Depression and anxiety, and associated factors among female community health volunteers in Parsa district, Nepal

Female community health volunteers (FCHVs) are the pillar of the health system. They are local women who work from the periphery of the community. The Government of Nepal has highly praised the role that FCHVs played in achieving Millennium Development Goals 4 and 5 and, through contextual adaptation, expects the same during the period of the Sustainable Development Goals by 2030. This study aimed to assess depression and anxiety and their associated factors among the female community health volunteers of the Parsa district, Nepal. A cross-sectional study was conducted among female community health volunteers. Participants were selected using the probability proportionate sampling technique. Data were collected through face-to-face interviews using an interview schedule, entered into EpiData version 3.1, and then transferred to the Statistical Package for the Social Sciences (SPSS) version 20. Depression and anxiety were assessed using the PHQ-9 and GAD-7, respectively. Ethnicity was classified according to the STEPS classification, with the disadvantaged non-Dalit Terai caste group used as the reference category. Descriptive and inferential analyses were performed, including chi-square tests and multivariable logistic regression. The average age of FCHVs across all 14 local levels was 36.87 years, and only 9.5% were under 25 years. The prevalence of depression and anxiety was 41.3% and 19.8%, respectively. Religion, family type, and the husband’s education status of the respondent were significantly associated with both depression and anxiety ( p < 0.05). FCHVs from other castes (Dalit, disadvantaged Janajati, and religious minorities combined) had higher odds of depression than those from the disadvantaged non-Dalit Terai caste (OR = 3.01, 95% CI: 1.76–5.15). Those living in joint families had lower odds of anxiety compared with those in nuclear families (OR = 0.29, 95% CI: 0.10–0.86). Religion, family type, and the husband’s educational status of the respondents were significantly associated with both depression and anxiety. Psychosocial counseling and family support programs should be implemented, particularly for FCHVs.