# Depression and anxiety symptoms among women in post-conflict Somalia: a cross-sectional study in maternal and child health centres

## TL;DR

This study found high rates of depression and anxiety among women in post-conflict Somalia, linked to low income and weak coping skills.

## Contribution

The study provides new insights into mental health prevalence and risk factors among women in post-conflict Somalia.

## Key findings

- Depressive and anxiety symptoms were prevalent in 36% and 38% of women respectively.
- Low socioeconomic status and weak sense of coherence were key risk factors.
- Sense of coherence showed a protective effect against mental health symptoms.

## Abstract

Mental health issues can be regarded as a severe public health problem that affects low-, middle-, and high-income countries worldwide. However, certain populations in post-conflict countries may have particularly vulnerable mental health, such as women of childbearing age in Somalia. Despite our understanding of this vulnerable group, data on mental health among women living in conflict and post-conflict settings are still scarce. Therefore, this study aims to identify the prevalence of depressive and anxiety symptoms among women living in post-conflict Somalia and their association with sense of coherence (SOC), perceived social support, and individual sociodemographic factors.

Data were collected from 900 women who attended nine maternal and child health centres (MCHs) in the Banadir region of Somalia, using a self-report validated questionnaire in Somali. This questionnaire was based on the depression component of the Patient Health Questionnaire-9, the Generalised Anxiety Disorder scale, SOC, and sociodemographic factors. The data were analysed using multiple logistic regression with STATA software (v. 16) to determine the factors associated with depression and anxiety.

Depressive symptoms (36%) and anxiety symptoms (38%) were mainly associated with higher income, unstable housing, and comorbid anxiety or depression. Sense of coherence consistently showed a protective effect. No significant associations were found with pregnancy status, MCH visits, social support, or most other sociodemographic factors.

The study identified a high prevalence of depressive and anxiety symptoms among women attending MCH centres, with low socioeconomic status and low sense of coherence emerging as key associated factors. These findings underscore the urgent need to integrate routine mental health screening and support services within primary health care and MCH centres to improve early identification, reduce stigma, and strengthen women's well-being in post-conflict Somalia.