Evaluation of Postnatal Depression Screening Practices at Primary Healthcare Facilities in Cross River State

Background: Postnatal depression is a common but frequently undetected mental health condition with significant consequences for maternal and infant wellbeing. This study evaluates the practices and gaps in postnatal depression screening at primary healthcare facilities in Cross River State, South South geopolitical zone. Methods: A facility-based cross-sectional assessment enrolled 20 primary healthcare facilities and surveyed 140 healthcare workers involved in postnatal care delivery. A structured questionnaire assessed screening practices, use of validated tools, and referral pathways. Direct observation of postnatal consultations supplemented self-reported data. Results: Formal postnatal depression screening using validated tools such as the Edinburgh Postnatal Depression Scale was absent in all audited facilities. Emotional wellbeing assessment was informal and unstructured. Healthcare workers reported limited training in perinatal mental health. Referral pathways for identified cases were poorly defined. Conclusion: Postnatal depression screening is critically absent from primary postnatal care in Cross River State. Family medicine departments must integrate validated screening tools into postnatal care protocols and provide workforce training in perinatal mental health recognition and referral. Keywords: postnatal depression, screening, primary healthcare, Cross River State, perinatal mental health