Integrating agenda-setting theory and the health belief model to understand newspaper coverage of postpartum depression and maternal help-seeking behaviour in Nigeria

Despite being a major but poorly recognised mental health condition among women in Nigeria, postpartum depression (PPD) is still neglected due to cultural stigma, lack of mental health literacy and lack of media coverage. Current studies have investigated the portrayal of PPD in the media and mental health stigma alone, and have not explained how the media coverage turns into individual beliefs that stimulate or hinder help-seeking. This theoretical essay fills that gap by examining the synergy between agenda-setting theory (AST) and health belief model (HBM) to illustrate the public salience of PPD as generated by newspaper coverage indicators, frequency of coverage, prominence, framing, priming, and depth, and the filtering of public salience through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy to shape maternal responses. Writes the article, the continued coverage of PPD in a culturally responsive manner in newspapers can move this from a private, spiritual issue to a legitimate public health issue, while stigmatising or superficial coverage can cause silence to reign. Discussion about implications for health communication practice, journalistic training and maternal mental health policy in low- and middle-income contexts is discussed.