depression as individual level barriers; (ii) community low awareness, health-seeking behaviours and cultural norms about perinatal depression as socio-cultural level barriers; (iii) lack of government capacity, readiness, and priority of screening and managing perinatal depression as organisational level barriers; and (iv) lack of mental health policy, strategies, and healthcare systems as structural level barriers of perinatal mental health implementation in Ethiopia. The introduction of the new Mental Health Gap Action Programme (mhGap), health professionals’ commitment, and simplicity of screening programs were identified enablers of, or opportunities for, perinatal mental health service implementation. This qualitative inquiry identified important barriers and potential opportunities that could be used to address perinatal depression in Ethiopia. Building the capacity of policy makers and planners, strengthening the mental healthcare system and governance should be a priority issue for an effective integration of maternal mental health care with the routine maternal health services in Ethiopia.

中文翻译：

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“我们不知道如何筛查和提供治疗”：对埃塞俄比亚实施围产期抑郁症卫生服务的障碍和推动因素的定性研究

埃塞俄比亚缺乏评估孕产妇心理健康服务的定性研究，现有证据针对的是普通人群中的严重精神疾病。我们进行了一项定性研究，探讨埃塞俄比亚实施围产期抑郁症卫生服务的障碍、推动因素或机会。我们对埃塞俄比亚医疗系统不同级别的精神和孕产妇健康服务管理人员进行了 13 次面对面访谈。我们用阿姆哈拉语（当地语言）进行采访，转录并翻译成英语，然后导入 NVivo。我们使用主题框架分析对翻译后的采访进行归纳分析。研究发现：(i) 卫生管理人员对围产期抑郁症的了解程度较低，这是个人层面的障碍；(ii) 社区对围产期抑郁症的认识较低、寻求健康的行为和文化规范是社会文化层面的障碍；(iii) 政府缺乏筛查和管理围产期抑郁症的能力、准备和优先事项，这是组织层面的障碍；(iv) 缺乏心理健康政策、战略和医疗保健系统，成为埃塞俄比亚实施围产期心理健康的结构性障碍。新的心理健康差距行动计划（mhGap）的推出、卫生专业人员的承诺以及筛查计划的简单性被认为是实施围产期心理健康服务的推动因素或机会。这项定性调查确定了可用于解决埃塞俄比亚围产期抑郁症的重要障碍和潜在机会。建设政策制定者和规划者的能力、加强精神卫生保健系统和治理应成为埃塞俄比亚将孕产妇心理保健与常规孕产妇保健服务有效结合的优先事项。