Purpose: This study aimed to estimate the prevalence of perinatal depression in rural Kakamega, Kenya while exploring risk and protective factors in the context of the COVID-19 pandemic. Methods: The mixed method approach employed i) quantitative data collected in a longitudinal maternal health evaluation conducted from October 2019 to May 2021 and ii) an ethnographic study conducted from March to July 2022, which provided detailed insights on the risk and protective factors of perinatal depression. The quantitative sample of 135 Pregnant and postpartum women was screened monthly for depression (>13) using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression assessed the association between socioeconomic status, clinical and psychosocial variables, and perinatal depression. A sample of 20 women was enrolled in the qualitative component of the study. Results: The cumulative prevalence of perinatal depression was 11%. Depression symptoms were seen in 7% of pregnant women and 13% of mothers. During COVID-19, the odds of depression increased with maternal complications (aOR=7.05, 95%CI 1.66-29.94) and financial stress (aOR=1.40, 95%CI 0.66-2.98). Live birth outcomes reduced the odds of depression (aOR 0.03, 95%CI 0.002-0.73). Risk factors included health and healthcare challenges, lack of spousal and social support, intimate partner violence, and financial difficulties. Protective factors included adequate spousal and social support and access to economic resources, including digital platforms for soft loans and income hiding. Conclusion: One in seven women experienced perinatal depressive symptoms. Increase in depression during the COVID-19 pandemic is indicative of the need for i) financial and social safety nets to cushion perinatal women during emergencies, ii) Integration of depression screening into healthcare and establishing confidential pathways for psychosocial support.

The authors have declared no competing interest.

https://pubmed.ncbi.nlm.nih.gov/34526072/

This study was funded as part of the overall prospective study by the Amsterdam Institute of Global Health and Development. BRAC Institute of Governance and Development funded the qualitative component of this study

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