Prevalence and factors associated with postpartum depression at a primary healthcare 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 in 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 healthcare facility in Eswatini. SETTING: The study was conducted at the King Sobhuza II Public Health Unit in 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 6 weeks of postpartum at the King Sobhuza II Public Health Unit, Manzini, Eswatini. Multiple logistic regression analysis was conducted to determine sociodemographic and clinical factors associated with PPD. RESULTS: A majority of the participants were older than 24 years (52.6%) and unemployed (64.9%), whereas 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 to ensure early detection and treatment of PPD.