title: Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey.
abstract: BACKGROUND
  Postpartum common mental disorders (CMD) such as depression and anxiety are increasingly recognized for their burden in low-resource countries such as Ethiopia. However, the magnitude of postpartum CMD in Ethiopia is not well-established. This short report describes the mental health status of women who had given birth in the last 24 months in the Amhara region of Ethiopia.
  
  
  METHODS
  A cross-sectional survey was conducted among 1,319 women aged 15-49 years old who had a delivery in the previous 24 months from 30 randomly selected kebeles (smallest administrative unit in Ethiopia) across Amhara region. The survey included the Self-Reporting Questionnaire (SRQ-20) developed by the World Health Organization-a CMD screening instrument that includes 20 yes/no questions on depression, anxiety, and somatic symptoms experienced in the last 30 days. We used 2 cutoff scores to determine probable cases of mental disorder: (1) 4/5 (≤ 4 "yes" responses=non-case, ≥ 5 "yes" responses=case) based on a study that validated the SRQ-20 against a diagnostic tool in Butajira, Ethiopia, and (2) a more conservative and commonly used 7/8 cutoff.
  
  
  RESULTS
  Among the 1,294 women who completed the full survey including the SRQ-20, 32.8% had probable CMD using the 4/5 cutoff score versus 19.8% using the more conservative 7/8 cutoff. About 15% of the women responded affirmatively that they had had suicidal thoughts.
  
  
  CONCLUSIONS
  Poor mental health was common among the surveyed women who had given birth in the past 24 months in Amhara region, Ethiopia. Integrating mental health care into maternal and child health services could potentially alleviate the burden of CMD among women in the extended postpartum period.
authors.affiliation: FHI 360, Washington, DC, USA. Now with Duke Global Health Institute at Duke University, Durham, NC, USA joy.baumgartner@duke.edu.
authors.forename: Joy Noel
authors.initials: JN
authors.lastname: Baumgartner
authors.affiliation: University of North Carolina at Chapel Hill, Gillings School of Public Health, Chapel Hill, NC, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Parcesepe
authors.affiliation: FHI 360, Addis Ababa, Ethiopia.
authors.forename: Yared Getachew
authors.initials: YG
authors.lastname: Mekuria
authors.affiliation: Bahir Dar University, Bahir Dar, Ethiopia.
authors.forename: Dereje Birhanu
authors.initials: DB
authors.lastname: Abitew
authors.affiliation: Amhara Regional Health Bureau, Bahir Dar, Ethiopia.
authors.forename: Wondimu
authors.initials: W
authors.lastname: Gebeyehu
authors.affiliation: FHI 360, Addis Ababa, Ethiopia. Now with Abt Associates, SHOPS Project, Bethesda, MD.
authors.forename: Francis
authors.initials: F
authors.lastname: Okello
authors.affiliation: FHI 360, Livelihoods and Food Security Technical Assistance II (LIFT II), Durham, NC, USA.
authors.forename: Dominick
authors.initials: D
authors.lastname: Shattuck
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000453:epidemiology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D011247:Pregnancy; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D055815:Young Adult