Relationship Between Psychosocial Interventions and Management of Postpartum Depression Among Mothers in Maternity Wards at Murang'a County Referral Hospital, Murang'a County, Kenya

Abstract

Postpartum depression remains a significant maternal health concern affecting women's psychological well-being globally, with the World Health Organization (2023) reporting that approximately 10–15% of women in developed countries and up to 20% of women in developing countries experience postpartum depression following childbirth. Despite this prevalence, no comprehensive study has examined the relationship between psychosocial interventions and management of postpartum depression among mothers specifically in maternity wards at Murang'a County Referral Hospital, where understanding intervention effectiveness could inform clinical practice in county referral hospital settings. This research study investigated the relationship between psychosocial interventions and the management of postpartum depression among mothers in maternity wards at Murang'a County Referral Hospital, Murang'a County, Kenya. The study employed a cross-sectional descriptive research design using a mixed-methods approach, with Rational Emotive Behavior Theory and Stress and Coping Theory utilized as theoretical frameworks. A sample of 173 participants was included in the study using stratified random sampling, census sampling, and criterion-based purposive sampling, comprising 161 mothers and 12 healthcare professionals. Data was collected using questionnaires and semi-structured interviews. The instruments demonstrated strong reliability, with EPDS showing Cronbach's alpha of 0.83 in Kenyan populations, TEQ ranging from 0.82–0.91, and PSS-4 showing 0.65–0.78 in East African contexts. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 28.0 which explored relationships between variables and test research hypotheses. The study found that moderate depression was the most prevalent severity level, with the majority of mothers experiencing some level of postpartum depression requiring intervention. Intervention types analysis revealed that multiple psychosocial interventions were being utilized including individual counseling, group therapy, and social support mechanisms, with group therapy receiving the highest endorsement. Perceived benefits assessment showed that the majority of mothers reported high perceived benefits from psychosocial interventions, while management outcomes indicated most mothers demonstrated moderate perceived stress levels. Chi-square analysis revealed statistically significant associations between all study variables and management of postpartum depression, with perceived benefits showing the strongest relationship (χ² = 379.532, p = 0.000), followed by prevalence of postpartum depression (χ² = 365.789, p = 0.000) and intervention frequency adequacy (χ² = 89.506, p = 0.000). The study concludes that perceived benefits of psychosocial interventions demonstrate significantly stronger influence on management outcomes than any other variable examined, while postpartum depression remains a widespread phenomenon requiring systematic screening and comprehensive intervention. The study recommends that Murang'a County Referral Hospital administration strengthen the implementation of systematic postpartum depression screening protocols, the Ministry of Health increase human resources for mental health services, healthcare professionals develop systematic family involvement protocols, county government address financial barriers through medication assistance programs, hospital administration strengthen follow-up systems through home visits and telephone-based counseling, and community and religious leaders support psychoeducation campaigns to reduce stigma and promote help-seeking in maternity ward settings across Kenya's county referral hospitals.