Prevalence of Depression and Anxiety among Adolescent Mothers and Access to Counseling in Western Kenya
DOI:
https://doi.org/10.47941/ijhs.2198Keywords:
Adolescent Motherhood, Anxiety, Depression, AccessAbstract
Purpose: There is still paucity of research exploring the prevalence of depression and anxiety among adolescent mothers aged 10-19 years and availability and access of support services in Kenya. This study therefore sought to (1) determine the prevalence of depression and anxiety and (2) examine access to counselling for depression and anxiety among adolescent mothers in Western Kenya during antenatal period.
Method: This was a cross-sectional design with a convergent parallel mixed approach conducted between January and August 2023 among a sample of 438 adolescent mothers aged 10-19 years attending maternal health services at level four health facilities in Kakamega, Kisumu and Siaya Counties in Western Kenya. Lottery method was used to select counties included in the study. On the other hand, participants were sequentially selected from out-patient departments, child welfare clinics, and postnatal wards and were screened for depression using Patient Health Questionnaire (PHQ-9) and General anxiety disorder (GAD-7) for anxiety. Cut-off points of 5 was used to identify participants with symptoms for both depression and anxiety.
Results: Out of 423 adolescent mothers, who completed the PHQ-9 screening tool, 398 (94.1%) had experienced depression while 424 (100%) adolescent mothers who completed GAD-7 screening tool experienced anxiety at varying degrees. Furthermore, 230 (54.2%) experienced severe anxiety followed by 163 (40.4%) who experienced moderate anxiety. Depression was more common among 15-19 age-group (n=349, 82.5%); those who depended on parents or guardians for financial support (n=223, 52.7%) and para 1 (n=328, 77.5%). In addition, religion, parity, source of financial support, education level were found to significantly contribute to both depression and anxiety as shown by p < 0.05. Out of 438 respondents, only 146 (33.3%, p =0.246) received counseling on depression and anxiety.
Recommendations: Findings of this study, highlight pertinent need for inclusion of mental health care for adolescent mothers in the antenatal care policy. In addition, it recommends incorporation of screening for depression and anxiety, as well as counseling for adolescent mothers into the routine antenatal care and postnatal care programs so as to enhance the overall well-being of adolescent mothers.
Downloads
References
Adina, J., Morawska, A., Mitchell, A. E., Haslam, D., & Ayuku, D. (2022). Depression and anxiety in second and third trimesters among pregnant women in Kenya: A hospital-based prevalence study. Journal of Affective Disorders Reports, 10, 100447.
Agnafors, S., Bladh, M., Svedin, C. G., & Sydsjö, G. (2019). Mental health in young mothers, single mothers and their children. BMC psychiatry, 19, 1-7.
Akyirem, S., Salifu, Y., Bayuo, J., Duodu, P. A., Bossman, I. F., & Abboah‐Offei, M. (2022). An integrative review of the use of the concept of reassurance in clinical practice. Nursing Open, 9(3), 1515-1535.
Al-Abri, K., Edge, D., & Armitage, C. J. (2023). Prevalence and correlates of perinatal depression. Social psychiatry and psychiatric epidemiology, 58(11), 1581-1590
Anderson, C. A., & Ruiz, J. (2022). Depressive symptoms among Hispanic adolescents and effect on neonatal outcomes. Hispanic Health Care International, 20(1), 25-32.
Astuti, A. W., Hirst, J., & Bharj, K. K. (2020). Indonesian adolescents’ experiences during pregnancy and early parenthood: a qualitative study. Journal of Psychosomatic Obstetrics & Gynecology, 41(4), 317-326.
Ayamolowo, S. J., Olajubu, A. O., & Akintola, F. E. (2019). Perceived social support and depression among pregnant and child-rearing teenagers in Ile-Ife, Southwest Nigeria. African Journal of Midwifery and Women's Health, 13(4), 1-9.
Banerjee, S. C., Haque, N., Schofield, E. A., Williamson, T. J., Martin, C. M., Bylund, C. L., ... & Ostroff, J. S. (2021). Oncology care provider training in empathic communication skills to reduce lung cancer stigma. Chest, 159(5), 2040-2049.
