Main Article Content
Abstract
Background: Postpartum depression (PPD) is a significant public health concern affecting maternal and child health outcomes. Midwives play a crucial role in early detection through systematic screening, yet evidence suggests substantial gaps in knowledge and practice, particularly in resource-limited settings. This study assessed midwives' knowledge and practice of postpartum depression screening at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Nigeria, and identified factors influencing both knowledge and practice.
Methods: A descriptive cross-sectional survey was conducted among 150 registered midwives working in obstetrics and gynecology units at AEFUTHA. Data were collected using a validated, self-administered questionnaire (Cronbach's alpha = 0.77) covering socio-demographic characteristics, knowledge of PPD screening, screening practices, and influencing factors. Data were analyzed using descriptive statistics, chi-square test, and binary logistic regression.
Results: The majority of participants (62.0%) were aged 31–35 years, with 73.3% holding bachelor's degrees. While 74.7% were aware of PPD screening, only 49.3% engaged in actual screening practice. Chi-square analysis revealed a significant association between knowledge and practice (χ² = 8.62, p = 0.003). Logistic regression identified good knowledge (OR = 4.12, p = 0.009), availability of screening tools (OR = 3.95, p = 0.001), and ≥10 years' experience (OR = 2.08, p = 0.047) as significant predictors of good practice, while heavy workload significantly reduced practice likelihood (OR = 0.42, p = 0.021). Educational qualification (OR = 2.32, p = 0.002), years of experience (OR = 1.43, p = 0.017), and previous training on PPD (OR = 3.09, p = 0.005) significantly predicted knowledge levels.
Conclusion: Despite moderate awareness, substantial knowledge-practice gaps exist in PPD screening among midwives at AEFUTHA. Targeted interventions including structured training programs, provision of validated screening tools, and workload optimization are essential to enhance routine PPD screening and improve maternal mental health outcomes.
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References
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- Ajzen, I. (1991). The theory of planned behaviour. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T
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- Edet, O. B., Mgbekem, M. A., & Etowa, J. B. (2021). Postpartum depression screening practices among nurses in tertiary health institutions in Cross River State, Nigeria. Journal of Nursing Education and Practice, 11(8), 1-9. https://doi.org/10.5430/jnep.v11n8p1
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- National Institute for Health and Care Excellence. (2014). Antenatal and postnatal mental health: Clinical management and service guidance (Clinical guideline CG192). https://www.nice.org.uk/guidance/cg192
- Osam, C. S., Ankobea-Kokroe, F., Kretchy, I. A., Agyabeng, K., Appiah, B., Danquah, S. A., & Ae-Ngibise, K. A. (2023). Training needs assessment for perinatal depression screening among midwives in Ghana. BMC Pregnancy and Childbirth, 23(1), Article 123. https://doi.org/10.1186/s12884-023-05445-w
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References
Adewuya, A. O., Ola, B. A., Aloba, O. O., Mapayi, B. M., & Okeniyi, J. A. O. (2005). Impact of postnatal depression on infants' growth in Nigeria. Journal of Affective Disorders, 88(2), 199–201. https://doi.org/10.1016/j.jad.2005.07.005
Adeyemo, E. O., Oluwole, E. O., Kanma-Okafor, O. J., Izuka, O. M., & Odeyemi, K. A. (2020). Awareness and knowledge of post-partum depression among mothers attending immunisation clinic at a primary health centre, Lagos, Nigeria. BMC Public Health, 20(1), Article 1346. https://doi.org/10.1186/s12889-020-09461-1
Ajzen, I. (1991). The theory of planned behaviour. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T
American College of Obstetricians and Gynecologists. (2018). ACOG Committee Opinion No. 757: Screening for perinatal depression. Obstetrics & Gynecology, 132(5), e208-e212. https://doi.org/10.1097/AOG.0000000000002927
Edet, O. B., Mgbekem, M. A., & Etowa, J. B. (2021). Postpartum depression screening practices among nurses in tertiary health institutions in Cross River State, Nigeria. Journal of Nursing Education and Practice, 11(8), 1-9. https://doi.org/10.5430/jnep.v11n8p1
Mphuthi, D. D., Mabaso, M., & Mntambo, N. (2021). Knowledge and attitudes of midwives towards perinatal mental health in Lesotho. African Journal of Midwifery and Women's Health, 15(2), 1–10. https://doi.org/10.12968/ajmw.2020.0027
National Institute for Health and Care Excellence. (2014). Antenatal and postnatal mental health: Clinical management and service guidance (Clinical guideline CG192). https://www.nice.org.uk/guidance/cg192
Osam, C. S., Ankobea-Kokroe, F., Kretchy, I. A., Agyabeng, K., Appiah, B., Danquah, S. A., & Ae-Ngibise, K. A. (2023). Training needs assessment for perinatal depression screening among midwives in Ghana. BMC Pregnancy and Childbirth, 23(1), Article 123. https://doi.org/10.1186/s12884-023-05445-w
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403
Stewart, D. E., & Vigod, S. (2016). Postpartum depression. New England Journal of Medicine, 375(22), 2177-2186. https://doi.org/10.1056/NEJMcp1607649
