Electronic Screening Of Perinatal Depression In Kampala, Uganda – Survey Results (Preprint)

BACKGROUND New and expectant mothers face several unique health challenges related to the physical and psychological changes accompanying motherhood. However, in low-income settings where mothers grapple with meeting basic physical needs like access to safe water, proper nutrition, access to health facilities and health workers, psychological needs may end up being ignored. Psychological needs are an important factor that can impact the physical health of the mother and the development of the child. OBJECTIVE In this paper, we report key findings from a survey of perinatal depression in 7518 women in Kampala, Uganda. The goal of the exercise was to establish statistical baselines for the prevalence of perinatal depression in Kampala and understand its relationship with key demographic variables. METHODS We employed an Android implementation of the Edinburgh Postnatal Depression Scale (EPDS). The scale gives depression scores from 0 to 30. Results were transmitted to a web-based backend MySQL server. Two EPDS depression classification scales were employed. The more common coarse-grained binary classification flags respondents who score 13 on the EPDS and above as possibly depressed. RESULTS Based on this classification it was found that 21.83% (95% CI: 20.91%–22.79%) of respondents were possibly depressed. We also employed a more detailed fine-grained classification, which classifies scores of 6 or less as minimal or mild depression, scores of 13 or less as mild depression, scores of 19 or less as moderate depression and scores greater than 20 as severe depression. Based on this classification, 60.59% (95% CI: 59.47%–61.69%) of respondents were found to be mildly depressed. 19.59% (95% CI: 18.7%–20.51%) of respondents were flagged as moderately depressed and 17.58% (95% CI: 16.73%–18.46%) were flagged as not or minimally depressed and 2.23% (95% CI: 1.91%–2.59%) were found to be severely depressed. CONCLUSIONS Spousal employment category was found to be a key determinant for respondents’ overall depression and anxiety score and respondent’s relationship status was found to be an important factor for suicidal ideation. This conclusively means that financial stability greatly influences mental stability and as such, advocacy to have men support their spouses is crucial