Prevalence and factors associated with recent intimate partner violence and relationships between disability and depression in post-partum women in one clinic in eThekwini Municipality, South Africa

Depression and Intimate Partner Violence (IPV) in mothers 6 weeks to 12 months post-delivery in a rural setting in Kenya

Using a cohort of 544 postpartum mothers, 6 weeks to 12 months post-delivery in the largely rural Makueni County in Kenya, we aimed to determine: (1) the prevalence of postpartum depression (PPD) and the prevalence of each of the four domains of intimate partner violence (IPV), that is physical violence, sexual violence, emotional violence, and controlling behavior; (2) the co-occurrence of PPD and IPV; (3) risk factors and associations between sociodemographic variables and IPV, PPD and IPV and PPD co-occurring. We concurrently administered a researcher-designed sociodemographic ad hoc questionnaire, the WHO Intimate Partner Violence questionnaire and the Mini-International Neuropsychiatric Interview for adults (MINI Plus) for DSM-IV/ICD10 depression. The prevalence of PPD was 14.5%; Emotional violence 80.3%; Controlling behavior 74.4% (a form of emotional violence); Physical violence 40.3%; Sexual violence 28.9%. We found the following overlaps: 39% of participants reported both physical and emotional violence; 39% had both sexual and emotional violence; 15% experienced physical and sexual violence; and 15% of participants reported physical, sexual, and emotional violence. Postpartum depression was associated with physical violence during pregnancy, self-employed status, history of mood disorders and medical problems in the child. Further, we report associations between various types of IPV and history of depression, physical violence during pregnancy, low education level, marital status, and current depression diagnosis. IPV and PPD were highly prevalent in our population of postpartum mothers. Various types of IPV were significantly associated with various sociodemographic indicators while only sexual violence was significantly associated with PPD. Based on our results, we provide suggestions for potential interventions in the Kenyan setting.

Depression among currently married ever pregnant adolescents in Uttar Pradesh and Bihar: Evidence from understanding the lives of adolescents and young adults (UDAYA) survey, India

Background

Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar.

Methods

This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied.

Results

Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression.

Conclusions

This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers.

Postnatal depression and its social-cultural influences among adolescent mothers: A cross sectional study

In rural Malawi, adolescent mothers represent 31% of pregnancies. While some adolescent mothers experience motherhood as an exciting, positive, and affirming experience, for others, it may increase their risk of postnatal depression (PND). Social norms and culture contribute to adolescent mothers' experiences and may influence their mental health. However, there is limited research around the prevalence of PND and its cultural influences among adolescent mothers. A cross-sectional survey was administered from 7th September 2021 to 31st March 2022. Three hundred and ninety-five adolescent postnatal mothers aged ≤19 were conveniently recruited at Mitundu hospital in Lilongwe, Malawi. The Edinburgh Postnatal Depression Scale was used to assess depression. A cutoff point of ≥ 10 was employed to categorize probable PND. Binary logistic regression was used to determine the predictors of depression. The mean age of participants was 17 (SD 1.157). and 43.6% (n = 172) presented with PND (EPDS scores ≥10). When all factors were considered in a binary logistic model, adolescents who had ever experienced intimate partner violence (IPV) were 13.6 times more likely to report PND after controlling for age and other predictors compared to those without an experience of IPV (aOR 13.6, p = 0.01, 95% CI 2.10-88.9). Participants whose families did not decide for them (regarding their care) were 2.3 times more likely to present with PND than those whose families decided for them (aOR 2.3 p = 0.03, 95% CI 1.04-5.2). Adolescent mothers who had interacted with their health worker were less likely to report PND than those who had no interaction with the health worker (aOR 0.4 P0.02, CI 0.17-0.67). Social and cultural factors can impact mental health of adolescent mothers. It is recommended that targeted and integrated interventions are developed, implemented. and evaluated. There is a need to improve policy and practice to better support adolescent mothers postnatally.

The prevalence of intimate partner violence against women with disabilities: a systematic review of the literature

PURPOSE

Although systematic reviews have already been conducted on violence and disability, the evidence is not conclusive in Intimate Partner Violence (IPV). This study examined the prevalence of IPV in women with disabilities, taking account of the different types of violence and disability.

METHODS

We performed a search in five databases. We included observational studies that analysed the frequency of IPV in women with disabilities compared to women without. Two independent reviewers selected and assessed studies. We made a qualitative synthesis according to the type of IPV analysed in relation to disability.

