Hospital-based Cross-sectional Study on Demographic Aspects of Hormonal Contraception Use and its Association with Depression Among Somali Women in Mogadishu

Abstract

Though hormonal contraception is known to precipitate depression in some women, it is a successful public health initiative and has numerous personal and community advantages. It contributes to reducing unsafe abortions and maternal and child mortality. The purpose of this study was to assess the prevalence of depression among women who use the hormonal contraceptive (HC) method in Mogadishu, which at times led to circumstances for discontinuation of the contraceptives. A hospital-based cross-sectional study was conducted among women who use HCs and attend a tertiary Benadir mother-and-child hospital and a Somali-Sudanese hospital in Mogadishu, Somalia, from August 2022 to December 2022. The data were collected using Patient Health Questionnaire-9 (PHQ-9). Data were analysed in both descriptive and inferential statistics such as percentage, t-test, analysis of variance, and binary as well as multiple logistic regression. On the HC usage characteristics, 43.6% of the participants have been on Jadelle Implants (a levonorgestrel-releasing implant), with a significance, while only 18.1% use pills (progestin and oestrogen), and the rest used Norplant capsules. In evaluating the physiological side effect incurred by respective HC, 39.6% of respondents were taking anti-depression therapy with a comparative significance, 78.9 were in overall good health, while 21.1% of participants were in poor health. Based on PHQ-9 majority of the respondents (26.9%) had moderate depression, and thirteen (13.1%) had minimal depression, fifty (22.0%) had mild depression. Yet, 43 (18.9%) experienced moderate depression, while another 43 (18.9%) had severe depression. Female housewives were 1.91 times more at risk of any form of depressive disorder than those who are employed. Respondents who had more than $600 were 0.45 times less likely to develop depression compared to those who had less than $600. However, women who used implants (Jadelle) and pills were more likely to develop depression with a p-value of 2.4x10-2 and 1.40x10-2, respectively, than those who used Norplant, respectively. In addition, women who use HCs for one year and more/over are less likely to develop depression compared to those who use HCs for more than 3 months and 6 months, respectively. In conclusion, housewives, low-income level, type of HC, and long duration of HCs were the determinants of depression. As a result, women should be aware of the Hormonal Contraceptives' side effects related to depression and seek the advice of doctors or other medical professionals.