Prevalence of depression and associated factors among health care workers in Jinja District

Abstract

Background Depression affects about 5% of the global adult population. Health workers (HCWs) continue to be at an increased risk of suffering from depression. Despite the existence of evidence on its detrimental effects, little remains known about its burden among HCWs and their attitudes towards seeking help for it. Objective This study aimed at estimating the prevalence of depression and its associated factors, and exploring the attitudes of HCWs towards seeking help, in Jinja district. Methods This was a cross-sectional mixed methods study, where quantitative and qualitative data were collected using the concurrent triangulation design. Survey data were collected from a sample of 192 HCWs while qualitative data was collected from seven (7) key informants (hospital administrators). Data were then cleaned using Microsoft excel 2016 and transferred to STATA 15.0 for further analysis. The prevalence of depression was assessed using the CES-D-10 item, a shortened self-report questionnaire tool, rated on a 4 point scale, developed by Andresen et al. (1994). The sum of scores from the 10 questions ranged from 0 to 30 with scores (≥10) indicating greater depressive symptoms. Factors associated with depression and HCWs’ attitudes towards seeking help for depression were identified using a structured questionnaire and KIIs respectively (7). Socio demographic data were descriptively analyzed and summarized into means, percentages and frequencies. Modified poisson regression was used to assess factors associated with depression. Qualitative results were thematically analyzed. Results The prevalence of depression among HCWs was estimated to be at 24% (46/192). Results showed that lack of support from the HCWs’ employers (APR=3.1, 95% CI (1.75-5.36) p value= 0.001) and lack of support from HCWs’ fellow employees/ workmates (APR= 2.0, 95% CI (1.08-3.79) p value= 0.028) were significantly associated with higher depressive symptoms among HCWs. Factors such as; age, designation, being overworked, having enough rest, lack of adequate PPEs and medical supplies, and support from relatives, were not significantly associated with depression. HCWs do not seek help for depression due to stigma towards those with mental illness, lack of specialized care, and limited psycho-social support at their work places. xi Conclusions Depression was highly prevalent (24%) among HCWs in Jinja district’s public health facilities which is about 5 times higher than the global general population figure of 5%. Work-related factors such as lack of support from HCWs’ employers and lack of support from HCWs’ fellow employees/ workmates were associated with depression in this study which calls for a work place review of practices that promote mental well-being. The hindrance to seeking care due to stigma towards those with mental-illness is a big concern that requires immediate public interventions to reduce it. Employers should work towards conducting employee satisfaction surveys, such that they are able to keep track of work place stressors. This will enable them to come up with relevant interventions to address gaps that would have been captured in those surveys. Additionally, employers should develop and implement comprehensive work place mental health policies that include clear procedures for reporting and addressing mental health concerns (depression), such as confidentiality and non-discriminatory protocols.