Postpartum Depression: Knowledge, Attitudes, Practices, and Underdiagnosis Among Zambian Health Practitioners

Abstract

Background: Post-partum depression (PPD) is an underdiagnosed condition, affecting 1 in 8 women worldwide. This study aimed to investigate the knowledge, attitudes, beliefs, and practices in relation to PPD among health practitioners at Levy Mwanawasa University Teaching Hospital Obstetrics and Gynaecology (OBS/GYN) departments. The study further sought to gain insight from mental health practitioners at Chainama Hills College Hospital (CHCH) on the reasons for the underdiagnoses of PPD.

Methods: This cross-sectional study collected data from 20 OBS/GYN health practioners at LMUTH through questionnaires and CHCH mental health practioners through a focus group discussion. Quantitative data was analyzed using descriptive statistics in SPSS Version 27, while qualitative data was analyzed thematically in Nvivo software.

Results: 85% (17) of the respondents could define PPD, 50% (10) were able to identify risk factors, only 40% (8) had attended to patients with PPD, with 60% (12) reporting not having provided care to patients with PPD. Additionally, 80% (16) of the respondents had negative attitudes towards early assessment and diagnostic interventions for PPD, citing its perceived rarity and the time required for screening as reasons. Themes underlying underdiagnosis of PPD include prioritization of child care over maternal well-being and time constraints within postnatal clinics.

Conclusion: This study identified critical gaps in healthcare practitioners' knowledge and attitudes toward postpartum depression (PPD), particularly regarding early assessment and diagnosis. Factors contributing to PPD underdiagnosis include community-related issues such as cultural misconceptions, practitioner-related limitations including insufficient knowledge and skills, and facility-related challenges like prioritizing child care over maternal care. These findings highlight the need to incorporate comprehensive PPD education into healthcare training programs, implement routine screening protocols, foster supportive patient-care environments, address cultural misconceptions at the community level, enhance healthcare practitioners' competencies through ongoing training, and promote interdisciplinary collaboration.