When sadness has no name: communication, culture, and the social construction of postpartum depression in northern Nigeria

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Introduction Postpartum depression (PPD) is a poorly identified condition in Northern Nigeria, where the understanding of emotional distress is processed through sociocultural and communicative contexts. This paper discusses the impact of information sources on the understanding and help-seeking intentions and contributes to a Communication-Integrated Health Belief Model (CI-HBM). Materials and methods The study design is phenomenological, and focus group discussions (FGDs) were used. A purposive selection of 16 FGDs took place with 128 women aged 18-49 years in urban and rural settings in Niger and Yobe States, Nigeria. Semi- structured guides were developed in local languages and used for data collection. Data were analysed thematically as suggested by Braun and Clarke, with an explanation-building strategy. Informed consent and ethical approval were obtained. Results Women manoeuvred through a disjointed information system of family, religious, peer, traditional, and media. Although these sources were helpful in offering emotional support, they tended to normalise or spiritualise distress and minimise perceived severity and postpone professional help-seeking. City dwellers were more prone to online health knowledge, and rural women used interpersonal communication. Culturally plausible communication spaces were the arenas where social negotiation of health beliefs took place. Conclusion PPD is redefined as a communicative phenomenon that is socially constructed. The suggested CI-HBM builds on the old Health Belief Model with the emphasis on the necessity of culturally-resonant, communication-based interventions that would incorporate biomedical knowledge into trusted community and religious networks.

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