RESULTS

We identified 26 articles. The frequency and risk of IPV were greater in women with disabilities than in those without. All of the articles that studied financial violence, 81.3% of those that studied physical violence, 78.5% of those that studied psychological violence, 75% of those that studied physical/sexual violence, 73.3% of those that studied sexual violence and 50% of those that studied any type of violence found a significant association whit disability.

CONCLUSIONS

Women with disabilities are at higher risk of IPV. Rehabilitation centers and its professionals must have a leading role in the identification of these situations and this should be considered in IPV prevention plans.Implications for rehabilitationPeople with disabilities are at higher risk of multiple types of violence.Violence against women with disabilities therefore involves two public health issues interacting simultaneously.Rehabilitation centers and its professionals should have a leading role in the identification of IPV in women with disabilities.IPV prevention plans should consider rehabilitation centers and its professionals as a main component of interventions in women with disabilities.

Disability and intimate partner violence: a cross-sectional study from Mwanza, Tanzania

BACKGROUND

Women with disabilities are at heightened risk of experiencing intimate partner violence [IPV], although the mechanisms through which disability acts as a risk factor for IPV are not clear.

OBJECTIVE

We analyzed cross-sectional data (n = 867) from Wave 3 of the MAISHA longitudinal study, conducted in Mwanza, Tanzania, to i) describe the levels of disability and IPV amongst women, and ii) to assess the association between level and type of disability and IPV experience.

METHODS

IPV was assessed using the WHO Multi-Country study instrument. Levels of disability (none, mild and severe) were categorized based on responses to the Washington Group Short Set questions. We fitted logistic regression models to determine the risk of experiencing each type of IPV according to disability level and type of disability.

RESULTS

We found significant associations between mild and severe disability and different types of IPV. For example, in multivariate analyses controlling for socio-demographic variables, women reporting severe disability were significantly more likely to report physical and/or sexual IPV, sexual IPV. controlling behaviors, economic IPV, and severe IPV, whereas for mild disability compared to no disability, physical and/or sexual IPV, sexual IPV, and economic IPV were significantly more likely to be reported. Cognitive disability was a significant correlate of all forms of IPV apart from physical IPV.

CONCLUSIONS

Our findings that specific types of disability and not others were associated with an elevated risk of IPV exposure indicate the need for nuanced measurement and analysis of the association between disability and IPV.

Predicting the Vulnerability of Women to Intimate Partner Violence in South Africa: Evidence from Tree-based Machine Learning Techniques

Intimate partner violence (IPV) is a pervasive social challenge with severe health and demographic consequences. Global statistics indicate that more than a third of women have experienced IPV at some point in their lives. In South Africa, IPV is considered a significant contributor to the country's broader problem with violence and a leading cause of femicide. Consequently, IPV has been the major focus of legislation and research across different disciplines. The present article aims to contribute to the growing scholarly literature by predicting factors that are associated with the risk of experiencing IPV. We used the 2016 South African Demographic and Health Survey dataset and restricted our analysis to 1,816 ever-married women who had complete information on the variables that were used to generate IPV. Prior research has mainly used regression analysis to identify correlates of IPV; however, while regression analysis can test a priori specified effects, it cannot capture unspecified inter-relationship across factors. To address this limitation, we opted for machine learning methods, which identify hidden and complex patterns and relationships in the data. Our results indicate that the fear of the husband is the most critical factor in determining the experience of IPV. In other words, the risk of IPV in South Africa is associated more with the husband or partner's characteristics than the woman's. The models developed in this study can be used to develop interventions by different stakeholders such as social workers, policymakers, and or other interested partners.

Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa

Background

Depression affects 14.8% – 38.8% of patients with rheumatoid arthritis (RA) in developed countries. The prevalence and risk factors for depression in patients with RA in sub-Saharan Africa is not well established.

Aim

To determine the prevalence of depressive symptoms in patients with RA.

Setting

Public sector regional hospital in South Africa.

Methods

A cross-sectional descriptive study was undertaken with 110 adult RA patients. A structured socio-demographic and clinical questionnaire, the modified health assessment questionnaire (mHAQ), the simplified disease activity index (SDAI) for RA, the patient health questionnaire (PHQ-9), and the Household Food Insecurity Access scale (HFIAS) for nutritional status, were used. Correlates of depressive symptomatology in participants with RA were identified using t-tests and regression analyses.

