Exploring paternal postpartum depression and contributing factors in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Paternal postpartum depression (PPD) is a significant yet often neglected mental health issue affecting fathers during the postpartum period. While maternal postpartum depression is extensively studied, the psychological challenges faced by new fathers, particularly in resource-limited settings like Ethiopia, receive considerably less attention. Paternal postpartum depression not only impacts fathers' well-being but also affects the health and development of their children and their relationships with partners. Understanding the prevalence of paternal postpartum depression and its underlying causes in Ethiopia is essential for developing effective healthcare policies and tailored support programs for new fathers. The goal of this meta-analysis and systematic review is to compile the information currently available regarding the prevalence of and contributing factors to postpartum depression in Ethiopian fathers.

Methods: This study adhered to the PRISMA guidelines and focused on research from Ethiopia. A comprehensive search was performed across multiple databases, including Google, Google Scholar, PubMed, Web of Science, and Medline. Data were systematically collected using a structured checklist and analyzed with STATA version 11. To assess heterogeneity, the Cochrane Q test and I² statistic were applied. Publication bias was also checked using Egger's regression analysis, a funnel plot, and Begg's test.

Results: Five studies with a total of 2,055 participants were included in the meta-analysis. The pooled prevalence of paternal postpartum depression in Ethiopia was 20.86% (95% CI: 16.43-25.29). Significant factors associated with paternal postpartum depression included low family income (OR = 3.04, 95% CI: 1.46-6.32), substance use (OR = 2.96, 95% CI: 1.63-5.37), poor social support (OR = 4.28, 95% CI: 2.53-7.23), unplanned pregnancy (OR = 3.42, 95% CI: 2.24-5.24), and infant sleep problems (OR = 4.78, 95% CI: 2.35-9.73). Heterogeneity was high (I² = 97.9%, P < 0.05). A subgroup analysis was conducted to better understand the variations among the primary studies.

Conclusion: The study reveals a significant prevalence of paternal postpartum depression in Ethiopia, highlighting key risk factors such as low family income, substance use, poor social support, unplanned pregnancies, and infant sleep difficulties. These findings emphasize the need for routine depression screening for fathers, improved social support programs, education on infant sleep management, and further research to develop targeted prevention and treatment strategies.

Keywords: Ethiopia; Meta-analysis; Paternal postpartum depression; Systematic review.

Fig. 1

A PRISMA method for selecting studies in a meta-analysis and systematic review

Fig. 2

A forest plot of pooled prevalence of pooled prevalence of Paternal Postpartum Depression in Ethiopia 2024

Fig. 3

A funnel plot of the included studies, assessing publication bias

Fig. 4

Subgroup analysis forest plot based on sample size in the included articles

Fig. 5

Forest plot of subgroup analysis based on the region in the included articles

Fig. 6

Forest plot of factors associated with postpartum depression among fathers in Ethiopia