An exploratory study of neighborhood-level risk factors of perinatal depression and anxiety among Ethiopian perinatal women
Year: 2024
Type: article
Abstract: Background: Perinatal depression and anxiety are common in high-income countries (HICs), with 10-15% of women suffering from these conditions.In contrast, perinatal depression rates in low-and middle-income countries (LMICs) range from 19% to 48%.Depressive and anxiety symptoms in pregnant women and mothers of children under two years of age have been linked to various individual-level risk factors in the Sub-Saharan African region (SSA).Individual-level risk factors such as stressful life events, intimate partner violence, poor social support, and childhood trauma are associated with depressive and anxiety symptoms in studies conducted in the SSA region and the U.S., but neighborhoods may also play a role in perinatal mental health.Developing a thorough understanding of neighborhood-level factors (e.g., social isolation due to a lack of social cohesion) that contribute to poor maternal mental health outcomes (e.g., depression/anxiety) may aid in reducing SSA women's high rates of depressive and anxiety symptoms.Neighborhood violence has been shown to increase depressive and anxiety symptoms.Neighborhood social cohesion is also associated with poor mental health outcomes.Purpose: The purpose of this research was to explore the association between perceived neighborhood social cohesion and perceived neighborhood violence and depressive and anxiety symptoms among Ethiopian women who are pregnant or who have children under two.The objective was to survey 111 women and conduct 50 qualitative interviews with women who met the cutoff for depressive or anxiety symptoms.Methods: This was a mixed-methods study with women from low-income neighborhoods in Addis Ababa, Ethiopia.Demographic data was collected using either a self-administered or a nurse-administered instrument.Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-2) with a score range of 0-6.Anxiety was measured using the two-item Generalized Anxiety Disorder support these propositions.Additionally, the qualitative data does not provide evidence in favor of the argument that social cohesion is absent in violent neighborhoods.While the participants reported witnessing criminal activities, feelings of fear, victimization, and acts of violence, leading to a diminished sense of safety, they also reported feeling connected to their neighbors.The qualitative data also showed that the women felt a sense of neighborhood social cohesion despite having depressive and anxiety symptoms.The quantitative results showed that marital status attenuated the effect of neighborhood violence on depressive symptoms.Single parenthood is an important predictor even when faced with living in a poor neighborhood where violence is observed.Still, the qualitative data also showed that despite living in an unsafe neighborhood, pregnant women and mothers of children under the age of two experiencing depressive and anxiety symptoms can connect with their neighbors.Future studies should explore the potential protective benefits of neighborhood social cohesion in poor neighborhoods in Addis Ababa, Ethiopia because how we conceptualize social cohesion in the West may not be true of Ethiopia.v ACKNOWLEDGMENTS "You are the light of the world-like a city on a hilltop that cannot be hidden.No one lights a lamp and then puts it under a basket.Instead, a lamp is placed on a stand, where it gives light to everyone in the house.In the same way, let your good deeds shine out for all to see so that everyone will praise your heavenly Father" (Matt 5:14-16).I give all the glory and honor to the Lord Christ, who has strengthened me through this marathon journey.I am grateful to God because he has always connected me with the right people who have helped me grow spiritually and intellectually.I express profound gratitude towards my advisor and dissertation committee chair, Dr. Lara-Cinisomo, despite the numerous hurdles I had throughout this journey, for your invaluable mentorship and support, which have been influential in establishing the groundwork for my professional trajectory.Regardless of its magnitude, your advice has been highly beneficial and will serve as a guiding force for my future pursuits.I value the impeccable balance of professionalism, independence, proficiency, patience, and candor you have bestowed upon me as a mentor.I aspire to emulate your guidance as an advisor, educator, and scholar.Also, no words describe my gratitude towards my dissertation committee member, Dr. Josiah Alamu, at Nova Southeastern University.Your mentorship since the first day of my Masters of Public Health program ten years ago at the University of Illinois has been invaluable for my growth as a person of color in the Public Health field.Also, Professor Reginald Alston, dissertation committee member, I cannot thank you enough for all the support you have provided me.There are countless African American men and women you have mentored over the years, and it was an honor to look up to you when I had issues in my personal life
Author: Melesse, Biniyam Berhanu
Institution: The Ohio State University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7220826160