Postpartum Mental Health and Psychosocial Support among Mothers in Central Freetown, Sierra Leone: A Mixed-Methods Study

Abstract

Postpartum maternal mental health remains an under-recognized public health concern in low-resource urban settings such as central Freetown, Sierra Leone, where maternal health services largely prioritize physical outcomes over psychosocial well-being. This mixed-methods study examined the relationship between psychosocial support and maternal mental health among postpartum mothers, identified major psychosocial stressors, and explored coping strategies in contexts of limited support. Data were collected from a survey of 60 postpartum mothers, supplemented by in-depth interviews, focus group discussions, and key informant interviews. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed thematically. Findings revealed that 45% of mothers experienced moderate to severe depressive symptoms. Family support emerged as the strongest protective factor, showing a significant negative correlation with depressive symptoms. Religious practices and informal social networks were common coping strategies, though formal support services were limited. Major barriers included stigma, financial constraints, and poor access to mental health services. The findings highlight the need for integrated psychosocial support within maternal and child health programs. Implications for social work practice include family-centered interventions, community-based support groups, healthcare worker training, and policy reforms prioritizing maternal mental health within national health strategies.