Results

Most of the participants were women (90.9%), 67% had moderate to severe RA disease on the SDAI score, 92.7% reported functional disability (HAQ score of ≥ 1), and 87.2% reported mild to severe depressive symptoms. Unemployment (p < 0.01), severe food insecurity (p < 0.01) and functional disability (p = 0.02), were significantly associated with the depressive symptoms, but not with disease activity (p = 0.8) or inflammatory markers (p = 0.63). Unemployment (adjusted β = −5.07, p < 0.01) and severe food insecurity (adjusted β = −4.47, p < 0.01) were significantly associated with depressive symptoms, based on the adjusted regression model.

Conclusion

As RA effects functional status, with the impact of the resulting unemployment and food insecurity being associated with depression, affected people should be screened for depression and managed using a multidisciplinary approach, especially considering the role of social determinants in RA patients with depression.

A scoping review of measurement of violence against women and disability

INTRODUCTION

Existing evidence indicates that prevalence of violence against women with disability is elevated compared to women without disability. We conducted a scoping review with a focus on measurement to assess the forms of measurement and study design utilized to explore the intersection of violence against women with disabilities, and to identify strengths and limitations in current approaches to measuring violence against women with disabilities. This scoping review is designed to inform current debates and discussions regarding how to generate evidence concerning violence against women with disabilities.

METHODS AND RESULTS

We conducted systematic searches of the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice, and Dissertations & Theses Global, and conducted structured searches of national statistics and surveys and grey literature available on-line. We identified 174 manuscripts or reports for inclusion. n = 113 manuscripts or reports utilized acts-specific measurement of violence. In terms of measurement of disability, we found that amongst the included manuscripts and reports, n = 75 utilized measures of functioning limitations (n = 20 of these were Washington Group questions), n = 15 utilized a single question approach and n = 67 defined participants in the research as having a disability based on a diagnosis or self-report of a health condition or impairment.

DISCUSSION

This scoping review provides a comprehensive overview of measurement of violence against women with disabilities and measurement of violence within disability-focused research. We identified several important gaps in the evidence, including lack of sex and disability disaggregation, limited evidence concerning adaptation of data collection methods to ensure accessibility of research activities for women with disabilities, and limited evidence concerning differential relationships between types of disability and violence exposure. This scoping review provides directions for sub-analyses of the included studies and further research to address gaps in evidence.

Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa

ABSTRACT

Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, 1.10-11.37) were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.

The Association of Depressive Symptoms and Intimate Partner Violence Against Women in Northwestern Botswana

Although links between mental health and intimate partner violence (IPV) have been discussed extensively in the scholarly literature, little empirical data exist about these phenomena in Botswana. This study addressed this gap by examining the nature, extent, and risk factors associated with symptoms of major depressive disorders (MDD) using cross-sectional data collected in 2009-2010 in northwestern Botswana. A random sample of 469 women participated in semistructured interviews about their lives, health, and experiences with violence. Thirty-one percent of respondents were found to meet the symptom criteria for MDD. Factors associated with MDD included emotional or physical violence by an intimate partner and being in a relationship in which both partners consumed alcohol. One in five women reported a recent experience of emotional violence, while 37% of respondents reported recent physical IPV. Women who have experienced emotional or physical IPV in the last 12 months have 89% and 82% greater odds, respectively, of having symptoms of MDD (p < .05) than women who have not recently experienced either form of violence. Women in relationships in which both partners consumed alcohol had more than twice the odds of MDD compared with women in relationships where neither partner or only one partner drank. Given the significant association of violence, alcohol, and MDD, screening for all three conditions should be part of routine care in health care settings in Botswana. Interventions to reduce IPV and alcohol consumption may help alleviate the burden of MDD in women in this setting.

A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa

A systematic review and meta-analysis were employed to address the associated factors of gender-based violence (GBV) in sub-Saharan African (SSA) countries. The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. A total of 4931 studies were found and 50 studies met the inclusion criteria. Pooled meta-analyses revealed that low educational attainment, higher alcohol consumption, substance use, history of child and family abuse, limited decision-making skills, experiencing depression, males having multiple sexual partners, and younger age were found to be individual- and family-associated factors that increase the experiences of GBV. Community tolerant attitudes to violence, women's unemployment, being Muslim, lower socioeconomic class, food and social insecurity were found to be community- and societal-associated factors of GBV. Alcohol consumption, low educational attainment, experiencing depression, being younger, a history of child and family abuse, tolerant attitudes to violence, and low socioeconomic status were poignant factors associated with GBV amongst women in SSA countries. The need to develop a multipronged approach of intervention is a top priority in SSA to reach the Sustainable Development Goals' (SDGs) target of 2030 to eliminate all forms of violence. Socio-behavioural change communication interventions at individual and community levels need to be introduced, and interventions need to address the prevention of child and family abuse and increase women's feelings of empowerment in order to prevent GBV in SSA.

