Prevalence and factors associated with depression among women seeking post-abortion care services at Kawempe National Referral Hospital

Abstract

Introduction: Literature has shown that women experiencing an abortion have psychological distress and some are consequently diagnosed with affective disorders including depression. However, despite the many women with abortions seen at KNRH, the prevalence of depression in this population is not known. This study aimed at determining the prevalence and factors associated with depression among women seeking post-abortion care (PAC) services at KNRH. Methods: This was a cross-sectional study conducted from 6th April to 7th July 2023 among 345 women seeking PAC at KNRH. Beck’s depression inventory (BDI-II) was used to assess depression and an interviewer-administered questionnaire for potential associated factors. Data was entered using KoboToolBox, cleaned and exported to STATA version16.0 for analysis. The prevalence was calculated as a ratio with the number of those screening positive for depression as the numerator and the number of all participants as the denominator. Logistical regression was used to analyze the potential associated factors. The level of significance was set at P<0.05 at multivariate analysis. Results: The prevalence of depression was 11%, with 7.8% having mild, 2.3% moderate, and 0.9% severe forms of depression. The factors found to be significantly associated with depression were being a housewife (AOR 3.72, 95% CI: 1.34-10.32; p = 0.011), being employed (AOR 3.01, 95% CI: 1.06-8.93; p = 0.039), having a monthly income of <100,000 Ugandan Shilling (AOR 3.73, 95% CI: 1.24-6.91; p = 0.014), a prior abortion(s) (AOR 2.57, 95% CI: 1.23-5.39; p = 0.012), and having a complication following the recent abortion (AOR 4.51, 95% CI: 1.90-10.67; p = <0.001). Conclusion: There is an 11% prevalence of depression among women seeking PAC at KNRH. Associated factors of this depression include being a housewife, being employed, having a monthly income of <100,00 UGX per month, having had a prior abortion(s), and having a complication following the recent abortion. Recommendations: Grief counselling should be routine when offering PAC services and care should be taken to identify those with associated factors, follow them up, and link them to psychiatric care where needed. Guidelines for referral for psychiatric care should also be well stipulated within the facility.