Expectant fathers' knowledge and attitudes towards postpartum depression and the associated factors: a cross-sectional study in a rural community, Sri Lanka.

Introduction: Postpartum depression is easily managed when detected early. Since mothers' and newborns' health is influenced by fathers, good knowledge and positive attitudes toward postpartum depression among fathers would help in early detection and early intervention.

Objective: To describe the knowledge and attitudes of expectant fathers about postpartum depression and factors associated with their knowledge and attitudes about postpartum depression in a rural community in Sri Lanka.

Methods: A descriptive cross-sectional study was conducted among 440 expectant fathers selected using cluster sampling. A pretested self-administered questionnaire was used with 30 knowledge statements with a maximum score of 30 points and 15 Likert scale attitude statements with a maximum score of 60 points. Good knowledge was defined as ≥ 50% of the total knowledge score. Positive attitudes were defined as ≥ 50% of the total attitude score. The chi-square test was applied to identify the significance of the associations between sociodemographic factors and knowledge and attitude levels. Multiple logistic regression was performed, and the results were expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results: The response rate was 93.6%. Most of the expectant fathers (58.2%, n = 256) had never heard about postpartum depression. The median knowledge score was 10 (IQR 4-16), and 33.6% (n = 148) of participants had good knowledge. Good knowledge was significantly associated with a higher educational level (p < 0.001), having a close relative/friend with postpartum depression (p < 0.001), and having heard about postpartum depression before (p < 0.001). Logistic regression revealed significant associations only with higher educational level (aOR = 2.53; 95% CI = 1.54-4.15) and having heard about postpartum depression before (aOR = 5.46; 95% CI = 3.47-8.59). The median attitude score was 36 (IQR 31-40.75), and 83.4% (n = 367) had positive attitudes. Although the bivariate analysis showed that working in the private sector (p = 0.04) and expecting their first child (p = 0.04) were significantly associated with positive attitudes, logistic regression did not reveal any significant association.

Conclusions: The majority of fathers had positive attitudes toward postpartum depression, but their knowledge was limited. Since their attitudes are favorable, the knowledge gap should be minimized by imparting knowledge to facilitate the early detection of postpartum depression among mothers in the area.