Perinatal suicidal behavior in sub-Saharan Africa: A study protocol for a systematic review with meta-analysis

Perinatal mental illnesses are predominant during gestation and continue for a year after delivery. According to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), suicide is classified as a direct cause of death among the maternal population. The occurrence of suicidal behavior among perinatal women was considered the main contributor to the burden of the disorder. Hence, the current study will develop a protocol for a systematic review as well as a meta-analysis on estimating the prevalence and determinants of perinatal suicidal behavior in Sub-Saharan African countries.

PubMed/MEDLINE, Scopus, EMBASE, PsycINFO, and the Web of Science electronic databases will be searched for studies reporting primary data. The second search strategy will be done with Google Scholar, using a combination of the medical subject headings and keywords as the search terms. The studies will be classified into included, excluded, and undecided categories. The studies will be judged based on the eligibility criteria. Heterogeneity will be checked by using the I2 test (Cochran Q test) at a p-value of 0.05 and assuming that the I2 value is > 50%. Publication bias will be checked using a funnel plot, Beg's rank, and Eggers linear statistical tests. A subgroup analysis and sensitivity test will be carried out. The risk of bias will be assessed using the Joanna Briggs Institute (JBI), and the quantitative analysis will determine whether or not to proceed based on the results.

This protocol's comprehensive review is expected to generate sufficient evidence on the prevalence of suicidal behavior and its determinants among women during the perinatal period in Sub-Saharan African countries over the last two decades. Hence, this protocol will be imperative to collect and combine empirical data on suicidal behavior during the perinatal period, and doing so will help to provide essential implications or better evidence to plan different kinds of interventions considering determinants expected to impact the burden of suicidal behavior during the perinatal period.

PROSPERO (CRD42022331544).