How do programmes to prevent intimate partner violence among the general population impact women with disabilities? Post-hoc analysis of three randomised controlled trials

INTRODUCTION

Women with disabilities experience higher rates of intimate partner violence (IPV) than women without disabilities. There remains limited evidence about whether IPV prevention interventions for the general population have benefits for women with disabilities that compare to those for women without disabilities. Using data from IPV prevention randomised controlled trials in diverse locations (Rwanda, South Africa and Afghanistan), we assess whether outcomes differed by disability status.

METHODS

We assessed disability at baseline in three IPV prevention trials. We performed post-hoc analysis of intervention impacts at endline (22 or 24 months post-baseline) stratified by disability status at study baseline and tested an interaction term for disability at baseline by intervention arm for three sets of outcomes: (1) past year experiences of physical, sexual and severe IPV; (2) economic and livelihood outcomes; and (3) health, mental health and substance use outcomes.

RESULTS

At baseline between 17.7% and 26.2% of women reported being disabled. For IPV prevention, in seven out of eight tests across three studies, women with and without disabilities had similar outcomes. For economic, health and substance use outcomes, there was more variation, with women with disabilities reporting both better and worse outcomes than women without disabilities; however there was no clear pattern in these differential results.

CONCLUSION

IPV prevention programmes targeting general populations can prevent IPV among women with disabilities participants with benefits that mirror those for women without disabilities. Benefits for participants with and without disabilities on secondary programme outcomes related to economic empowerment and health may be more varied and should be explicitly monitored.

Intimate partner violence among women with and without disabilities: a pooled analysis of baseline data from seven violence-prevention programmes

INTRODUCTION

Intimate partner violence (IPV) is a serious public health and human rights violation which impacts approximately one in three women worldwide. Some existing evidence suggests that women with disabilities are at higher risk of IPV, but is largely limited in geographical scope to the Global North, and comparison across settings has been hampered by inconsistent measurement of both IPV and disability.

METHODS

Pooled analysis of baseline data from 8549 adult women participating in seven IPV prevention studies in five countries across Africa and Asia that used collaborative, comparative measurement strategies to assess both disability and IPV.

RESULTS

After adjusting for age, women with disabilities were more likely to experience past 12-month physical IPV (adjusted OR (aOR)=1.79; 95% CI 1.49 to 2.17), sexual IPV (aOR=1.98; 95% CI 1.36 to 2.89), emotional IPV (aOR=1.84; 95% CI 1.49 to 2.27) and economic IPV (aOR=1.66; 95% CI 1.45 to 1.89), with an overall association between disability and past 12-month physical/sexual IPV of aOR=1.93 (95% CI 1.52 to 2.46). Compared to women without disability, women with moderate and severe disability showed a trend of increasing risk of IPV in the past 12 months for each of physical, sexual, emotional and economic IPV. Overall, both women with moderate disability (aOR=1.86, 95% CI 1.57 to 2.21) and women with severe disability (aOR=2.63; 95% CI 1.95 to 3.55) were significantly more likely to experience any form of IPV when compared with women without disability.

CONCLUSION

Women with disabilities are at increased risk of past-year IPV compared to women without disabilities across a range of settings in the Global South, and the risk of IPV increases with increasing severity of disability. IPV prevention and response efforts in these settings must find ways to include and address the needs of women with disabilities, including increased outreach and improved accessibility of programmes.

