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Screening for Antepartum Depression Through Community Health Outreach in Swaziland

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Abstract

Maternal depression, including antepartum and postpartum depression, is a neglected public health issue with potentially far-reaching effects on maternal and child health. We aimed to measure the burden of antepartum depression and identify risk factors among women in a peri-urban community in Swaziland. We conducted a cross-sectional study within the context of a community outreach peer support project involving “Mentor Mothers”. We used of the Edinburgh Postnatal Depression Scale (EPDS) to screen women for depression during the third trimester of pregnancy, using a cut-off score of ≥13 to indicate depression. We also collected demographic and socioeconomic factors, and assessed the association of these factors with EPDS score using logistic regression models. A total of 1038 pregnant women were screened over a period of 9 months. Almost a quarter (22.7 %) had EPDS scores ≥13 and 41.2 % were HIV positive. A fifth, 17.5 % were teenagers and 73.7 % were unemployed. Depression was not associated with HIV status, age or employment status. However, women with multiple socioeconomic stressors were found to be more likely to score highly on the EPDS. Depression was common among pregnant women in the peri-urban areas of Swaziland. Screening for depression using the EPDS is feasible and can be included in the community health worker standard tool box as a way to improve early detection of depression and to highlight the importance of maternal mental health as a core public health concern.

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Acknowledgments

The authors would like to acknowledge the everyday work of Siphilile’s Mentor Mothers to make their community a better place. This study was funded by Swedish International Development Cooperation Agency and Church of Sweden.

Authors’ Contributions

MM conceptualized the study. TM and MB collected data. MM performed analyses and prepared the first draft of the manuscript. All authors gave input to and have approved the final version.

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Authors and Affiliations

  1. International Maternal and Child Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Mats Målqvist & Mattias Bergman

  2. Siphilile Maternal and Child Health (NGO), Matsapha, Swaziland

    Mats Målqvist & Themba Matsebula

  3. Church of Sweden, Uppsala, Sweden

    Mats Målqvist

  4. University College London, London, UK

    Kelly Clarke

  5. Stellenbosch University, Stellenbosch, South Africa

    Mark Tomlinson

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  1. Mats Målqvist
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  2. Kelly Clarke
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Correspondence to Mats Målqvist.

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Målqvist, M., Clarke, K., Matsebula, T. et al. Screening for Antepartum Depression Through Community Health Outreach in Swaziland. J Community Health 41, 946–952 (2016). https://doi.org/10.1007/s10900-016-0175-9

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  • DOI: https://doi.org/10.1007/s10900-016-0175-9

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