There is a lack of awareness among women about their own health problemsThere is a lack of awareness among women about their own health problems

There is a lack of awareness among women about their own health problems. They have been used to the idea of “normal” to have health issues and to not seek treatment until the condition deteriorates further. There is a social stigma attached to feeling emotional and vulnerable. This culture of silence is even more when there are mental health issues involved. Mental health problems create a sense of feeling abnormal in women with involuntary childlessness. Hence, it is quite difficult to quantify the impact of mental health on reproductive capacities cannot be truly ascertained.
1.3.3.1 Determinants Of Mental Health
The World Health Organization defines mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. This can also be interpreted as, the lack of mental health problems also do not assure good mental health.
Individuals with involuntary childlessness have been known to have mild to moderate depression,anxiety and difficulties in coping with stressful situations. The “capability approach” by Amrtya Sen says that “the range of things which people value doing or being may vary from “elementary ones (such) as being adequately nourished and being free from avoidable disease to very complex activities or personal states, such as being able to take part in the life of the community and having self-respect”. This condition also needs to be seen from a capability based approach since, all individuals seeking treatment by their choice are seeking resorts within their limitations to absolve their insecurities and live a life of self-fulfilment.
There are five broad determinants of mental health which can be applied to identify and apply strategies to seek interventions for reduction in mental disorders and promote well-being of mental health in an person. “The determinants are:
1.Life course : Prenatal, Pregnancy and perinatal periods, early childhood, adolescence, working and family building years, older ages all related also to gender;
2.Parents, families, and households: parenting behaviours/attitudes; material conditions (income, access to resources, food/nutrition, water, sanitation, housing, employment), employment conditions and unemployment, parental physical and mental health, pregnancy and maternal care, social support;
3.Community: neighbourhood trust and safety, community based participation, violence/crime, attributes of the natural and built environment, neighbourhood deprivation;
4.Local services: early years care and education provision, schools, youth/adolescent services, health care, social services, clean water and sanitation;
5.Country level factors: poverty reduction, inequality, discrimination, governance, human rights, armed conflict, national policies to promote access to education, employment, health care, housing and services proportionate to need, social protection policies that are universal and proportionate to need.”*

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