Mental Health Burden in Impoverished Zimbabwean Community

Zimbabwe is a lower-middle-income country with a population of 15 million. Between 34 and 49% of the population live in extreme poverty, defined as living on <$1.90 per day.¹⁷ Zimbabwe has one of the highest HIV prevalences in Sub-Saharan Africa, at 12.9%.¹⁸ We analysed pre-existing data from a cross-sectional survey that had taken place at a large primary healthcare centre in Mbare. The original survey had been conducted to validate the Patient Health Questionnaire-9 for depression and the Shona Symptom Questionnaire for common mental disorders.^{19 (link)}Mbare is the oldest high-density suburb in the southern district of the capital city of Harare. The predominant language of its population is Shona, followed by Ndebele and English. Mbare is characterised by high levels of deprivation, unemployment, mobility and crime.²⁰ Many households lack adequate electric, water and sanitation services. The major determinants of poverty in high-density suburbs in Harare are large family size, low education level of the household head, lack of income from permanent employment, low cash transfers and short length of residence in the suburb.²¹ The primary healthcare centre caters to a catchment population of 200 000. It has an average attendance of 140 patients per day and provides a range of services, including acute primary care, chronic disease out-patients, family planning, maternity, and services for the prevention and treatment of HIV and tuberculosis.