Capacity of midwives to Screen for post-partum depression, a descriptive study in Matara district, Sri Lanka

Abstract

Postpartum Depression (PPD) occurs in 10-20% of post-partum women but less than half of the cases are detected. PPD can have significant consequences for the well-being of mother and infant. Screening for PPD is done as part of the maternity care program in Sri Lanka. Public health midwives (PHMs) are the main category of health staff involved in this screening program. Hence, assessing their capacity of performance will justifiably be important for evaluating this screening program. A community-based descriptive cross-sectional study was carried out in the Matara district, from March 2016 to August 2017 with the participation of all (260) PHMs attached to 17 MOH offices who were enrolled after obtaining informed written consent. A pretested self-administered questionnaire was used to assess five specific objectives. Socio-demographic and work-related factors, organization-related factors, knowledge, attitude, and associated factors of these two were assessed. Statistical package for social science (SPSS) version 21 was used to analyze data. Good knowledge-score: at or above 50% Poor knowledge-score: less than 50%. Cross tabbing was done with some independent variables and statistically analyzed. Ethical clearance was obtained from PGIM Colombo. Out of the study population, 55.7% (136) were satisfied with the service of the medical officer of mental health (MOMH). 65.6% (160) of PHMs were not satisfied with the facilities available for screening a mental disease in clinics. 201PHMs (82.4%) had knowledge of (PPD) and treatment of PPD. Only 50% of respondents had good knowledge of the Edinburg Postpartum Depression scale (EPDS). Further, 64.8% (158) had a strong attitude towards the importance of in-service training and inclusion of mental health into their basic training. There were statistically significant associations between their good level of knowledge and the number of training programs attended and their family support (p<0.05). Furthermore, statistically significant associations between good attitude and time were taken to arrive at the working station and field experience were found (p<0.05). There are gaps in knowledge and attitude, therefore giving up-to-date information, improvement of clinic facilities for maternal health care and periodical in-service training especially aiming at PPD will help to fill these gaps.