Maternal depression symptoms are highly prevalent among food-insecure households in Ethiopia

Objective: We aimed to evaluate the association between household food insecurity and maternal depression in Ethiopia. Design/Setting/Subjects: In 2014, we conducted a cross-sectional study in southern Ethiopia, including 591 food-secure and 2500 food-insecure households. We measured depression status of women using the Patient Health Questionnaire-9 validated for Ethiopia, with a cut-off of >= 5. We evaluated household-level food insecurity using a validated Household Food Insecurity Access Scale. We applied Bayesian modelling to evaluate the relationship between food insecurity and maternal depression accounting for other observed characteristics. Results: Among the analytic sample, 80.8 (95 % CI 79.4, 82.2) % of women were living in food-insecure households. The overall prevalence of probable depression (mild and moderate forms) was 4.7 (95 % CI 4.1, 5.6) %. All individual depressive symptoms had a significantly higher prevalence in the food-insecure group, except for suicidal ideation (but small numbers; P<0.001). In the Bayesian model adjusting for paternal characteristics, there was a significant dose-response linear relationship (trend) between household food insecurity and maternal depression (P<0.01). The adjusted OR (95 % Bayesian credible interval) for depression for differing levels of food insecurity were: mild food insecurity, 3.29 (1.63, 6.18); moderate, 3.82 (1.91, 7.45); severe, 12.50 (3.38, 32.70). Conclusions: The study documented a high burden of depression among women who lived in food-insecure households. Given this finding, we recommend integrating mental health in the livelihood programmes in areas suffering from food insecurity.