Understandings of depression among community members and primary healthcare attendees in rural Ethiopia: a qualitative study

Bethlehem Tekola, Rosie Mayston, Tigist Eshetu, Rahel Birhane, Barkot Milkias, Charlotte Hanlon, Abebaw Fekadu

Research output: Contribution to journalArticlepeer-review


Available evidence in Africa suggests that the prevalence of depression in primary care settings is high and often goes unrecognized. In this study, we explored how depression is conceptualised and communicated among community members and primary care attendees diagnosed with depression in rural Ethiopia with the view to informing the development of interventions to improve detection. We conducted individual interviews with purposively selected primary care attendees with depression (n=28; 16 females and 12 males) and focus group discussions (FGDs) with males, females, and priests (n=21) purposively selected based on their knowledge of their community. Data were analysed using thematic analysis. None of the community members identified depression as a mental illness. They considered depressive symptoms presented in a vignette as part of a normal reaction to the stresses of life. They considered medical intervention only when the woman’s condition in the vignette deteriorated and ‘affected her mind’. In contrast, participants with depression talked about their condition as illness. Symptoms spontaneously reported by these participants only partially matched symptoms listed in the current diagnostic criteria for depressive disorders. In all participants’ accounts, spiritual explanations and traditional healing were prominent. The severity of symptoms mediates the decision to seek medical help. Improved detection may require an understanding of local conceptualisations in order to negotiate an intervention that is acceptable to affected people.
Original languageEnglish
JournalTranscultural Psychiatry
Publication statusAccepted/In press - 11 Sept 2020


  • Depression; Explanatory model; Symptoms; Primary care; Qualitative method; Ethiopia


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