ArticleGlobal health action2026
Psychosocial and structural factors associated with postpartum depressive symptoms and maternal continuum of care in Borama, Somaliland: a cross-sectional study.
Article in Global health action, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPostpartum depression (PPD) and fragmented maternal care are critical public health challenges in sub-Saharan Africa.
objectiveTo examine the associations of psychosocial, structural, clinical, and health-system factors with self-reported postpartum depressive symptoms and maternal continuum-of-care (CoC) completion in Borama, Somaliland.
methodsA community-based cross-sectional study analyzed 442 postnatal women. Postpartum depressive symptoms were assessed via binary self-report, and CoC was summarized using a 0-3 index (ANC4+, facility delivery, and postnatal care). Multivariable logistic regression estimated adjusted odds ratios (aORs) for depressive symptoms; robust multiple linear regression estimated adjusted CoC-score differences (
resultsDepressive symptoms were reported by 109/442 women (24.7%), and 152/442 (34.4%) completed all three CoC components. Higher adjusted odds of symptoms were observed among single mothers (aOR = 2.27, 95% CI 1.11-4.65), women with labor complications (aOR = 2.06, 95% CI 1.10-3.87), university/technical education (aOR = 2.49, 95% CI 1.16-5.33), and fair/poor self-rated health (aOR = 6.66, 95% CI 2.62-16.90). Among symptom-positive women, 37.6% spoke to no one about their distress. Adjusted symptom probabilities declined across increasing spousal-support categories, but the overall association was not statistically significant (
conclusionsPostpartum depressive symptoms and incomplete continuity of care were prevalent in this sample. Maternal-health planning should consider integrating routine emotional symptom enquiry with strategies that strengthen early ANC engagement and postnatal follow-up.
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