Prevalence and factors associated with postnatal depression among women in two rural districts of Manicaland, Zimbabwe

Background: Low- and middle-income countries are disproportionately affected by postnatal depression (PND). High prevalence of PND in urban Zimbabwe has been reported but the situation in rural settings is largely unknown and this is one of the first studies to report prevalence of PND in Chipinge and Mutasa districts. Objectives: This study explored the prevalence and associated factors of PND among women attending postnatal care services in two rural districts of Chipinge and Mutasa, Manicaland, Zimbabwe between August and September 2017. Methods: One hundred and ninety-two women were recruited consecutively as they attended postnatal services at 7 days and 42 days post delivery. The Diagnostic and Statistical Manual for Mental Disorders, fifth edition criteria was used to classify depression among participants. Prevalence of PND and 95.0% confidence intervals (CIs) were estimated and associations with key socio-demographic and risk factors assessed. Results: The mean age of participants was 23.7 years (standard deviation=6.14). Pooled prevalence of PND across the two districts was 26.0% (95% CI: 19.04­31.74). There was ahigher prevalence of PND in Mutasa (31.0%) as compared to Chipinge (21.48%) but this was not statistically significant (p=0.142). Having insufficient food in the household, intimate partner violence and having a child with birthweight under 2500 g significantly increased the likelihood of PND twofold: adjusted odds ratio (aOR)=2.8 (95% CI: 1.2­6.1),aOR=2.5 (95% CI: 1.2­5.3) and aOR=2.4 (95% CI: 1.1­5.6), respectively. Conclusion: The high prevalence of PND and its associated risk factors indicates the need for routine screening and targeted interventions for PND in Zimbabwe, especially in rural areas