Abstract
BackgroundAdolescent pregnancies within urban resource-deprived settlements predispose young girls to adverse mental health and psychosocial adversities, notably depression. Depression in sub-Saharan Africa is a leading contributor to years lived with disability (YLD). The study’s objective was to determine the prevalence of depression and related psychosocial risks among pregnant adolescents reporting at a maternal and child health clinic in Nairobi, Kenya.MethodsA convenient sample of 176 pregnant adolescents attending antenatal clinic in Kangemi primary healthcare health facility participated in the study. We used PHQ-9 to assess prevalence of depression. Hierarchical multivariate linear regression was performed to determine the independent predictors of depression from the psychosocial factors that were significantly associated with depression at the univariate analyses.ResultsOf the 176 pregnant adolescents between ages 15-18 years sampled in the study, 32.9% (n = 58) tested positive for a depression diagnosis using PHQ-9 using a cut-off score of 15+. However on multivariate linear regression, after various iterations, when individual predictors using standardized beta scores were examined, having experienced a stressful life event (B = 3.27, P = 0.001, β =0.25) explained the most variance in the care giver burden, followed by absence of social support for pregnant adolescents (B = − 2.76, P = 0.008, β = − 0.19), being diagnosed with HIV/AIDS (B = 3.81, P = 0.004, β =0.17) and being young (B = 2.46, P = 0.038, β =0.14).ConclusionDepression is common among pregnant adolescents in urban resource-deprived areas of Kenya and is correlated with well-documented risk factors such as being of a younger age and being HIV positive. Interventions aimed at reducing or preventing depression in this population should target these groups and provide support to those experiencing greatest stress.
Highlights
Adolescent pregnancies within urban resource-deprived settlements predispose young girls to adverse mental health and psychosocial adversities, notably depression
We found that 15.3% (n = 27) of pregnant adolescents were of ages 15-16 years indicative of a fairly early sexual initiation in our participants
Our findings suggest that the indicators for social support need to be multidimensional – covering parental, partner, educational and health contexts to assess the quality of support available to the young girls
Summary
Adolescent pregnancies within urban resource-deprived settlements predispose young girls to adverse mental health and psychosocial adversities, notably depression. Two thirds of young people, worldwide are growing up in countries like Kenya where preventable and treatable health problems like HIV/AIDS, early pregnancy, unsafe sex and depression are common and where injury and violence remain a daily threat to their health, wellbeing and prospects in life [3,4,5,6]. With the growth of urban informal settlements, populated with an emerging class of citizens known as ‘urban poor’; a large number of whom are children and young people with poor access to health, education or even basic sanitation and resources in an additional challenge in several African counties including Kenya [9]. Sexual and reproductive health education and services and absence of robust maternity services are common problems in these informal settlements [10]. In the urban resourcedeprived settlements it predisposes young girls to adverse mental health outcomes and enormous psychosocial stresses including stigma and discrimination [3]
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