Long-term effects on depressive symptoms among Ugandan mothers - Findings from a follow-up of a cluster-randomized education trial in a rural low-resource setting.

Journal: Journal of affective disorders

Volume: 351

Issue: 

Year of Publication: 2024

Affiliated Institutions:  Department of Family Life and Consumer Studies (Home Economics), Kyambogo University, Kampala, Uganda. Electronic address: gmuhoozi@kyu.ac.ug. Department of Nutrition, IMB, University of Oslo, Oslo, Norway; Department of Haematology, Oslo University Hospital, Oslo, Norway; Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa. Division of Obstetrics and Gynecology, Department of Obstetrics, Oslo University Hospital - Rikshospitalet, Oslo, Norway; School of Health Sciences, Kristiania University College, Oslo, Norway. KEMRI Wellcome Trust Research Programme, Kilifi, Kenya and Department of Public Health, School of Health & Human Sciences, Pwani University, Kilifi, Kenya. Department of Nutrition, IMB, University of Oslo, Oslo, Norway. Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.

Abstract summary 

Depression is increasingly affecting mothers in poor countries such as Uganda. Various interventions have been implemented to tackle this problem, but their sustainability is under-researched. Here we present follow-up data on maternal depression six years after a cluster-randomized controlled maternal education trial in rural Uganda.The intervention lasted six months and consisted of nutrition, hygiene, sanitation and child stimulation education, delivered to 511 mothers of 6 to 8 months' old children. Six years later we assessed maternal depressive symptoms using two psychometric tools; the Beck Depression Inventory II (BDI-II) and Center for Epidemiologic Studies Depression scale (CESD).For this follow-up study, data was available from 307/511 (60 %) mothers. Intention-to-treat analyses adjusting for clustering showed that the intervention mothers had non-significantly less depression symptoms (absolute score difference - 2; 95 % CI -5 to 0; p = 0.07) on BDI-II, and borderline significantly less depression symptoms (absolute score difference - 3; 95 % CI -5 to 0; p = 0.05) on CES-D compared to the controls. For categorized depression scores, the control mothers had significantly higher proportion of women classified in the worse depression categories for both BDI-II and CESD. We did not find any baseline characteristics associated with maternal depression.The BDI-II and CES-D tools are both self-reported and we cannot rule out the possibility of social desirability bias in reporting of depression symptoms.Six years after the maternal education trial, some benefits on maternal mental health were sustained. More studies are warranted on sustainability and scale-up of such interventions.

Authors & Co-authors:  Muhoozi Iversen Westerberg Ngari Kakwangire Atukunda

Study Outcome 

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Statistics
Citations : 
Authors :  6
Identifiers
Doi : 10.1016/j.jad.2024.01.263
SSN : 1573-2517
Study Population
Women,Female,Mothers
Mesh Terms
Female
Other Terms
Children;Depression;Education;Mothers;Nutrition;Sanitation
Study Design
Study Approach
Country of Study
Uganda
Publication Country
Netherlands