PREDICTORS OF SYMPTOMS OF POSTNATAL DEPRESS ION AND THEIR ASSOCIATION WITH CHILD DEVELOPMENT IN LAMU AND KILIFI COUNTIES, KENYA

Abstract

Background mental health problems are of major public health concern, worldwide. However, there is limited systematic research investigating the correlates and impact of postnatal mental health problems in low and middle-income countries such as Kenya. This is not to underpin the good work done by many scholars both in low and middle income countries and high income countries who extensively explored and researched on predictors/ risk factors of postnatal maternal depression. It is through the good work of these researchers that we were able examine the prevalence, correlates and impact of postnatal maternal depressive symptoms in Kilifi and Lamu counties. Methods: This was a cross-sectional study involving 655 participants; women drawn from the counties of Lamu and Kilifi in Kenya. Mothers of children 6 weeks to 12 months were randomly recruited into the study. The Patient Health Questionnaire (PHQ-9), the Developmental Milestones Checklist (DMC) and a socio-demographic questionnaire were administered. The data collected was analyzed using STATA version 13 statistical packages. Frequency tables and logistic regression used to summarize and analyze the data. Results: 4.6% (n=30) of the mothers presented with depressive symptoms in this population based on the recommended cut-off scores for PHQ-9 of ≥10. Four risk factors independently observed to be associated with postnatal depression; ≥ 5 children aOR 3.72 CI 95%, (1.45, 9.59) p 0.01, abnormal pregnancy aOR 4.77 at 95% CI, (1.94, 11.72) p 0.001, separated/divorced aOR 6.93 at 95% CI (2.08, 23.10) p < 0.01, widowed aOR 13.39 at 95% CI (1.07, 168.20) widowed having the highest odds for depressive symptoms. When analysed separately the prevalence of postnatal maternal depressive symptoms in Kilifi would slightly higher at 6.5%. Categorizing the mothers by age, the study found mothers who were below 18years had the least depressed while age category 18 – 34 the most affected by postnatal depressive symptoms. Maternal depressive symptoms were not associated with childhood developmental outcomes in this population in motor, language and personal domains, even after controlling for the child’s mid upper arm circumference MUAC, mothers maternal age and parental social economic. Conclusions: The study suggests that the prevalence of maternal depressive symptoms is generally low in the two counties of Lamu and Kilifi. We found that Salient risk factors among mothers with depressive symptoms included being resident in Kilifi vi County and having many children, not having a marital partner and complications during pregnancy. It is good to note that out of the 655 postnatal mothers interviewed in the study not a single mother was found to have symptoms of postnatal depression from Lamu County all of them came from Kilifi County. We also found no association between mother’s postnatal depressive symptoms and child development outcomes. Having zero prevalence of postnatal depressive symptoms in lamu and having found no association or correlation between depressive symptoms and child development outcome could be as a result of measuring tools used because most of the studies that found association between the two used different tools from the ones that were used in this study, the PHQ 9 tool that was used to measure depressive symptoms could also be not very sensitive and to come with better results more than one tool each could have been used .