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J Affect Disord. 2018 Feb;227:48-55. doi: 10.1016/j.jad.2017.10.022. Epub 2017 Oct 12.

Depression among female heads-of-household in rural Mozambique: A cross-sectional population-based survey.

Author information

1
Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, United States; Vanderbilt University Medical Center, Department of Health Policy, United States; Friends in Global Health, Mozambique. Electronic address: carolyn.m.audet@vanderbilt.edu.
2
Columbia University, Department of Psychiatry, United States.
3
University of Pennsylvania, Department of Psychiatry, United States.
4
Vanderbilt University, Peabody Research Institute, United States.
5
Vanderbilt University Medical Center, Department of Biostatistics, United States.
6
Friends in Global Health, Mozambique.
7
Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, United States; Friends in Global Health, Mozambique.
8
Friends in Global Health, Mozambique; Vanderbilt University Medical Center, Department of Pediatrics, United States.
9
Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, United States; Friends in Global Health, Mozambique; Vanderbilt University Medical Center, Department of Pediatrics, United States.

Abstract

BACKGROUND:

An estimated 350 million people live with depression worldwide. In Mozambique, there are no national data quantifying the burden of mental illnesses. With the sixth highest suicide rate in the world, there is strong evidence of an unmet mental health need. We conducted a survey to measure the prevalence of depression among female heads of household and assess individual, social, and cultural risk factors associated with a positive depression screening.

METHODS:

This survey was conducted across 14 rural districts in central Mozambique in 2014. We gathered information from 3543 female heads of household (100% response rate) on > 500 variables, including a depression screening tool (PHQ-8). Weighted percentages of survey responses are reported.

RESULTS:

Among female heads of household, 14% screened positive for depression (PHQ-8 score ≥ 10). Our adjusted models show increased odds of depression per additional year of age (aOR: 1.02 [1.01, 1.04]; p = 0.002), additional year of education (aOR: 1.06 [1.02, 1.11]; p = 0.006), and additional kilometer from the nearest clinic (aOR: 1.05 [1.02, 1.07]; p = < 0.001). Experiencing food insecurity (aOR: 1.05 [1.02, 1.08]; p = 0.003) was associated with increased odds of depression. Being single (aOR: 0.42 [0.29, 0.60]) or divorced/widowed/separated (aOR: 0.57 [0.34, 0.98]; p < 0.001) vs. married was protective against depression, as was a perceived "sufficient" household income (aOR: 0.37 [0.19, 0.69]; p = 0.008).

LIMITATIONS:

Social desirability bias may have led women to underreport feelings of depression.

CONCLUSIONS:

The association of more education and marriage with increased odds of depression may reflect a frustration with limited opportunity for success experienced by some women in rural Mozambique.

KEYWORDS:

Depression; Mozambique; Rural sub-Saharan Africa; Women

PMID:
29053975
PMCID:
PMC5805617
DOI:
10.1016/j.jad.2017.10.022
[Indexed for MEDLINE]
Free PMC Article

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