Diksha Sapkota

Teenage childbirth is considered a contributing factor to lifelong health and social disparities for mothers; however, evidence is mostly derived from cross-sectional studies utilizing self-report surveys and is often limited to one or a few psychosocial outcomes. We compared the risk of adverse psychosocial outcomes during young adulthood, including inpatient hospitalization for mental illness (MI) or substance use disorder (SUD), and offending, among teenage mothers (< 20 years), adult mothers (≥ 20 years) and non-mothers. Data included females born in Queensland, Australia, in 1983 and 1984, followed to age 29–31 years who were registered as mothers via birth records ( N = 18,188). MI and SUD were identified from inpatient hospital records, while offending data were obtained from police and court records. Risks of adverse psychosocial outcomes in young adulthood were compared between teenage mothers, adult mothers and non-mothers using regression analyses. The lifetime prevalence of adverse psychosocial outcomes was significantly higher among teenage mothers (55.0%) than adult mothers (22.9%) and non-mothers (13.6%). Offending was the most common adverse outcome across all groups. Both adjusted analyses and propensity-scored matched analyses revealed that teenage childbirth was a significant risk factor for adverse psychosocial outcomes in young adulthood. Teenage mothers were at increased risk of inpatient hospitalizations with MI or SUD and involvement in offending compared with adult or nonmothers, even after controlling for known covariates. These findings highlight the need for holistic, continual, and integrated support for teenage mothers to improve their long-term health and social outcomes.

Background: Incarcerated mothers frequently experience multiple adversities that negatively affect their mental and physical health, yet the timing and nature of these relationships remain underexplored. Objective: This study aimed to examine the timing, type and extent of health problems and adversities experienced by incarcerated mothers in Australia in the five years preceding their current incarceration. Design: A cross-sectional study with retrospective life history data using a Life Events Calendar. Methods: Data were drawn from 120 mothers in prison who participated in a larger project on maternal incarceration and child wellbeing. Health problems and adversities occurring in the last five years before incarceration were summarised using descriptive statistics. Bivariate analyses were conducted to assess associations between specific adversities and any, physical, or mental health problems. The number of adversities experienced in each year were compared between mothers with and without health problems. Results: Of the 119 mothers included in the analysis, 47.9% reported physical health problems, 83.2% reported mental health problems and 42.9% reported both in the last five years. The most common adversities were problematic drug use and victimisation, each reported by 84.0% of mothers. Problematic drug use was strongly associated with all categories of health problems, while death of loved ones was associated with physical health problems. Mothers with physical health problems experienced more adversities in the one to three years before incarceration, while those with mental health problems had greater adversity exposure three to five years prior. Conclusion: Incarcerated mothers experience high levels of adversity and health problems, with mental health problems linked to earlier adversity and physical health problems linked to recent adversity. The findings underscore the need for early, holistic, and trauma-informed interventions, particularly those addressing substance use and victimisation, to improve health outcomes and intergenerational harm.

Most incarcerated women have histories of trauma, victimisation, poor mental health, and disadvantage, and most also have mothering roles. Their support needs differ markedly from those of incarcerated men, yet most correctional settings are designed for men. This paper sets out how we co‐created a new model of service combining a systems change focus (Transforming Corrections) with holistic, individualised support for incarcerated mothers and their children (Transforming Lives). The process drew on Ghate's approach to implementing services that meet the specific needs of families and the Design Council's Systemic Design Framework to developing social services. Input by imprisoned mothers and service stakeholders was central throughout. This paper contributes to the limited research on co‐creation within correctional settings and sets out a comprehensive transformational service delivery model for imprisoned mothers and their children that aims to break intergenerational disadvantage and support improved life outcomes.

Global health funding by the United States government declined precipitously in 2025, triggering a cascade of international disinvestment in women’s health in low and middle-income countries, followed by a new era of ‘America First’ aid policy. Successive budget cuts by other high-income countries compounded the effects of these abrupt policy and geopolitical changes on women’s health, safety, and access to life saving and health assuring prevention, care and treatment, worldwide. Abandonment of active programmes and research studies disproportionately harms women by disrupting employment, reversing progress in education, eroding essential services and undermining community partnerships. The global health funding crisis weakens systems and diminishes capacity, impacting women’s physical and mental health, economic survival, and equity of opportunity across the life-course. New proposals to tie aid funding to data sharing have disproportionate impacts on women, while continued hostility to gender diversity places non-binary and transgender people at increased risk of further marginalisation. The current moment of crisis also illuminates profound limitations of the international systems which previously governed global health, indicating opportunities for transformation. In this Essay, we outline the foreseeable, intergenerational harms of defunding initiatives which promote and enhance the health and safety of women everywhere or tie their funding to agendas which would erode women’s reproductive autonomy. Amid deliberate efforts to disorientate opposition through simultaneous and sequential upheavals and concerted censorship of academic freedom, we call for concerted outcry, organised resistance, and synchronous action to safeguard women’s health and rights before more damage is done.

