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Efforts to support the mental well-being of women during and after pregnancy in Singapore will be scaled up, Second Minister for Health Masagos Zulkifli said during the Ministry of Health (MOH) Committee of Supply debate on Friday (Mar. 3).

In Singapore, about one in five pregnant women experience depressive symptoms during pregnancy or after delivery.

Additionally, about one in 10 women experience postnatal depression within the first three months postpartum.

The local study, "Growing Up in Singapore Towards Healthy Outcomes", found that maternal mental well-being during pregnancy could affect the brain development of the foetus, which could give rise to vulnerability, such as mood or anxiety disorders later in life.

The study also found that positive maternal mental health and well-being play an important role in the child's development after birth.

To address this, MOH aims to intervene early to better support the mental well-being of women during and after their pregnancy and avoid or minimise any detrimental effects on their children.

Mental health support for pregnant women in Singapore

New programme at KKH for pregnant women

KK Women's and Children's Hospital (KKH) has implemented the Psychological Resilience in Antenatal Management (PRAM) programme, which offers universal antenatal mental health screening for all pregnant women receiving outpatient obstetric care at KKH since December 2022.

PRAM will enable early detection and intervention for pregnant women with depressive symptoms.

Those showing depressive symptoms will be referred to the necessary care, said Masagos.

Prenatal mental health guidelines for women of child-bearing age

In February 2023, KKH and the College of Obstetricians and Gynaecologists Singapore launched a set of perinatal mental health guidelines for women of child-bearing age in Singapore.

With these guidelines, women and their families will be equipped with the relevant know-how to recognise changes in their mental well-being during pregnancy, identify basic signs and symptoms of mental health conditions, and be encouraged to seek help when needed.

The set of guidelines will be disseminated to healthcare professionals and the general public.

Masagos said:

"These guidelines provide comprehensive advice to better address maternal depression and anxiety during the preconception, and antenatal and postnatal phases. These guidelines are readable, and I encourage all, from family physicians, general practitioners (GP) to social workers and couples themselves to reference them."

More health support for mothers and families with young children

MOH will also be providing more support and targeted measures for families in Singapore to ensure that they stay healthy, said Masagos.

More Family Nexus sites to be rolled out

In March 2022, Masagos announced the piloting of Family Nexus at four sites across Singapore.

Family Nexus brings together selected health and social services under one roof, allowing families to easily access varied services at a one-stop community node near them.

This could be at or near a polyclinic, a GP clinic, or social service agency office.

Families can also navigate and sign up for other relevant programmes organised by community partners in the region, including breastfeeding and lactation support services, body mass index and growth assessment checks for young children, marriage preparation courses, activities that promote parents' emotional and mental well-being, parenting or grandparent programmes, and caregivers' training.

SingHealth and Families for Life have started operations of the first site at Our Tampines Hub since November 2022, and families with young children residing in Tampines or the East region can now access Family Nexus services and/or sign up for activities.

Other Family Nexus sites at Choa Chu Kang and Punggol will be progressively rolled out to support more families, Masagos announced.

He added that the Family Nexus at Sembawang will also be ready when the new Sembawang Polyclinic opens at Bukit Canberra later this year.

Plans to scale up mother-child dyad services across Singapore

The mother-child dyad services have also been implemented at nine polyclinics as of Mar. 1, 2023.

This includes pilot sites at Punggol and Yishun Polyclinics.

These services will be rolled out to several more polyclinics by the end of this year, said Masagos.

MOH aims to scale up these services to 14 polyclinics by 2025.

Under this effort, both mothers and their children can access healthcare services relevant to them in the same visit to the polyclinic.

For example, postnatal depression screening and breastfeeding support are provided to the mothers when they bring their child for vaccination and childhood developmental screening at the polyclinics.

New advisory on screen use for children aged 12 and below

MOH has also launched a new advisory on screen use for children up to 12 years of age in Singapore, announced Masagos.

While children can benefit from screen use, there are also potential downsides, particularly in children below 36 months, as it is a sensitive period of brain development.

Excessive screen use is also associated with poorer language skills and shorter attention spans in infants and toddlers.

It has also been observed that screen use is associated with insufficient good quality sleep, sedentary behaviours, increased obesity, and poorer mental health and well-being.

These potential negative consequences are linked to the degree that screen use displaces other activities, such as sleeping, playing and interacting with friends and being physically active.

MOH's new advisory will provide parents with more resources and practical help to support their children on healthy screen and device use.

The advisory was developed by an expert panel comprising professionals from healthcare, social and educational agencies under the ambit of the Child and Maternal Health and Well-being Taskforce.

Enhanced support for lower-income families

MOH will also be doing more to help families with lesser means to care for themselves, Masagos said.

Two regional pilots will be launched to provide more holistic and comprehensive support for preschool children from low-income families.

In the northeast region, SingHealth will be working alongside the KidSTART and ComLink teams, to lead cross-domain and multi-agency effort to support children through Project HOME (Holistic Management and Enablement).

NUH will also be rolling out a similar pilot in the west through the HEADS-UPP (HEAlth and Development Support in Preschool Partnerships) programme. NUH will work with Care Corner and PCF Sparkletots preschools in the region on this programme.

Both pilot programmes will equip preschool educators and social workers with skills to support the health and development screening of preschool children, identify at-risk children and refer them for intervention, and provide multi-disciplinary case management to children and their families.

There will also be home visits and additional support to equip and empower parents for families that are assessed as having complex needs.

Masagos said:

"These pilots will provide deeper insights on how we could further strengthen cross-domain collaborations to better support lower income families. If they are proven effective, we will explore scaling them nation-wide to benefit even more families."

Top image via Unsplash.