Exploring The Lived Experiences Of Depression Among Youths And Their Guardians In Sub-Saharan Africa: A Systematic Review and Meta-Aggregation

BackgroundThe cultural context influences how mental disorders like depression, are perceived and experienced. Most studies on lived experiences of depression by youths have been done in high-income countries. This has made it difficult for researchers to infer the findings in the context of SSA due to differences in cultures and socio-demographic characteristics. This systematic review thus, seeks to understand how depression is experienced by youths and their guardians in SSA. ObjectiveThis systematic review was done to address two key objectives: to explore and synthesize qualitative studies on the lived experience of depression among youths and their guardians and to identify common themes, and the impact of socio-cultural and contextual factors on the lived experience of depression among youths and their guardians in SSA. MethodologyTwo research assistants independently searched and selected articles from databases such as PubMed, using a set search strategy. Thereafter, two reviewers reviewed and extracted data from the selected articles, analysed it using meta-aggregation techniques. The identified papers underwent an independent quality assessment using the Critical Appraisal Skills Program checklist by the two independent researchers. Through this quality assessment, the risk of bias in the papers was also assessed. We have used the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) guidelines in reporting this review. ResultsOur search resulted into 14 unique studies spanning 8 countries in SSA, representing a total of 610 young people (10 to 24 years; 72% females) with lived experience of depression, 297 caregivers and 70 healthcare workers. Findings on the lived experience of youths were aggregated into eleven categories which were further grouped into three main synthesised findings of making sense of depression, mental health systems and services and contextual issues as key issues encompassing their lived experience. Regarding the experience of guardians, three key themes were identified: challenges faced by the guardians, their perception of youth depression and their experience in navigating through the healthcare system. Conclusionthe sociocultural context in SSA determines how the youth experience depression and that symptoms of depression as experiences by youths in SSA may not always match diagnostic criteria developed from the west. The experiences of the guardians have an impact on the young peoples experiences of depression. Systematic review registration: PROSPERO, CRD42024556661