Prevalence and factors associated with intimate partner violence after HIV status disclosure among pregnant women with depression in Tanzania

Intimate partner violence (IPV) exacts a heavy burden on women, resulting in poor health outcomes. This study had the following aims: (1) estimate the prevalence of IPV post-disclosure of HIV status among pregnant women living with HIV and depression; and (2) evaluate risk and protective factors for IPV post-disclosure. Participants were women accessing PMTCT services at 16 health facilities in Dar es Salaam and screened at the threshold of 9 on the PHQ-9. Generalized linear equations with a log link and standard errors clustered at the facility level were used to calculate associations between predictors and IPV post-disclosure. Among 659 women who were in an intimate relationship, 10.2% had experienced physical violence and 11.6% had reported sexual violence from their partner in the past six months; 327 had disclosed their HIV status to their partners. After disclosure to their partners 279 women (85.3%) experienced IPV. HIV-related stigma was associated with increased risk of IPV following disclosure and appreciative relationships with partners and higher hope were associated with reduced risk of IPV. There is a need to identify and advance approaches to HIV disclosure that prevent IPV. Interventions should be developed based on known risk and protective factors for IPV following HIV disclosure in Tanzania and similar settings.

Gender Based Violence against Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG’s) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG’s that will lead to sustainable changes in women’s health.

Antenatal and Postpartum Depression: Prevalence and Associated Risk Factors among Adolescents' in KwaZulu-Natal, South Africa

BACKGROUND

Maternal depression is a major public health concern as it affects both mothers and their children. Antenatal depression, which is often underdiagnosed, has been associated with preterm labour, low birth weight, and intrauterine growth restriction. Research has demonstrated that postpartum depression is associated with mother-infant bonding impairment, child abuse, child neglect, maternal substance abuse, and self-harm. Globally, the prevalence of depression in pregnant and postpartum adolescents varies. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant and postpartum adolescents in KwaZulu-Natal, South Africa.

METHODS

Data were generated by means of a descriptive cross-sectional study that was conducted between June and November 2017 utilizing a sample of 326 adolescent females accessing maternal health services in a medium-sized rural peripheral district hospital in Ugu, Southern KwaZulu-Natal. The Edinburgh Postnatal Depression Scale questionnaire was used to screen participating pregnant and postnatal adolescents for depression. A cut-off score of ≥13 was used to identify pregnant and postnatal adolescents with symptoms of depression. The data were analysed using R software.

RESULTS

The prevalence of depression among the pregnant participants was 15.9% (21/132), whereas it was 8.8% (17/194) among the postpartum participants. Antenatal depression was associated with physical violence (adjusted odds ratio (aOR) 6.47, 95% CI 1.36-30.53, p = 0.01) and verbal abuse (adjusted odds ratio (aOR) 4.8, 95% CI 1.5-15.16, p = 0.006). The pregnant participants who indicated they received a lot of support from their partners were 0.93% less likely to have depression. Postnatal depression was associated with physical violence (adjusted odds ratio (aOR) 7.32, 95% CI 1.66-29.44, p = 0.005), verbal abuse (adjusted odds ratio (aOR) 4.3, 95% CI 1.03-15.79, p = 0.03), and intimate partner violence (adjusted odds ratio (aOR) 9.58, 95% CI 1.58-48.82, p = 0.008).

CONCLUSION

The prevalence of antenatal depression was higher than postpartum depression in the study sample. In light of the findings, maternal healthcare professionals are cautioned to consider the mental health of pregnant and postpartum adolescents who seek their services at health facilities.

The missing link: exploring the intersection of gender, capabilities, and depressive symptoms in the context of chronic HIV

Depressive symptoms occur frequently among people living with HIV, especially women. These symptoms are associated with human, social, financial, and physical/natural capabilities and life stressors that differ between women and men. However, the link between depressive symptoms and functional limitations/disability is seldom discussed in the context of HIV, especially for gender-specific relationships. A cross-sectional survey of 1042 people living with HIV and using long-term antiretroviral therapy (ART) in South Africa was conducted from June to August 2014 to investigate the associations of disability, human, social, physical/natural, and financial capabilities, health, and adherence to ART, including possible gender-specific factors. Socio-demographic information, capabilities, health indicators, functional limitations/disability, and depressive symptoms (CES-D 10) were measured. We applied descriptive and bivariate statistics and multiple regression. Overall, 26% of people presented with depressive symptoms. Greater functional limitations and health symptoms and lower food security were strongly associated with depressive symptoms, while associations with financial capital and body mass index were gender-specific. The results call for the improvement of comprehensive care, including gender-sensitive mental health interventions. The results further indicate that functional limitations/disability needs to be considered, along with linking rehabilitation and livelihood programs with comprehensive HIV-care, in particular for those who experience depressive symptoms.

