The Need for Universal Screening for Postnatal Depression in South Africa: Confirmation from a Sub-District in Pretoria, South Africa

Abstract

Although postnatal depression (PND) is a worldwide public health problem, it is relatively higher in developing countries, including countries in Sub-Saharan Africa. Postnatal depression is not routinely screened for in primary healthcare facilities in South Africa, despite its reported compromise on mother and child health. The purpose of this study was to determine the prevalence of, as well as factors associated with, postnatal depression in a sample of clinic attendees in a sub district in Tshwane, South Africa. A quantitative and cross-sectional survey was conducted in a sample of 406 women in three healthcare facilities. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data from women who had infants between the ages of 0 and 12 months. The cut-off point for the EPDS for the depressed category was a score of 13 out of a maximum of 30. The majority of the women (57.14%, n = 232) had scores of 13 and above, which is indicative of postnatal depressive symptoms. On logistic regression, postnatal depressive symptoms were significantly associated with lack of support in difficult times (p < 0.001, 95% CI 10.57–546.51), not having the preferred sex of the baby (p = 0.001, 95% CI 0.37–0.58), low household income (p < 0.001, 95% CI 1.23–1.67), and an older baby (p = 0.005, 95% CI 1.21–1.49). The results show the high proportion of women who have postnatal depression but remain undiagnosed and untreated, and therefore confirm the need for routine screening for postnatal depressive symptoms in primary healthcare facilities, which are used by the majority of women in South Africa.

Prenatal depression exposure alters white matter integrity and neurodevelopment in early childhood

“…As PDE may have potentially long-term impact, it is important that maternal depression be identified and addressed early. This is especially pressing in LMIC settings such as our study setting, where rates of depression are much higher than in the general population (Mokwena & Masike, 2020 ), and where psychological interventions may be useful (Gajaria & Ravindran, 2018 ). The rate of depression in our larger DCHS cohort of 28% coincide with the higher rates in LMIC.…”

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

“…This indicate that the PND prevalence rate in this study is comparable but slightly higher than that of women attending the public hospitals which is expected since the mothers in this sample were exclusively from the slum settings and therefore extreme poverty. Recent research findings from other African countries show a high PND prevalence rates: Rwanda 63.6%, South Africa (57.14%) [ 35 ] and (38.8%) [ 36 ], Nigeria 35.6% [ 37 ]. Comparable to our finding, a systematic review and meta-analysis revealed a prevalence rate of 26% in Middle-East countries, while European countries had lower rates (8%) [ 38 ].…”

A comparative study of postnatal depression and associated factors in Gauteng and Free State provinces, South Africa

“…47,48 The validity in the study was enhanced by the use of the EPDS, which is an already valid, reliable, and standardised tool for screening of PND. 22 The EPDS tool has been used in previous South African studies. 13,30,49 Nonetheless, the tool was validated through content and face validity and a pilot study.…”

“…20 Although the negative impact of PND on both mother and child is well documented, 21 this area of maternal mental health has not enjoyed adequate attention in many countries, including South Africa. 22 The symptoms of PND can be easily identified by the use of the EPDS, a well-validated screening tool that is used in many countries. 23 Although this tool is economical and easy to use, PND is not routinely screened for in primary healthcare settings in South Africa.…”