Beyene, G. A. (2019). Prevalence of unintended pregnancy and associated factors among pregnant mothers in Jimma town, southwest Ethiopia: a cross sectional study. Contraception and reproductive medicine, 4, 1-8.
Bohns, V. K., & Flynn, F. J. (2021). Empathy and expectations of others' willingness to help. Personality and Individual Differences, 168, 110368.
Bomester, O. (2021). Exploring intrinsic religiosity as a means to militate against risky sexual behaviour in adolescents from Christian faith-based schools
Cherif, E., Martin-Verdier, E., & Rochette, C. (2020). Investigating the healthcare pathway through patients’ experience and profiles: implications for breast cancer healthcare providers. BMC Health Services Research, 20, 1-11.
Dadi, A. F., Wolde, H. F., Baraki, A. G., & Akalu, T. Y. (2020). Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis. BMC pregnancy and childbirth, 20(1), 1-13.
Deiana, G., Dettori, M., Arghittu, A., Azara, A., Gabutti, G., & Castiglia, P. (2023). Artificial intelligence and public health: evaluating ChatGPT responses to vaccination myths and misconceptions. Vaccines, 11(7), 1217.
Dubik, S. D., Yirkyio, E., & Ebenezer, K. E. (2021). Breastfeeding in primary healthcare setting: evaluation of nurses and midwives’ competencies, training, barriers and satisfaction of breastfeeding educational experiences in Northern Ghana. Clinical Medicine Insights: Pediatrics, 15, 11795565211010704
Duby, Z., McClinton Appollis, T., Jonas, K., Maruping, K., Dietrich, J., LoVette, A., ... & Mathews, C. (2021). “As a young pregnant girl… the challenges you face”: exploring the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa. AIDS and Behavior, 25, 344-353.
Duko, B., Ayano, G., & Bedaso, A. (2019). Depression among pregnant women and associated factors in Hawassa city, Ethiopia: an institution-based cross-sectional study. Reproductive health, 16, 1-6.
Fusar‐Poli, P., Correll, C. U., Arango, C., Berk, M., Patel, V., & Ioannidis, J. P. (2021). Preventive psychiatry: a blueprint for improving the mental health of young people. World Psychiatry, 20(2), 200-221
Govender, D., Naidoo, S., & Taylor, M. (2020). “I have to provide for another life emotionally, physically and financially”: understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa. BMC pregnancy and childbirth, 20, 1-21.
Gregory, K. D., Chelmow, D., Nelson, H. D., Van Niel, M. S., Conry, J. A., Garcia, F., ... & Women's Preventive Services Initiative*. (2020). Screening for anxiety in adolescent and adult women: A recommendation from the women's preventive services initiative. Annals of internal medicine, 173(1), 48-56
Hannawa, A. F., Wu, A. W., Kolyada, A., Potemkina, A., & Donaldson, L. J. (2022). The aspects of healthcare quality that are important to health professionals and patients: A qualitative study. Patient education and counseling, 105(6), 1561-1570
Hechler, C., Beijers, R., Riksen-Walraven, M., & de Weerth, C. (2019). Prenatal predictors of postnatal quality of caregiving behavior in mothers and fathers. Parenting, 19(1-2), 101-119.
Heron, R. L., Eisma, M. C., & Browne, K. (2022). Barriers and facilitators of disclosing domestic violence to the UK health service. Journal of family violence, 37(3), 533-543.
Kazal, H. R., Flanagan, P. J., Mello, M. J., Monteiro, K., & Goldman, R. E. (2021). Birth stories, support, and perinatal emotional health among minority adolescent mothers: A mixed methods study. Journal of Pediatric and adolescent gynecology, 34(6), 847-856.
Kenya National Bureau of Statistics. Kenya Demographic and Health Survey 2022 https://dhsprogram.com/pubs/pdf/PR143/PR143.pdf
Kumar, M., Huang, K. Y., Othieno, C., Wamalwa, D., Madeghe, B., Osok, J., & McKay, M. M. (2018). Adolescent pregnancy and challenges in Kenyan context: perspectives from multiple community stakeholders. Global Social Welfare, 5(1), 11-27
Kumar, M., Huang, K. Y., Othieno, C., Wamalwa, D., Hoagwood, K., Unutzer, J., ... & McKay, M. (2020). Implementing combined WHO mhGAP and adapted group interpersonal psychotherapy to address depression and mental health needs of pregnant adolescents in Kenyan primary health care settings (INSPIRE): a study protocol for pilot feasibility trial of the integrated intervention in LMIC settings. Pilot and Feasibility Studies, 6, 1-18.
