Patterns of intimate partner violence among perinatal women with depression symptoms in Khayelitsha, South Africa: a longitudinal analysis

Schneider, Marguerite; Baron, Emily; Davies, Thandi; Munodawafa, Memory; Lund, C

doi:10.1017/gmh.2018.1

Cited by 31 publications

(49 citation statements)

References 42 publications

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“…They were also at greater risk of committing suicide and were more likely to have a current or lifetime diagnosis of depression. These findings support previous evidence of the association between perinatal depressive symptoms in South African women and suicide risk [78], hazardous drinking [5, 24], IPV [3, 19, 20] and food insecurity [5, 14, 16, 17]. It is interesting to note that the same association between suicidal risk and trajectories were found when the suicide item was excluded from the HDRS scores used for the GMM and post-hoc analyses (results not presented here).…”

Section: Discussionsupporting

confidence: 90%

“…However, food insecurity, defined as the inability to access a sufficient quantity of healthy food on a daily basis and reported by 38% of households in South Africa [15], has consistently been identified as a risk factor for antenatal and postnatal depression in the Western Cape [5, 14, 16, 17]. Intimate partner violence (IPV) has also been reported as a risk factor for perinatal depression in South Africa [3, 18–20], where IPV is common and is reported by more than 40% of pregnant women [21].…”

Section: Introductionmentioning

confidence: 99%

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Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors

Garman

Schneider

Lund

2019

BMC Pregnancy Childbirth

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Background The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. Methods This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. Results Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. Conclusions A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings. Electronic supplementary material The online version of this article (10.1186/s12884-019-2355-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors

Garman

Schneider

Lund

2019

BMC Pregnancy Childbirth

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“…The majority (95%) [4,9,15,21, of research articles included in this review were cross-sectional and the remaining (5%) were cohort studies [86][87][88]. Only cross-sectional studies were used to estimate the pooled prevalence rates.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…The prevalence of IPV in various SSA countries was sourced from 25 studies. The findings showed the prevalence ranged from as low as 13.9% (95% CI 10.8, 17.6%) [86] in a study conducted on perinatal women with depression symptoms in South Africa to as high as 97% (95% CI 94.6, 98%) [37] in a study conducted among rural women in Nigeria. The overall meta-analysis estimate for prevalence of IPV was 44.4% (95% 38.4, 49.8%) ( Figure S2).…”

Section: Prevalence Of Ipv Among Women Aged 15-49 Years Of Agementioning

confidence: 99%

Gender Based Violence against Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Muluneh

Stulz

Francis

et al. 2020

IJERPH

167

140

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This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG’s) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG’s that will lead to sustainable changes in women’s health.

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“…Risk factors for perinatal depression faced by women in sub-Saharan Africa, include: HIV/AIDS [10–12], loss of a child or loved one [13], low social support [9,14], poverty [10,13–16], intimate partner violence [9,14,17,18] and relationship problems [10,13]. Perinatal depression has also been associated with unplanned pregnancy, a previous history of depression or anxiety, food insecurity and past experience of life threatening events [4,5,7,9,19].…”

Section: Introductionmentioning

confidence: 99%

“Passing through difficult times”: Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention

et al. 2019

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Purpose This study was conducted to explore the perceptions of perinatal women and key maternal care health workers about perinatal depression and the health service needs required to inform development of a culturally sensitive and acceptable psychosocial intervention. Methods This qualitative study used a descriptive exploratory design; it is the first phase of a larger mixed methods study aimed at adapting a psychosocial intervention for perinatal depression. We conducted in-depth interviews with 22 women who screened positive for depression using a locally validated Chichewa version of the Edinburgh Postnatal Depression Scale at antenatal and postnatal clinics in 1 rural and 1 urban health care setting in Lilongwe District, Malawi. We also conducted 10 key informant interviews with maternal care health workers. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of perinatal depression and health service needs. Interviews were transcribed, translated and analysed using content analysis approach. Results Perinatal depression was recognized as a common mental health problem that affected self-care activities and functioning of women in the perinatal period. Financial difficulties, relationship problems (polygamy, lack of support, neglect, and infidelity), traumatic events (intimate partner violence and loss) and fear of birth outcomes were identified as causes of depression. All study participants acknowledged the need for support and an intervention that will address the identified challenges. Additionally, they viewed strengthening the health delivery system as crucial to effectively address their needs and gaps identified in the system. Conclusion The results of this study support plans to develop a family focused intervention for perinatal depression in Malawi addressing relationship, psychosocial and economic issues. It also highlights the importance of strengthening the health delivery system especially at primary care level where the majority of women access care in Malawi and across Sub-Saharan Africa.

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Patterns of intimate partner violence among perinatal women with depression symptoms in Khayelitsha, South Africa: a longitudinal analysis

Cited by 31 publications

References 42 publications

Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors

Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors

Gender Based Violence against Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

“Passing through difficult times”: Perceptions of perinatal depression and treatment needs in Malawi - A qualitative study to inform the development of a culturally sensitive intervention

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