Is MIStreatment of women during facility-based childbirth an independent risk factor for POstpartum Depression in Ethiopia and Guinea? A mixed methods prospective study - MISPOD Study

In sub-Saharan Africa, 17% of postpartum women experience a

postpartum mental disorder, mainly postpartum depression, which can lead to self-harm, harm to the baby, compromised child health and development, and suicide. As 48% of women in the region do not receive postnatal care (81% in Ethiopia and 51% in Guinea), postpartum depression remains undiagnosed and untreated.

Globally, despite a critical evidence gap, there are growing reports of postpartum depression among women mistreated during facilitybased childbirth. Recent studies from Ethiopia and Guinea show that the prevalence of both mistreatment (28% - 83%) and postpartum depression is high, making a strong case to examine the association between the two. This study—one of the first in the field—uses a novel design to

1) examine the link between mistreatment and postpartum depression and

2) to explore health system capacity to improve respectful maternity care and maternal mental health services in urban settings.

We will conduct a prospective longitudinal survey of women from the third trimester of pregnancy to eight weeks postpartum and in-depth interviews with key health system informants. Data from the women’s survey will be analysed using a multilevel mixed-effects model; data from in-depth interviews by using a hybrid thematic analysis approach. The findings will inform actions aimed at mitigating mistreatment and providing care for

postpartum depression in low-resource settings.