Abstract
BackgroundThe perinatal period provides an opportune time for health care providers to screen for and proffer interventions for women suffering from depression. However, routine screening for depression is not done in primary care settings in Zimbabwe.AimThis narrative review discusses opportunities and obstacles surrounding screening for perinatal depression in primary care settings in Zimbabwe, with a view to stress the importance of routine screening to policy-makers.MethodsBoth electronic and manual searches were done on PubMed, PubMed Central, African Journals Online, Google Scholar and the University of Zimbabwe Institutional Repository (UZIR) using the following key terms: ‘women and antenatal depression’, ‘prenatal depression’, ‘postnatal depression’, ‘postpartum depression’, ‘depressive disorder’, or ‘common mental disorder’ and ‘screening and Zimbabwe’.ResultsAlthough opportunities for depression screening are possible because of the high antenatal and postnatal service coverage, the potential for universal screening is fraught with human and financial resource constraints, lack of training in mental health care among primary health care providers and lack of locally validated screening tools for depression.ConclusionThere is a need to channel resources into the training of midwives and other primary health care providers on mental health issues affecting women perinatally.
Highlights
Depression exerts a substantial burden on women during the perinatal period.[1]
A total of 25 articles were identified using PubMed Central, 6 articles were found using African Journals Online (AJOL), 4 (1 journal article and 3 dissertations) were found on the University of Zimbabwe Institutional Repository (UZIR) and 1240 articles were identified through Google Scholar
Health care workers could sensitise women on perinatal depression during health promotion sessions in primary care settings when women present for antenatal care (ANC) or for other primary care services
Summary
Depression exerts a substantial burden on women during the perinatal period.[1]. In a recent systematic review, it was shown that antenatal depression may have short- and long-term negative effects on the foetus, newborns and adolescents.[2]. The largest proportion of these depressive disorders occur between the ages of 15 and 64 years with women being the most affected.[8] Women in low- and middle-income countries (LMICs) are disproportionately affected by depression with prevalence of postnatal depression (PND) as measured by screening studies using the Edinburgh Postnatal Depression Scales (EPDS), reaching up to 34% in Zimbabwe.[9,10,11] In Zimbabwe, common mental disorders (CMDs) like depression and anxiety are prevalent among women.[12] Recently, it was reported that 21.4%, 21.6% and 4% of respondents to a survey conducted in Harare had PND as measured by the Center for Epidemiological Studies-Depression Scale, postpartum suicidal ideation and suicidal attempts, respectively, during the perinatal period.[13] Challenges, exist in estimating the true burden of perinatal depression. Routine screening for depression is not done in primary care settings in Zimbabwe
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