Suicidal Ideation and Attempts among Adults in Algeria, Eswatini, Malawi and Zambia based on WHO STEPS Surveys Data 2014–2019
Ilunga Ngalande, Wingston Felix Ng’ambi, Adoration Chigere, Cosmas ZyamboAbstract
Introduction:
Suicide is a major global health concern, claiming approximately 800,000 lives annually, predominantly in low- and middle-income countries. In Sub-Saharan Africa, research on suicidal behavior remains limited, hindered by stigma, inadequate mental health infrastructure and data scarcity. This study examines the prevalence and predictors of suicidal ideation and attempts across four African countries (Algeria, Eswatini, Malawi and Zambia) to guide culturally sensitive prevention strategies.
Methods:
This cross-sectional study analysed secondary data from WHO STEPS surveys (2014–2019). The study employed a multi-stage cluster sampling and standardised assessment to evaluate suicidal behavior among individuals aged 15 years and older. A total of 14,374 participants were assessed for ideation and 16,041 for attempts. Multi-variable logistic regression and spatial mapping were used to identify risk factors and geographic trends.
Results:
Findings revealed a 6.34% prevalence of suicidal ideation and a 5.69% prevalence of suicide attempts, with higher rates among females and youths aged 15–34 years. Males were significantly less likely to report suicidal thoughts than females (adjusted odds ratio [AOR] = 0.61; 95% confidence interval [CI]: 0.52–0.72;
Conclusion:
This study underscores the urgent need to integrate mental health services into primary care systems, enhance public awareness and reduce stigma surrounding suicide. Expanding access to affordable, culturally appropriate mental health resources is critical to addressing the high burden of suicidal behavior in Sub-Saharan Africa.