Current Issue
Issues
Aim & Scope
Open Access
Indexing
Why publish with us
Contact
Editorial Board
Manuscript Types
Manuscript Formatting
How to submit
For readers
For librarians
Authorship & COI
Principles of Transparency Checklist
Publication Ethics and Publication Malpractice Statement
CrossMark
Data Policies
RESEARCH PAPER
Prevalence and predictors of depression among midwives working in public hospitals in Amhara regional state in selected zones, Northwest Ethiopia: A cross-sectional study
1
Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
2
Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
Submission date: 2023-11-17
Final revision date: 2024-11-20
Acceptance date: 2025-02-16
Publication date: 2025-03-28
Corresponding author
Tiruye T. Mesele
Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
ΕΛΕΥΘΩ 2025;24(1):2
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Depression among healthcare professionals in Ethiopia is prevalent, and the burden remains high. However, few studies have addressed this issue in Ethiopia, and none have specifically focused on midwives in the study area. Therefore, the aim of this study was to determine the prevalence of depression and identify its predictors among midwives working in public hospitals in the West Gojjam, East Gojjam, and Central Gondar zones of the Amhara regional state, Northwest Ethiopia.
Methods:
An institution-based cross-sectional study design was employed between February and March 2022. The study was conducted among midwives who were working at public hospitals located in the three randomly selected clusters/zones in the Northwest Amhara region. There were 31 functional hospitals (4 tertiary hospitals, 3 general hospitals, and 24 primary hospitals) in the selected clusters. A simple random sampling technique was used for health facilities, and cluster sampling was employed for the selection of study participants. A self-administered questionnaire, including the Depression Anxiety Stress Scale-21 (DASS-21), was used to assess midwives' depression status. Statistical analyses were performed using SPSS Version 26.0. Both binary and multivariable logistic regression were used. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) was considered at a p-value of ≤0.05.
Results:
A total of 634 midwives participated in this study. The prevalence of depression among midwives was 25.7% (95% CI: 22.4-29.0). In multivariable analysis, being female (AOR=3.85; 95% CI: 2.29-6.46, p=0.001) and having a history of stress (AOR=5.56; 95% CI: 2.02-15.26, p=0.001) were significant predictors of depression. Participants who had work experience of fewer than 5 years (AOR=0.51; 95% CI: 0.31-0.84, p=0.008) and those who were unmarried (AOR=2.00; 95% CI: 1.24-3.25, p=0.005) were also found to be significant predictors of depression.
Conclusions:
There was a high prevalence of work-related depression symptoms among midwives working in Amhara region public hospitals. Being female, unmarried, having less work experience, and a history of stress were variables significantly associated with depression among midwives. Therefore, raising awareness through education about depression and implementing routine screening among midwives working in Amhara region public hospitals is crucial for early detection and management. Furthermore, for researchers, it is better to use both qualitative and quantitative study designs for further understanding of depression.
Depression among healthcare professionals in Ethiopia is prevalent, and the burden remains high. However, few studies have addressed this issue in Ethiopia, and none have specifically focused on midwives in the study area. Therefore, the aim of this study was to determine the prevalence of depression and identify its predictors among midwives working in public hospitals in the West Gojjam, East Gojjam, and Central Gondar zones of the Amhara regional state, Northwest Ethiopia.
Methods:
An institution-based cross-sectional study design was employed between February and March 2022. The study was conducted among midwives who were working at public hospitals located in the three randomly selected clusters/zones in the Northwest Amhara region. There were 31 functional hospitals (4 tertiary hospitals, 3 general hospitals, and 24 primary hospitals) in the selected clusters. A simple random sampling technique was used for health facilities, and cluster sampling was employed for the selection of study participants. A self-administered questionnaire, including the Depression Anxiety Stress Scale-21 (DASS-21), was used to assess midwives' depression status. Statistical analyses were performed using SPSS Version 26.0. Both binary and multivariable logistic regression were used. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) was considered at a p-value of ≤0.05.
Results:
A total of 634 midwives participated in this study. The prevalence of depression among midwives was 25.7% (95% CI: 22.4-29.0). In multivariable analysis, being female (AOR=3.85; 95% CI: 2.29-6.46, p=0.001) and having a history of stress (AOR=5.56; 95% CI: 2.02-15.26, p=0.001) were significant predictors of depression. Participants who had work experience of fewer than 5 years (AOR=0.51; 95% CI: 0.31-0.84, p=0.008) and those who were unmarried (AOR=2.00; 95% CI: 1.24-3.25, p=0.005) were also found to be significant predictors of depression.