Kumar, M., Yator, O., Nyongesa, V., Kagoya, M., Mwaniga, S., Kathono, J., ... & Swartz, H. A. (2022). Interpersonal Psychotherapy’s problem areas as an organizing framework to understand depression and sexual and reproductive health needs of Kenyan pregnant and parenting adolescents: a qualitative study. BMC Pregnancy and Childbirth, 22(1), 940.
Laurenzi, C. A., Gordon, S., Abrahams, N., Du Toit, S., Bradshaw, M., Brand, A., ... & Skeen, S. (2020). Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reproductive health, 17, 1-15.
Li, H., Bowen, A., Bowen, R., Muhajarine, N., & Balbuena, L. (2021). Mood instability, depression, and anxiety in pregnancy and adverse neonatal outcomes. BMC Pregnancy and Childbirth, 21, 1-9.
Mabila, L. N., Muthelo, L., Mbombi, M. O., Mphekgwana, P. M., Mashaba, R. G., Ntimana, C. B., ... & Maimela, E. (2023). Mental health needs among pregnant and parenting adolescent girls and young women in South Africa: A scoping review. African Journal of Reproductive Health, 27(2), 101-129
Manhica, H., Kidayi, P., Carelli, I., Gränsmark, A., Nsubuga, J., George-Svahn, L., ... & Björling, G. (2021). Promoting sustainable health and wellbeing for pregnant adolescents in Uganda–A qualitative case study among health workers. International Journal of Africa Nursing Sciences, 14, 100306
Materu, J., Kuringe, E., Nyato, D., Galishi, A., Mwanamsangu, A., Katebalila, M., ... & Wambura, M. (2020). The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study. BMC psychiatry, 20, 1-8.
Millman, M. (Ed.). (1993). Access to health care in America
Miriti, J. M., & Mutua, M. N. (2019). Teenage Pregnancies and Girls Education Capabilities In Nzambani Ward Kitui County In Kenya: School And Community Perspective. International Journal of Gender Studies, 4(1), 59-84.
Mumah, J. N., Mulupi, S., Wado, Y. D., Ushie, B. A., Nai, D., Kabiru, C. W., & Izugbara, C. O. (2020). Adolescents’ narratives of coping with unintended pregnancy in Nairobi’s informal settlements. PLoS One, 15(10), e0240797
Musyimi, C. W., Mutiso, V. N., Nyamai, D. N., Ebuenyi, I., & Ndetei, D. M. (2020). Suicidal behavior risks during adolescent pregnancy in a low-resource setting: A qualitative study. PLoS one, 15(7), e0236269.
Mutahi, J., Larsen, A., Cuijpers, P., Peterson, S. S., Unutzer, J., McKay, M., ... & Kumar, M. (2022). Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: a systematic review. EClinicalMedicine, 44.
Nakidde, G., Kumakech, E., & Mugisha, J. F. (2023). Maternal mental health screening and management by health workers in southwestern Uganda: a qualitative analysis of knowledge, practices, and challenges. BMC Pregnancy and Childbirth, 23(1), 477
Ntshayintshayi, P. N., Sehularo, L. A., Mokgaola, I. O., & Sepeng, N. V. (2022). Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict. Health SA Gesondheid (Online), 27, 1-8.
Odawa, L., Nyagwencha, S., & Kihara, M. (2023). Prevalence of Depression and Anxiety Disorders among Perinatal Teenage Girls Accessing Maternal Child Health Services in Nairobi County, Kenya. East African Journal of Health and Science, 6(1), 346-354.
Oladeji, B. D., Bello, T., Ayinde, O., Idowu, P., & Gureje, O. (2022). Prevalence and correlates of depression among pregnant adolescents in primary maternal care in Nigeria. Archives of Women's Mental Health, 25(2), 441-450.
