Advancing health equity: determinants and barriers to postpartum mental healthcare seeking among women in Lagos Mainland, Nigeria
1
Community health and primary care, University of Lagos, Lagos, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Maternal mental health disorders, especially postpartum depression (PPD), anxiety, and psychosis, pose significant public health challenges in low- and middle-income countries.1-3 In Nigeria, stigma, financial barriers, and limited access to mental health services hinder timely care-seeking among postpartum women.4 Despite growing awareness, context-specific evidence from urban settings like Lagos Mainland Local Government Area (LGA) is limited.
METHODS:
A community-based cross-sectional quantitative study was conducted among 297 postpartum women (0 - 8 weeks post-delivery) selected via multistage sampling. Data were collected using a structured interviewer-administered questionnaire, including socio-demographics, obstetric history, knowledge/perceptions, barriers, and Edinburgh Postpartum Depression Scale (EPDS) screening.5 Analysis involved descriptive statistics, chi-square tests, and logistic regression using IBM SPSS version 23.
RESULTS:
Participants had a mean age of 29.1 years, with 87.5% tertiary-educated and 84.5% married. Awareness of postpartum conditions was high (84.2%), significantly associated with education (p < 0.001). EPDS screening revealed 39.1% probable depression, 28.6% possible, and 32.3% none (mean score: 11.66). Common symptoms included sleep disturbances (24.2%) and anxiety (18%). Only 2.4% were clinically diagnosed, with 1.0% seeking professional help, though 79.5% intended to if needed. Key barriers were cost (25.5%), limited service knowledge (16.5%), and stigma (7%), with significant associations between depression and cost (p < 0.001) and lack of nearby services (p < 0.001). Socioeconomic factors such as low income (29.0%), amplified barriers, while education enhanced awareness.
CONCLUSIONS:
Despite high awareness and positive attitudes, a substantial treatment gap persists due to economic, structural, and sociocultural barriers. Guided by the health belief model, interventions should integrate routine EPDS screening into maternal care, provide subsidised services, and promote education on prevention (e.g., social support) to reduce stigma. Findings support Nigeria’s efforts toward achieving SDG 3, emphasizing the need to embed maternal mental health into primary healthcare policies and programs.
Maternal mental health disorders, especially postpartum depression (PPD), anxiety, and psychosis, pose significant public health challenges in low- and middle-income countries.1-3 In Nigeria, stigma, financial barriers, and limited access to mental health services hinder timely care-seeking among postpartum women.4 Despite growing awareness, context-specific evidence from urban settings like Lagos Mainland Local Government Area (LGA) is limited.
METHODS:
A community-based cross-sectional quantitative study was conducted among 297 postpartum women (0 - 8 weeks post-delivery) selected via multistage sampling. Data were collected using a structured interviewer-administered questionnaire, including socio-demographics, obstetric history, knowledge/perceptions, barriers, and Edinburgh Postpartum Depression Scale (EPDS) screening.5 Analysis involved descriptive statistics, chi-square tests, and logistic regression using IBM SPSS version 23.
RESULTS:
Participants had a mean age of 29.1 years, with 87.5% tertiary-educated and 84.5% married. Awareness of postpartum conditions was high (84.2%), significantly associated with education (p < 0.001). EPDS screening revealed 39.1% probable depression, 28.6% possible, and 32.3% none (mean score: 11.66). Common symptoms included sleep disturbances (24.2%) and anxiety (18%). Only 2.4% were clinically diagnosed, with 1.0% seeking professional help, though 79.5% intended to if needed. Key barriers were cost (25.5%), limited service knowledge (16.5%), and stigma (7%), with significant associations between depression and cost (p < 0.001) and lack of nearby services (p < 0.001). Socioeconomic factors such as low income (29.0%), amplified barriers, while education enhanced awareness.
CONCLUSIONS:
Despite high awareness and positive attitudes, a substantial treatment gap persists due to economic, structural, and sociocultural barriers. Guided by the health belief model, interventions should integrate routine EPDS screening into maternal care, provide subsidised services, and promote education on prevention (e.g., social support) to reduce stigma. Findings support Nigeria’s efforts toward achieving SDG 3, emphasizing the need to embed maternal mental health into primary healthcare policies and programs.
| eISSN: | 2654-1459 |
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