A Systematic Review of Community Health Worker-Led Postpartum Depression Screening and Its Impact on Mental Health Service Uptake in Sub-Saharan Africa: Evidence from 2005

Postpartum depression is a significant public health concern in Sub-Saharan Africa, yet mental health service utilisation among affected women remains low. Community health workers are increasingly deployed to bridge this service gap, but the effectiveness of their role in systematic postpartum depression screening and referral is not well synthesised. This systematic review aimed to analyse the effect of a community health worker-led postpartum depression screening and referral protocol on mental health service uptake among postpartum women in a specified setting within Sub-Saharan Africa. A systematic literature review was conducted following established guidelines. Multiple electronic databases were searched for relevant peer-reviewed studies. Included studies were critically appraised, and data were extracted and synthesised thematically. The search yielded a limited number of directly relevant empirical studies. Available evidence, though scant, suggests a positive association between community health worker-led screening and increased service linkage. A key theme identified was that successful referral depended heavily on integrated pathways between community and clinical services. Evidence on the specific impact of community health worker-led postpartum depression screening protocols in the specified context is currently insufficient. While the approach shows conceptual promise, its efficacy in improving service uptake cannot be robustly determined from existing literature. Further primary research employing robust designs is required. Programmes should focus on strengthening integrated care pathways and training community health workers in supportive counselling alongside screening. National health policies should formally recognise and fund such community-based mental health initiatives. postpartum depression, community health worker, screening, referral, mental health services, Sub-Saharan Africa, systematic review This review consolidates the limited existing evidence and identifies critical gaps in knowledge, providing a foundation for future research and programme planning in under-resourced settings.