Background Growing international concern surrounds the consistently high number of infants removed from their families, with a disproportionate impact on marginalised communities. Objectives The review aims to synthesise qualitative research that focuses on the experiences of mothers involved with child protection services during pregnancy. Method A systematic search was conducted across five electronic databases along with citation searches of relevant articles, identifying 6 publications published between 2010 and 2025, drawing on qualitative accounts of mothers’ experiences with child protection during pregnancy. Results Thematic analysis revealed three overarching themes: (1) avoidance of health and welfare services; (2) deficit-oriented systemic practices; and (3) mothers’ unaddressed underlying issues. Conclusion Findings highlight the profound impact of child protection involvement on mothers, including service avoidance, cumulative disadvantage, and missed opportunities for early intervention. The review underscores the urgent need for trauma-informed, culturally responsive, and relational approaches to child protection that address both infant safety and maternal wellbeing. Systemic reform and collaborative practice are essential to break cycles of disadvantage and improve outcomes for families and communities.

No single conceptual framework currently captures the overall well-being of children experiencing maternal incarceration. To address this gap, we examined whether an existing, population-based child well-being framework, developed by the Australian Research Alliance for Children and Youth’s (ARACY), is able to account for factors known to influence the well-being of children in the context of maternal incarceration. Using a meta-narrative method, our synthesis of 97 documents revealed that the domains in the ARACY framework account for the overall well-being of children experiencing maternal incarceration; contextual factors specific to these children were not well represented. These factors include those that shape what well-being looks like for children experiencing maternal incarceration, those that are common to these children but not directly related to maternal incarceration, and those directly related to maternal incarceration itself. Therefore, while population-based frameworks like ARACY’s can serve as a useful tool to improve understanding of the well-being outcomes of children experiencing maternal incarceration, such frameworks should not be used for policy and practice translation without consideration of these unique contextual factors. Failure to do so may lead to inadequate support targets and indicators that poorly measure meaningful change for this population. Based on our findings, we suggest policy and practice efforts prioritise understanding well-being from different cultural perspectives, address pre-existing disadvantage, and implement multisystemic interventions tailored to individual children’s needs. Future research should develop robust prevention and intervention strategies that account for implementation challenges while deepening the theoretical and empirical understanding of these children’s unique well-being needs.

Background: Health care providers (HCPs) in public health facilities in low- and middle-income countries, including Nepal, often lack adequate training to manage mental health problems effectively. Objective: This study evaluated the impact of structured mental health training on the knowledge, attitudes, confidence, and psychosocial support skills of nonspecialist HCPs in Madhesh Province, Nepal. Methods: This study is a nested substudy within a larger domestic violence (DV) intervention trial and used a mixed method, pre–post intervention design with a comparison group. A total of 46 nonspecialist HCPs were randomized into 2 groups: group 1 (n=24) received a 10-day comprehensive mental health and violence prevention training; group 2 (n=22) received a 3-day training focused on ethical considerations, the link between intimate partner violence (IPV) or DV and mental health, and available referral services. The training was based on the World Health Organization’s Problem Management Plus model, with augmented modules on safety planning and psychosocial support. Changes in knowledge and attitude scores were assessed at baseline, immediately post-training, and at 3-month follow-up. In-depth interviews with participants from group 1 were thematically analyzed. Results: At baseline, nearly 90% of nonspecialist HCPs had not received any prior formal mental health training. Both groups demonstrated significant improvements in mental health knowledge, with a greater increase observed in group 1 (mean score 41.33-48.41) compared to group 2 (41.18-44.27). Attitudes toward individuals with mental health problems also improved in both groups, reflected in reductions in social distance and perceived dangerousness scores. Thematic analysis of interviews indicated enhanced confidence and psychosocial support skills, particularly in managing mental health concerns among women experiencing IPV or DV. Conclusions: Structured mental health training significantly improved both knowledge and attitudes among nonspecialist HCPs in public health facilities in Madhesh Province. Participants also reported increased confidence in addressing common mental health concerns. This training model has potential for scale-up in other resource-limited settings to build frontline capacity in managing mental health problems and supporting women experiencing IPV or DV.