Conclusions:
There was a high prevalence of work-related depression symptoms among midwives working in Amhara region public hospitals. Being female, unmarried, having less work experience, and a history of stress were variables significantly associated with depression among midwives. Therefore, raising awareness through education about depression and implementing routine screening among midwives working in Amhara region public hospitals is crucial for early detection and management. Furthermore, for researchers, it is better to use both qualitative and quantitative study designs for further understanding of depression.
ABBREVIATIONS
ANC=Ante Natal Care, AOR=Adjusted Odd Ratio, COR=Crude Odd Ratio, CI=Confidence Interval, ETB=Ethiopian Birr, DASS= Depression Anxiety Stress Scale, NICU=Neonatal
Intensive Care
ACKNOWLEDGEMENTS
We would like to acknowledge the University of Gondar for providing
ethical clearance to conduct our study. Finally, we extend our gratitude
to the Amhara Regional Health Bureau for providing a supportive letter
to facilitate data collection on midwives working in public hospitals
in the Amhara region. We also appreciate the respective zonal health
departments for providing essential numerical data, which was vital for
the development of this study.
CONFLICT OF INTEREST
The authors have completed and submitted the ICMJE Form for
Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
ETHICAL APPROVAL
Ethical clearance was obtained from the School of Midwifery on behalf
of the Institutional Review Board (IRB) of the University of Gondar,
School of Midwifery (Approval number: PGC 302/1/2021; Date:
January 11, 2021). A formal support letter was then obtained from
the School of Clinical Midwifery and submitted to the respective public
hospitals. Written informed consent was obtained from each study
participant, who were informed that they could refuse or discontinue
participation at any time. Participants' privacy and confidentiality were
ensured by not recording names or any identifying information. All
methods were performed in accordance with relevant guidelines and
regulations.
DATA AVAILABILITY
The datasets from the current study are available from the
corresponding author upon reasonable request.
PEER REVIEW INFORMATION
Not commissioned; externally peer reviewed.
REFERENCES (29)
1.
Belete A, Anbesaw T. Prevalence and associated factors depressive symptoms among healthcare professionals at Dessie comprehensive specialized hospital, Ethiopia. BMC Psychiatry. 2022;22(1):446. doi:10.1186/s12888-022-04102-y
2.
Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 11th ed. LWW; 2014.
3.
Sheen K, Slade P, Spiby H. An integrative review of the impact of indirect trauma exposure in health professionals and potential issues of salience for midwives. J Adv Nurs. 2014;70(4):729-743. doi:10.1111/jan.12274
4.
Zhang LF, You LM, Liu K, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook. 2014;62(2):128-137. doi:10.1016/j.outlook.2013.10.010
5.
Favrod C, Jan du Chêne L, Martin Soelch C, et al. Mental health symptoms and work-related stressors in hospital midwives and NICU nurses: a mixed methods study. Front Psychiatry. 2018;9:364. doi:10.3389/fpsyt.2018.00364
6.
Kassahun EA, Kassie BA, Tilahun SY, Bizuneh AD. Depression, anxiety and stress, during COVID-19 pandemic among midwives in Ethiopia: a nationwide cross-sectional survey. Front Psychiatry. 2022;13:867040. doi:10.3389/fpsyt.2022.867040
7.
Knezevic B, Milosevic M, Golubic R, Belosevic L, Russo A, Mustajbegovic J. Work-related stress and work ability among Croatian university hospital midwives. Midwifery. 2011;27(2):146-153. doi:10.1016/j.midw.2009.04.002
8.
Elmir R, Pangas J, Dahlen H, Schmied V. A meta-ethnographic synthesis of midwives' and nurses' experiences of adverse labour and birth events. J Clin Nurs. 2017;26(23-24):4184-4200. doi:10.1111/jocn.13965
9.
Vafaei H, Roozmeh S, Hessami K, et al. Obstetrics healthcare providers' mental health and quality of life during COVID-19 pandemic: multicenter study from eight cities in Iran. Psychol Res Behav Manag. 2020;13:563-571. doi:10.2147/PRBM.S256780
10.
Maharaj S, Lees T, Lal S. Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses. Int J Environ Res Public Health. 2018;16(1):61. doi:10.3390/ijerph16010061
11.
