Depressive and anxiety symptomatology among caregivers of children 0-3 years in Nairobi City County: Community-based prevalence study

Abstract

Caregivers of young children in low-resource urban settings face multiple stressors, which can affect their mental health. There is limited population-based evidence on the prevalence and correlates of depression and anxiety among caregivers of young children in these contexts. This study assessed the prevalence and associated factors of depressive and anxiety symptoms among caregivers of young children in Nairobi City County. We conducted a cross-sectional household survey with 2,903 primary caregivers of children 0-3 years. Depressive and anxiety symptoms were assessed using validated Swahili versions of the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder-7, respectively, with a cut-off score of ≥10 indicating clinically relevant symptoms. Random intercept logistic regression models were fitted to assess the factors associated with depressive and anxiety symptoms while accounting for clustering within Nairobi City County's sub-counties. Approximately 13.8% of caregivers had depressive symptoms, and 8.0% had anxiety symptoms. Stronger paternal involvement in childcare and parenting responsibilities was associated with lower odds of depressive and anxiety symptoms (adjusted odds ratio (aOR)=0.95 and aOR=0.93, both P < 0.001). Factors associated with higher odds of depressive and anxiety symptoms were pregnancy-related complications (depression: aOR=2.36, P < 0.001; anxiety: aOR=1.61, P = 0.003), and moderate household food insecurity relative to a food secure status (depression: aOR=3.67; anxiety: aOR=4.59; both P < 0.001). Higher wealth status was associated with lower odds of depressive and anxiety symptoms. A child's history of hospital admission was additionally associated with higher odds of depressive symptoms (aOR=1.56, P = 0.018), while tertiary level education was associated with lower odds (aOR=0.65, P = 0.049). The noted prevalence of depressive and anxiety symptoms among caregivers in low-resource urban settings elucidates the need to integrate mental health services into the existing maternal and child health programmes in Kenya.