Prevalence of Perinatal Mental Health Problems and the Role of Traditional Healing Alongside Clinical Care in Southern Malawi: A Mixed-Methods Study

Background Maternal mental health remains a critical yet insufficiently addressed component of perinatal care in sub-Saharan Africa. In Southern Malawi, where cultural beliefs and traditional healing practices profoundly shape health-seeking behaviour, the intersection of traditional and clinical care presents both challenges and opportunities for improving maternal outcomes. Objective This study investigated the prevalence of perinatal mental health problems and explored the role of traditional healing practices alongside clinical care in supporting maternal mental health in Southern Malawi. Methods A convergent parallel mixed-methods design was employed. Quantitative data were collected from perinatal mothers (n = 330) using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Qualitative data were gathered through semi-structured interviews with perinatal mothers, healthcare providers (n = 10), and traditional healers (n = 10). Quantitative data were analysed with SPSS using descriptive statistics; qualitative data were analysed thematically. Results Approximately 35% of perinatal mothers reported moderate-to-severe depressive symptoms (mean PHQ-9 score: 10.5, SD = 4.3), while 30% exhibited moderate-to-severe anxiety (mean GAD-7 score: 9.2, SD = 3.9). Sixty percent of mothers relied on traditional healing methods for mental health concerns, citing cultural familiarity and trust. Forty percent faced barriers to clinical care, including stigma and limited awareness of available services. Qualitative data revealed that traditional healers provided essential emotional support and community cohesion, while healthcare workers reported inadequate training in perinatal mental health assessment. Conclusion The integration of traditional and clinical practices represents a promising strategy for enhancing maternal mental health outcomes in Southern Malawi. Findings highlight the urgent need for structured training of healthcare providers, community-sensitive interventions, and collaborative frameworks that leverage the complementary strengths of both healing systems. These insights are relevant to other low-resource settings across sub-Saharan Africa.