Omondi Aduda, D. S., Agot, K., Ohaga, S., Aoko, A., Onyango, J., Toroitich-Ruto, C., ... & Odoyo-June, E. (2024). Facility characteristics preferred by older men seeking medical male circumcision services in Kenya: qualitative findings from the ‘Tasco’study (May 2014-June 2016). BMC Public Health, 24(1), 1718.
Osok, J., Kigamwa, P., Stoep, A. V., Huang, K. Y., & Kumar, M. (2018). Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi. BMC psychiatry, 18, 1-10.
Palfreyman, A., & Gazeley, U. (2022). Adolescent perinatal mental health in South Asia and Sub-Saharan Africa: A systematic review of qualitative and quantitative evidence. Social science & medicine, 313, 115413.
Pereira, A. B., Silva, F. M. A. M., Pereira, D. C. A., Nina, V., & Figueredo, E. D. (2019). Depression and anxiety in pregnant adolescents. MOJ Womens Health, 8(2), 154-157.
Pokharel, A., Philip, S., Pokharel, A., Acharya, N., Dahal, S., & Ransing, R. (2023). Perinatal depression among teenage mothers in a tertiary care teaching hospital of Nepal: A cross-sectional study. Asian Journal of Psychiatry, 90, 103810.
Tenaw, L. A., Aragie, M. W., Ayele, A. D., Kokeb, T., & Yimer, N. B. (2022). Medical and psychological consequences of rape among survivors during armed conflicts in northeast Ethiopia. PLoS One, 17(12), e0278859.
Tele, A., Kathono, J., Mwaniga, S., Nyongesa, V., Yator, O., Gachuno, O., ... & Kumar, M. (2022). Prevalence and risk factors associated with depression in pregnant adolescents in Nairobi, Kenya. Journal of affective disorders reports, 10, 100424.
Torres, R., Goyal, D., Burke-Aaronson, A. C., Gay, C. L., & Lee, K. A. (2017). Patterns of symptoms of perinatal depression and stress in late adolescent and young adult mothers. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(6), 814-823
Upadhaya, N., Regmi, U., Gurung, D., Luitel, N. P., Petersen, I., Jordans, M. J., & Komproe, I. H. (2020). Mental health and psychosocial support services in primary health care in Nepal: perceived facilitating factors, barriers and strategies for improvement. BMC psychiatry, 20, 1-13
Vaingankar, J. A., Choudhary, N., Chong, S. A., Kumar, F. D. S., Abdin, E., Shafie, S., ... & Subramaniam, M. (2021). Religious affiliation in relation to positive mental health and mental disorders in a multi-ethnic Asian population. International journal of environmental research and public health, 18(7), 3368.
Van Lieshout, R. J., Savoy, C. D., Boyle, M. H., Georgiades, K., Jack, S. M., Niccols, A., ... & Lipman, E. L. (2020). The mental health of young Canadian mothers. Journal of Adolescent Health, 66(4), 464-469.
Wainaina, C. W., Sidze, E. M., Maina, B. W., Badillo-Amberg, I., Anyango, H. O., Kathoka, F., ... & Okoror, C. E. (2021). Psychosocial challenges and individual strategies for coping with mental stress among pregnant and postpartum adolescents in Nairobi informal settlements: a qualitative investigation. BMC pregnancy and childbirth, 21(1), 1-11.
Wan, S., Ancar, F., Tewari, H., & Kaushal, D. (2020). Impact of Depression in Teenage Pregnancy [17K]. Obstetrics & Gynecology, 135, 118S.
Webb, L., Kyaddondo, D., Ford, T., Bergqvist, A., & Cox, N. (2023). Psychosocial health in adolescent unmarried motherhood in rural Uganda: Implications for community-based collaborative mental health education, and empowerment strategies in the prevention of depression and suicide. Transcultural psychiatry, 60(3), 537-551
Zulaika, G., Nyothach, E., Van Eijk, A. M., Obor, D., Mason, L., Wang, D., ... & Phillips-Howard, P. (2021). Factors associated with the prevalence of HIV, HSV-2, pregnancy, and reported sexual activity among adolescent girls in rural western Kenya: A cross-sectional analysis of baseline data in a cluster randomized controlled trial. PLoS medicine, 18(9), e1003756
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Anne A. Ibworo, Elizabeth Omondi, PhD, Dickens Omondi Aduda, Jane Owenga, PhD
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
