Prevalence and factors associated with postpartum depression at a primary health care facility in Eswatini

Abstract

Background: Routine mental health screening has not been integrated into maternal and child health (MCH) services in many developing countries, including Eswatini (formerly Swaziland). As a result, the burden of postpartum depression (PPD) is not well understood and thus PPD remains untreated in such settings.

Aim: To describe the prevalence and factors associated with PPD among women seeking postnatal and child welfare services at a primary health care facility in Eswatini

Setting: King Sobhuza II Public Health Unit, Manzini, Eswatini

Methods: This was a cross-sectional study that used convenience sampling and the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression among 114 mothers during the first six weeks of postpartum. Multiple logistic regression analysis was conducted to determine socio-demographic and clinical factors associated with PPD.

Results: A majority of the participants were older than 24 years (52.6%) and unemployed (64.9%), while 47.4% screened positive for PPD (≥13 score). Adjusting for other covariates, those who were unemployed (odds ratio (OR) = 3.20, 95% confidence interval (CI): 1.17, 8.79) and with poor social support from their partners (OR = 9.41, 95% CI: 3.52, 25.14) were more likely to be depressed, while those who attended antenatal classes fewer than four times, were less likely to be depressed (OR = 0.32, 95% CI: 0.11, 0.92).

Conclusion: We found a high prevalence of PPD. There is a need to introduce routine maternal mental health screening during the postpartum period in order to ensure early detection and treatment of PPD.