Abstract

Introduction: Postnatal depression (PND) is a major cause of negative health-related behavior and outcomes during infancy, childhood and adolescent periods. In Africa, the burden of postnatal depression is likely common but under-investigated and under-treated. To fill this information gap and to initiate further intervention we aimed at analyzing its epidemiology in Africa.

Methods: Observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 was searched in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. The quality of articles was assessed using the Newcastle Ottawa Scale (NOS) and only studies with good quality were included. Higgins I² statistics were calculated to test heterogeneity between the included studies. Tweedie’s and Duval Trim and Fill analysis were used to adjust for publication bias. The protocol has been registered in the PROSPERO (Protocol No.CRD42018100461).

Results: Of the total 965 records, 19 studies that involved 40,953 were included in this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). Moreover, the odds of postpartum depression was higher among women with bad obstetric condition (POR= 2.11; 95% CI: 1.11-4.01), had history of adverse birth and infant health outcomes (POR= 2.85; 95% CI: 1.29-6.25), had history of common mental health disorder (POR= 2.47; 95% CI: 1.51-4.04), had poor social support (POR=2.06; 95% CI: 1.05-4.05), and lower economic status (POR= 2.38; 95% CI: 1.75-3.23).

Conclusion: The pooled prevalence of postpartum depression in Africa was found to be high. We also identified postnatal mothers at increased risk of developing PND. Therefore, there is a need to design and escalate comprehensive strategies to abate its burden focusing on those women at risk of PND.

Keywords: Postnatal depression, Postpartum mothers, Africa, Systematic Review and Meta-analysis