Bridging the Language Gap in Maternal Mental Health: Psychometric Evaluation of the Siswati Edinburgh Postnatal Depression Scale During Pregnancy

The integration of antenatal depression screening into routine antenatal care necessitates the validation of existing screening tools. This study investigated the validity and reliability of the Siswati version of the Edinburgh Postnatal Depression Scale (EPDS) among antenatal women. This cross-sectional study included 505 antenatal women, half of whom ( n  = 252) were included in exploratory factor analysis (EFA) and the other half ( n  = 253) in confirmatory factor analysis (CFA). Cronbach’s alpha and intraclass correlation coefficients were determined to evaluate the scales’ reliability. The Depression Anxiety Stress Scales (DASS) were used to examine concurrent validity. Approximately 26% of the women had depressive symptoms. With acceptable model fit indices, the CFA confirmed the following two factors, which were identified during the EFA: anhedonia (Items 1 and 2) and anxiety/depression (Items 3–10). The Cronbach’s alpha and intraclass correlation coefficient values were .83 and .86, respectively. The EPDS had satisfactory concurrent validity. The Siswati version of the EPDS is a valid and reliable tool for screening for antenatal depressive symptoms in primary care settings. Future studies should explore the diagnostic accuracy of the scale. The tool will ensure early detection of perinatal depressive symptoms, enable timely interventions and improve maternal and child outcomes.