Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study

Abstract

Background Postnatal depression (PND) is a universal mental health problem that prevents mothers’ optimal existence and mothering. Although research has shown high PND prevalence rates in Africa, including Kenya, little research has been conducted to determine the contributing factors, especially in low-resource communities. Objective This study aimed to investigate the PND risk factors among mothers attending Lang’ata and Riruta Maternal and Child Health Clinics (MCH) in the slums, Nairobi. Methods This study was cross-sectional. It is part of a large study that investigated the effectiveness of a brief psychoeducational intervention on PND. Postnatal mothers (567) of 6-10 weeks postanatal formed the study population. Depression rate was measured using the original 1961 Beck’s Depression Inventory (BDI). In addition, a sociodemographic questionnaire (SDQ) was used to collect hypothesized risk variables. Multivariable logistic regression analysis was used to explore predictors of PND. Results The overall prevalence of PND in the sample of women was 27.1%. Women aged 18-24 (β = 2.04 95% C.I.[0.02; 4.05], p = 0.047), dissatisfied with body image (β = 4.33 95% C.I.[2.26; 6.41], p < 0.001), had an unplanned pregnancy (β = 2.31 95% C.I.[0.81; 3.80], p = 0.003 and felt fatigued (β = − 1.85 95% C.I.[− 3.50; 0.20], p = 0.028) had higher odds of developing PND. Participants who had no stressful life events had significantly lower depression scores as compared to those who had stressful life events (β = − 1.71 95% C.I.[− 3.30; − 0.11], p = 0.036) when depression was treated as a continuous outcome. Sensitivity analysis showed that mothers who had secondary and tertiary level of education had 51 and 73% had lower likelihood of having depression as compared to those with a primary level of education (A.O.R = 0.49 95% C.I.[0.31-0.78], p = 0.002) and (A.O.R = 0.27 95% C.I.[0.09-0.75], p = 0.013) respectively. Conclusion This study reveals key predictors/risk factors for PND in low-income settings building upon the scanty data. Identifying risk factors for PND may help in devising focused preventive and treatment strategies.

Prevalence and associated factors of maternal depression among mothers of children with undernutrition at comprehensive specialized hospitals in northwest, Ethiopia, 2023: a cross‑sectional study

“…The screening tools used in Northern Ghana, Kenya and Brazil were different from the screening tools used in the current study. Centre for Epidemiological Studies Depression Screening Scale (CES-D), Beck's Depression Inventory (BDI) and EPDS were used in Northern Ghana, Kenya and Brazil respectively, Whereas the current study used PHQ-9 which has more sensitivity compared to tools employed in previous studies in Africa and Brazil (49)(50)(51) In this regard, the use of PHQ-9 may overestimate the prevalence of maternal depression among mothers of children with undernutrition. The other plausible explanation for the discrepancy in the prevalence rate between our current study and the previous study in Brazil may be attributable to the type of research design employed, speci cally the cohort used in Brazil (51).…”

“…The current prevalence nding of maternal depression was also higher in studies done outside Ethiopia in a study among mothers of children with malnutrition that involved a comparative study between African countries; speci cally Northern Ghana, Kenya for which the prevalence rate was reported at 27.8% and 27.1% respectively (49,50), Similarly in the current study the prevalence of maternal depression was also higher than a study done at Brazil which reported 17.9% (51). The possible reason for those variations may be due to differences in the socioeconomic status of participants, maternal educational status, screening tools and cut-off points, study setting and availability of health facilities between those countries.…”

Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support

“…The impact of intimate partner violence aligns with the importance of good partner support. Additionally, previous mental health issues, which may be triggered or exacerbated by extreme negative events, are known to be associated with PND, emphasizing the significance of individual's personal history in assessing the risk of PND (18,35). It is noteworthy that many of the economic and social factors typically associated with PND did not emerge as significant predictors in the multivariate or bivariate analyses.…”

Factors Influencing the Effectiveness of Midwife Led Debriefing on Prevention of Postpartum Depression in Western, Kenya

“…Women in Rural Ethiopia received less social support or even help in family and house work (Abadiga, 2019). According to Kariuki et al (2022), low income for women in the African countries affects negatively their emotional state. This was because mothers may not concentrate on the current state but remain in deep thoughts of what is ahead of them in terms of their inability to pay hospital fees or even afford a meal for herself, baby and entire family (Kariuki et al, 2022).…”