A cross sectional study of factors impacting mental wellbeing in Tanzanian school-attending adolescents

Abstract

Objectives: To examine the association between (i) certain socio-demographic variables indicating marginalisation (“marginality indicators” or “MIs”) and (ii) mental wellbeing in Tanzanian adolescent school students, and differences between female and male students.

Methods: 3052 adolescents aged 15+ years from 5 districts of Tanzania (3 rural and 2 urban locations) participated in a cross sectional survey in August 2020, responding to questions enabling calculation of their Warwick-Edinburgh Mental Wellbeing Scale (“WEMWBS”) score as well as questions relating to their socio-demographic characteristics and the MIs. Descriptive statistical analysis, linear regression and logistic regression analyses were performed.

Results: A wide range of MIs are associated with lower mean mental wellbeing in Tanzanian adolescents on a univariate basis, with females more likely to experience most MIs. 17.3% of students (20.9% of females and 13.5% of males) had WEMWBS scores potentially indicative of depressive illness. Linear regression analysis of the 17 MIs with a statistically significant relationship to reduced mental wellbeing on a univariate basis (adjusted for age, sex, form and district) found that 3 MIs (all of which were prevalent) had a statistically significant negative effect on student mental wellbeing: (i) parents being unable to afford the cost of healthcare; (ii) doing outside work which interferes with schoolwork; and (iii) lacking a permanent home. Two MIs related to (ii) and (iii) – needing to earn income for their family, and lacking shelter – were statistically significantly associated with scores consistent with probable clinical depression upon logistic regression analysis. Although there were points of commonality, different marginality indicators were associated with mental wellbeing (and scores indicative of possible/probable depression) in males and females.

Conclusion: This study identified several factors whose presence correlates with statistically significant reductions in the mental wellbeing of Tanzanian adolescents, which can hopefully be used to inform future policy and interventions.