Major depression and household food insecurity among individuals with multidrug-resistant tuberculosis (MDR-TB) in South Africa

PURPOSE

Household food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidemic, and having the largest share of poverty in South Africa, this relationship remains unexamined. This study investigated the association between major depressive episode (MDE) and household food insecurity among individuals with MDR-TB.

METHODS

We enrolled and interviewed 141 newly admitted microbiologically confirmed MDR-TB inpatients at a specialized TB hospital in KwaZulu-Natal Province, South Africa. Logistic regression models were fitted to assess the relationship between MDE and household food insecurity, while accounting for socio-demographic status (e.g., age, gender, education, marital status, social grant status, income, and preference for living in one's community).

RESULTS

The prevalence of MDE and household food insecurity was 11.35% and 21.01%, respectively. MDE was significantly associated with household food insecurity (aOR 4.63, 95% CI 1.17-18.38). Individuals who are female (aOR 6.29, 95% CI 1.13-35.03), young (aOR 8.86, 95% CI 1.69-46.34), have low educational attainment (aOR 6.19, 95% CI 1.70-22.59) and receive social grants (aOR 7.60, 95% CI 2.36-24.48) were most at risk of household food insecurity.

CONCLUSIONS

MDE in individuals with MDR-TB was significantly associated with household food insecurity, independent of socio-economic status. Although MDR-TB is not exclusively a disease of the poor, individuals from socio-economically disadvantaged backgrounds (e.g., female, young adults, low education, and social grant recipients) were more likely to experience household food insecurity. Our study underscores the need to address the co-occurring cycles of food insecurity and untreated MDE in South Africa.

Alcohol Drinking by Husbands/Partners is Associated with Higher Intimate Partner Violence against Women in Angola

Intimate partner violence (IPV), as the most prevalent form of violence against women, is a commonly encountered phenomenon across sub-Saharan African countries, including Angola. As a fast-growing economy, Angola is experiencing a booming alcohol industry and persistent IPV and women’s rights issues, along with weak prohibition and enforcement against this practice. However, so far, there is no systematic research investigating the predictors of IPV in Angola and whether spousal alcohol drinking has any relationship with women’s experience of IPV. Therefore, in this study, we aimed to assess the predictors of IPV (defined as physical, emotional, and sexual violence) among Angolan women with a special focus on their partners’ alcohol drinking habit. Cross-sectional data on 7669 women aged 15–49 years from the Angola Demographic and Health Survey were used for this study. Data were analyzed using descriptive and logistic regression methods. Results indicated that physical IPV (32.3%, 95% Confidence Interval = 30.3 to 34.5) was most prevalent, followed by emotional (27.3%, 95% CI = 25.3 to 29.4) and sexual IPV (7.4%, 95% CI = 6.6 to 8.4). In the multivariate analysis, higher education and household wealth status showed protective effects against certain forms of IPV. Alcohol drinking by husbands/partners was associated with significantly higher odds of experiencing physical [OR = 2.950; 95% CI = 2.632, 3.306], emotional [OR = 2.470; 95% CI = 2.187,2.789], and sexual IPV [OR = 2.729; 95% CI = 2.220, 3.354] among women. Women who reported experiencing physical IPV had increased odds of drinking alcohol [OR = 1.474; 95% CI = 1.290, 1.684] compared with those who did not. These findings reflect the widespread prevalence of IPV in sub-Saharan African countries. Special focus should be given to married men with alcohol drinking habits to reduce women’s vulnerability to IPV and dependence on alcohol use.

Sociodemographic correlates of depressive symptoms: a cross-sectional analytic study among healthy urban Ghanaian women

BACKGROUND

Studies on healthy individuals that show minor signs of distress and depression-but that are not significant enough to be debilitating or to report to the hospital for treatment-are rare. Our primary objective was to measure the prevalence of depressive symptoms and sociodemographic correlates among healthy women 18 years and above in urban Accra, Ghana.

METHOD

We used secondary data from the Women's Health Study of Accra, Wave 1 (WHSA-1), a large scale, analytic, cross-sectional study conducted in Accra, Ghana involving 3183 women. The presence or absence of depressive symptoms within the past 30 days was estimated from the average score on three common symptoms of depression: sleep, anxiety, and sadness. The explanatory variables were age-group, socioeconomic level, marital status, ethnicity, religion, education, employment, and parity. Frequencies and means were used to summarize categorical and continuous variables, respectively. Logistic regression analyses were employed to determine the predictors of depressive symptoms.

