Association between the continuum of care and postpartum depression among Angolan mothers.

Journal: Journal of affective disorders

Volume: 339

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan. Electronic address: aoki-ai@ncchd.go.jp. Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan. Domus Custodius (SU) Lda. Tchikos Agency, Luanda, Angola. School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Human Development Department, Japan International Cooperation Agency, Tokyo, Japan. National Directorate of Public Health, Ministry of Health, Luanda, Angola.

Abstract summary 

This study investigated the association between maternal and child health service utilization patterns and postpartum depression (PPD).This study analyzed a dataset of women who participated in a randomized controlled trial to examine the effectiveness of the Maternal and Child Health Handbook in Angola. We defined probable PPD as an Edinburgh Postpartum Depression Scale (EPDS) score ≥ 10. The EPDS was administered at approximately 6 months postpartum. Service utilization patterns were defined using numbers of antenatal care (ANC), facility delivery, and vaccination visits by 6 months postpartum. The association between service utilization patterns and PPD was examined using logistic regression analyses adjusting for socioeconomic factors and parity. The continuum of care (CoC) complete pattern (four ANC/facility delivery/four vaccination) was used as a reference.The data of 7087 participants whose children were alive and aged 6 months or older at the endline survey were analyzed. Prevalence of PPD was 17.9 % in urban and 43.2 % in rural municipalities. In urban municipalities, dropouts from the CoC at delivery and after delivery had significantly higher odds of PPD (AOR = 1.45, 95 % CI = 1.00-2.10; AOR = 1.57, 95 % CI = 1.24-1.99). In rural municipalities, dropouts from the CoC after delivery (AOR = 1.60, 95 % CI = 1.12-2.28) had significantly higher odds of PPD.The onset of depressive symptoms was not assessed. The EPDS was validated in some Portuguese speaking countries but not in Angola.PPD was associated with irregular service utilization patterns such as dropouts from the CoC. Therefore, CoC and mental health must be promoted simultaneously.

Authors & Co-authors:  Aoki Ai A Mochida Keiji K Balogun Olukunmi Omobolanle OO Tomo Caroline Kaori CK Tchicondingosse Lino L Sapalalo Pedro P Aiga Hirotsugu H Francisco Ketha Rubuz KR Takehara Kenji K

Study Outcome 

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Citations : 
Authors :  9
Identifiers
Doi : 10.1016/j.jad.2023.07.020
SSN : 1573-2517
Study Population
Women
Mesh Terms
Child
Other Terms
Continuum of care;Health service utilization;Longitudinal analysis;Postpartum depression;Sub-Saharan Africa
Study Design
Study Approach
Country of Study
Angola
Publication Country
Netherlands