Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey

BACKGROUND: Household food insecurity is the situation where individuals and families have limited/uncertain access to nutritionally adequate and safe foods for healthy living. Family size is the number of persons in the family. Household food insecurity and family size are risk factors for depression. However, their synergistic and/or multiplicative effect on depression is not well investigated. This study investigated/examined household food insecurity, family size and their interaction on depression prevalence among teenaged pregnant girls in Ghana. METHODS: Population based cluster survey was conducted among 225 teenaged pregnant girls in 20-electoral areas at Twifo-Atti-Morkwa district in the central region of Ghana. Simple random sampling was used to recruit study participants and structured questionnaire used to collect demographic variables. Household Food Insecurity Access Scale (HFIAS) and Revised Children’s Anxiety and Depression Scale (RCADS-25) were used to collect data. Multinomial logistic regression models were used to analyzed the data. RESULTS: Moderate and high depression prevalence reported among teenaged pregnant girls in Twifo-Atti-Morkwa district were 35.1(28.1–42.1) and 33.5 (26.5–40.5) respectively. Moderate family size (AOR = 1.08, 95%CI = 1.17–3.71) and large-family-size (AOR = 2.78, 95%CI = 3.98–10.19) were significant for depression. Moderate food insecurity (AOR = 0.12, 95%CI = 0.41 − 0.35) and high food insecurity (AOR = 0.27, 95%CI = 0.11–0.71) were significant for depression. Interaction between moderate food insecurity and moderate family size (AOR = 1.69, 95%CI = 2.79–17.51), interaction between high food insecurity and low family size (AOR = 1.24, 95%CI 1.57–11.41) and interaction between high food insecurity and large family size (AOR = 1.01, 95%CI = 1.72–14.57) were significant for depression among teenaged pregnant girls. CONCLUSION: There is moderate and high depression prevalence among teenaged pregnant girls in Twifo-Atti-Morkwa district. Interaction between household food insecurity and family size are the major predictors for depression among the teenaged girls in the district. We therefore recommend that public health officers should be up with health education campaigns in the district to create awareness on the depression prevalence among teenaged girls, and urge them to come out and seek support to prevent the catastrophic effect of depression.