RESULTS

The prevalence of depressive symptoms within the previous 30 days was 26.5% (95% CI: 25.0-28.1). Women 55 years and older were more likely than women between the ages of 18 and 24 to experience depressive symptoms (AOR 2.8, 95% CI: 2.0-4.0, p < 0.001), whilst women between the ages of 35 and 54 were 1.95 times more likely than women between the ages of 18 and 24 to experience depression (AOR 1.95, 95% CI: 1.40-2.70, p < 0.001). Self-employed women were less likely to report depressive symptoms compared to the unemployed (AOR 0.70, 95% CI: 0.56-0.87, p < 0.01). Akans were less likely to experience depressive symptoms compared to Ga women (AOR 0.75, 95% CI: 0.61-0.92, p < 0.01). Non-orthodox Christians were more likely to report depressive symptoms compared to Orthodox Christians (AOR 1.32, 95% CI: 1.09-1.60, p < 0.01).

CONCLUSION

The prevalence of symptoms of depression among healthy urban Ghanaian women is high. Older women, those with low education, and unemployed women appear to be at higher risk for depression and therefore should be targeted for interventions. Groups at risk for depression-especially older adults or individuals under economic strain-should be targeted for mood assessment as part of routine medical care.

Prevalence and factors associated with postnatal depression among women in two rural districts of Manicaland, Zimbabwe

Background

Low- and middle-income countries are disproportionately affected by postnatal depression (PND). High prevalence of PND in urban Zimbabwe has been reported but the situation in rural settings is largely unknown and this is one of the first studies to report prevalence of PND in Chipinge and Mutasa districts.

Objectives

This study explored the prevalence and associated factors of PND among women attending postnatal care services in two rural districts of Chipinge and Mutasa, Manicaland, Zimbabwe between August and September 2017.

Methods

One hundred and ninety-two women were recruited consecutively as they attended postnatal services at 7 days and 42 days post-delivery. The Diagnostic and Statistical Manual for Mental Disorders, fifth edition criteria was used to classify depression among participants. Prevalence of PND and 95.0% confidence intervals (CIs) were estimated and associations with key socio-demographic and risk factors assessed.

Results

The mean age of participants was 23.7 years (standard deviation = 6.14). Pooled prevalence of PND across the two districts was 26.0% (95% CI: 19.04–31.74). There was a higher prevalence of PND in Mutasa (31.0%) as compared to Chipinge (21.48%) but this was not statistically significant (p = 0.142). Having insufficient food in the household, intimate partner violence and having a child with birthweight under 2500 g significantly increased the likelihood of PND twofold: adjusted odds ratio (aOR) = 2.8 (95% CI: 1.2–6.1), aOR = 2.5 (95% CI: 1.2–5.3) and aOR = 2.4 (95% CI: 1.1–5.6), respectively.

Conclusion

The high prevalence of PND and its associated risk factors indicates the need for routine screening and targeted interventions for PND in Zimbabwe, especially in rural areas.

Postpartum physical intimate partner violence among women in rural Zambia

Objective

To examine the demographic characteristics and mental health of women in rural Zambia who experienced physical intimate partner violence (IPV) postpartum.

Methods

The present secondary analysis was conducted using baseline data from an impact evaluation of a maternity waiting home intervention in rural Zambia. A quantitative household survey was conducted over 6 weeks, from mid‐April to late May, 2016, at 40 rural health facility catchment areas among 2381 postpartum women (13 months after delivery; age ≥15 years).

Results

A total of 192 (8.1%) women reported experiencing any type of physical IPV in the preceding 2 weeks; 126 had experienced severe physical IPV (had been kicked, dragged, beat, and/or choked by a husband or partner). High levels of depression were recorded for 174 (7.3%) women in the preceding 2 weeks. Being a female head of household was associated with an increased likelihood of experiencing severe physical IPV (aOR 2.64, 95% CI 1.70–4.10). Women with high depression scores were also at an increased risk of experiencing any physical IPV (aOR 17.1, 95% CI 8.44–34.9) and severe physical IPV (aOR 15.4, 95% CI 5.17–45.9).

Conclusion

Future work should consider the implications of government and educational policies that could impact the screening and treatment of pregnant women affected by all forms of physical IPV and depression in rural Zambia.

Postpartum physical intimate partner violence among women in rural Zambia was associated with being a female head of household and high levels of depression.