POST-natal depression (PND) is a major global public concern, largely under-reported and neglected in Lesotho, affecting women in different ways after giving birth, a public health specialist of a local clinic, Health Direct Pharmaceutical, ’Mamonica Mokhesi Makhozonke, has found in a recent scientific study.
Feb. 9, 2024
4 min read
Post-natal depression ‘under-reported’
A new mother and her baby
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Makhozonke recently published a scientific study called The Prevalence of Postnatal Depression and Associative Factors among Clinic Attendees in Maseru Lesotho.
Speaking to the Public Eye, she said the study was about determining the prevalence of postnatal depression and associated factors among mothers attending Primary Health Care (PHC) in Maseru and screening for postnatal depression symptoms among women attending primary health care facilities within Maseru City Council in Lesotho.
She further said the high prevalence of postnatal depression in the current study suggests a significant burden of an undetected mental health condition among mothers in Maseru.
Postnatal depression is a type of depression that women experience after having a baby. It often peaks within four to six weeks after childbirth, but symptoms can persist for up to four years, during which time it impacts negatively on the health and social well-being of the mother, her child, and the whole family.
The main symptoms of postnatal depression include a decreased mood with overwhelming feelings of sadness, apathy, guilt, and worry. Affected mothers also experience reduced enjoyment and a loss of interest in daily activities, with consequential difficulties in coping with their maternal responsibilities.
The study reveals that, despite all the consequences of postnatal depression that affect the mother, child, and family unit, maternal mental health is often neglected in developing countries.
“As with other countries in Sub-Saharan Africa, Lesotho has limited resources and programmes that are dedicated to maternal mental health; therefore, routine screening for post-natal depression in primary health care facilities is not practiced, and the burden of postnatal depression is not known.
“The sleeping difficulties, diminished concentration, fatigue, changes in appetite, continuous crying, and contemplating self-harm significantly compromise the quality of life of the woman, resulting in strained interpersonal relationships,” the study discloses.
Postnatal depression in this study has also been associated with risky behavioural tendencies, such as substance abuse, which further compromises the ability of the woman to care for her child.
According to the study, infants of postnatally depressed mothers are more likely to have reduced quality of life, which includes cognitive development delays as well as language.
“Other health challenges for such children include frequent hospitalisations, poor nutritional status, irregular sleeping patterns, and higher risks of infant mortality. Because affected mothers are more likely to be unresponsive to the needs of their children, such children experience deprived emotional and social development and, consequently, compromised wellbeing for the baby,” it narrates.
Also, affected children are more likely to display behavioural problems and have a higher propensity towards violence in later years.
Makhozonke also outlined that the risks associated with postnatal depression are a combination of biological, social, and economic, and they expose women to postnatal depression. Women from lower socio-economic backgrounds are at a heightened risk, with contributory factors such as financial difficulties, poverty, unemployment, insecure accommodation, and lower levels of education being more prevalent.
“Lack of access to social support and good interpersonal relationships results in women feeling lonely, isolated, and overwhelmed with the duties associated with motherhood,” she reported.
Other stressful life events, such as the ill health of the baby, the death of a loved one, or being a victim of a violent crime, may also negatively affect maternal mental health.
The study further reveals that women who did not plan their pregnancies were at a two-fold higher risk than those who did.
On the other hand, a higher prevalence of postnatal depression was identified among HIV-positive women in several communities.
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Finding out about the HIV-positive status of the mother, along with related concerns about the health of the baby, also increases the risk of antenatal depression.
As a result, the high prevalence of postnatal depression highlighted the need to integrate routine screening of mothers, which will enable early diagnosis and treatment and thus contribute to the improvement of maternal and child well-being in the country.
It is recommended that routine screening for postnatal depression be integrated into Lesotho’s maternal healthcare services, and this requires policy change.
“Early diagnosis and treatment of affected women will limit complications and thus contribute towards improved maternal and child well-being in the country. It is also recommended that further studies on the burden of postnatal depression in Lesotho be conducted, with a focus on rural areas, where the majority of Basotho live,” Makhozonke advised.
The results, supported by literature from other African countries, suggest that other areas within Lesotho may also be greatly affected, thus indicating a need for further research, especially in rural areas, where the burden might be higher due to worse socio-economic issues.