Henriksen L, Lukasse M. Burnout among Norwegian midwives and the contribution of personal and work-related factors: a cross-sectional study. Sex Reprod Healthc. 2016;9:42-47. doi:10.1016/j.srhc.2016.08.001
12.
Pezaro S, Clyne W, Fulton EA. A systematic mixed-methods review of interventions, outcomes and experiences for midwives and student midwives in work-related psychological distress. Midwifery. 2017;50:163-173. doi:10.1016/j.midw.2017.04.003
13.
Muliira RS, Sendikadiwa VB, Lwasampijja F. Predictors of death anxiety among midwives who have experienced maternal death situations at work. Matern Child Health J. 2015;19(5):1024-1032. doi:10.1007/s10995-014-1601-1
14.
Sidhu R, Su B, Shapiro KR, Stoll K. Prevalence of and factors associated with burnout in midwifery: a scoping review. Eur J Midwifery. 2020;4:4. doi:10.18332/ejm/115983
15.
Sheen K, Spiby H, Slade P. Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: prevalence and association with burnout. Int J Nurs Stud. 2015;52(2):578-587. doi:10.1016/j.ijnurstu.2014.11.006
16.
Dahlen HG, Caplice S. What do midwives fear?. Women Birth. 2014;27(4):266-270. doi:10.1016/j.wombi.2014.06.008
17.
Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC Pregnancy Childbirth. 2017;17(1):13. doi:10.1186/s12884-016-1212-5
18.
European Agency for Safety and Health at Work. Calculating the cost of work-related stress and psychosocial risks. EU-OSHA; 2014. Accessed February 16, 2025. https://osha.europa.eu/sites/d...
19.
Hunter B, Fenwick J, Sidebotham M, Henley J. Midwives in the United Kingdom: levels of burnout, depression, anxiety and stress and associated predictors. Midwifery. 2019;79:102526. doi:10.1016/j.midw.2019.08.008
20.
Båtsman A, Fahlbeck H, Hildingsson I. Depression, anxiety and stress in Swedish midwives: a cross-sectional survey. Eur J Midwifery. 2020;4:29. doi:10.18332/ejm/124941
21.
Mohammad KI, Al-Reda AN, Aldalaykeh M, et al. Personal, professional and workplace factors associated with burnout in Jordanian midwives: a national study. Midwifery. 2020;89:102786. doi:10.1016/j.midw.2020.102786
22.
Tarecha D, Tarafa H, Asnake G, Mekonen H, Roba G. Depressive symptoms and associated factors among youth attending public high school in Bahir Dar City, Northwest Ethiopia: a cross-sectional study. J Dep Anxiety. 2022;11(8):478. doi:10.35248/2167-1044.22.11.478
23.
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335-343. doi:10.1016/0005-7967(94)00075-u
24.
Bete T, Gemechu K, Anbesaw T, Tarafa H, Tadessa J. Depressive symptoms and associated factor among public school teachers in Jimma town, Southwest, Ethiopia 2020: a multi-disciplinary, cross-sectional study. BMC Psychiatry. 2022;22(1):343. doi:10.1186/s12888-022-03941-z
25.
Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey. BMC Pregnancy Childbirth. 2017;17(1):13. doi:10.1186/s12884-016-1212-5
26.
Vaičienė V, Blaževičienė A, Macijauskiene J, Sidebotham M. The prevalence of burnout, depression, anxiety and stress in the Lithuanian midwifery workforce and correlation with sociodemographic factors. Nurs Open. 2022;9(4):2209-2216. doi:10.1002/nop2.948
27.
Kidanu K, Kassa M, Damtie A, Bayray A, Berhe H, Demtsu B. Assessment of knowledge, attitude, and practices on depression and associated factors among Mekelle University College of Health Sciences students in Mekelle City, Ethiopia, 2010/11. Int J Ther Appl. 2016;32:69-76. doi:10.20530/IJTA_32_69-76
28.
Aklilu M, Warku W, Tadele W, et al. Assessment of job satisfaction level and its associated factors among health workers in Addis Ababa health centers: a cross-sectional study. Adv Public Health. 2020;2020:1085029. doi:10.1155/2020/1085029
29.
St John PD, Montgomery PR. Marital status, partner satisfaction, and depressive symptoms in older men and women. Can J Psychiatry. 2009;54(7):487-492. doi:10.1177/070674370905400710
Share
RELATED ARTICLE
| ISSN: | 1106-6822 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
