No maternal health without perinatal mental health: a framework for standardized indicators

Perinatal mental health (PMH), the psychological wellbeing of women during pregnancy and up to one year postpartum, is increasingly recognized as a critical determinant of maternal and child health. Despite substantial evidence demonstrating the prevalence and consequences of perinatal mental health conditions, global monitoring systems rarely include standardized indicators to measure these conditions or the services addressing them. This gap limits the ability of countries to track progress, allocate resources, and design effective interventions. In this perspective article, we present the development of a proposed framework of indicators for global monitoring of perinatal mental health. The framework was informed by a scoping review of existing indicators, expert consultations, and two rounds of interest-holder surveys coordinated with the World Health Organization (WHO) and the Mother and Newborn Information for Tracking Outcomes and Results (MoNITOR) advisory group. Indicators were prioritized according to relevance, feasibility, validity, and their potential to support global advocacy and accountability. The resulting framework proposes six perinatal mental health indicators for future testing: three primary indicators, namely the existence of a national PMH policy or plan, prevalence of depressive symptoms, and screening coverage during the perinatal period; and three secondary indicators related to health system capacity and service provision. While implementing standardized monitoring will require strengthening health systems, workforce capacity, and data collection mechanisms, integrating these indicators into existing platforms such as routine health information systems and national surveys offers a feasible pathway forward. Systematic monitoring of perinatal mental health is essential for advancing maternal and newborn health agendas globally. Establishing a core set of indicators can support policy prioritization, guide resource allocation, and accelerate progress toward more comprehensive maternal health care that includes mental health.