Unveiling the hidden burden: Common mental disorders among women attending antenatal care in selected health facilities of Lusaka, Zambia

Abstract

Mental health disorders disproportionately affect women during pregnancy and postpartum, with high prevalence in low-income countries. Mental health disorders during the antenatal period can lead to serious complications for both mother and child, including preterm birth, developmental issues and postpartum depression. However, mental health screening remains neglected during the antenatal period in resource-limited settings. We investigated the prevalence and determinants of common mental disorders (CMD) among women attending antenatal care (ANC) in selected health facilities of Lusaka, Zambia. A cross-sectional study was conducted between 26th April and 6th July 2024 in two purposively selected health facilities in low socioeconomic areas of Lusaka. A systematic sample of pregnant women in the third-trimester attending ANC were invited to participate. Common mental disorders were defined using a cut-off score of ≥8 on the WHO Self-Reporting Questionnaire (SRQ)-20, administered through face-to-face interviews. Logistic regression models were employed to identify determinants of common mental disorders. Stata 18 SE was used for analysis. We included 331 participants who were predominantly young adults (50.5% aged 20-29), married/cohabiting (69%), and almost a quarter (23.9%) living with HIV. Most had unplanned pregnancies (58.6%), experienced pregnancy-related body changes (73.1%) and had delivery concerns (68.6%). The study found a high prevalence of common mental disorders (65.8%). Participants who were less than 20 years, primary level education, had history of complications during previous pregnancy, were worried about the birth process and reported unpleasant body changes due to pregnancy exhibited higher prevalence for common mental disorders. On the other hand, women with medium or high social connectedness had lower odds of common mental disorders. The high burden of common mental health disorders among pregnant women in Lusaka, Zambia, underscores the importance of integrating mental health screening and support into routine antenatal care, with targeted attention to high-risk groups such as adolescents.