Data collection

We measured common mental disorder (CMD) symptoms using the World Health Organization’s (WHO’s) self-reporting questionnaire (SRQ-20) [24]. This 20-item questionnaire asks about depressive, anxiety and somatic symptoms encountered in the past one month. The SRQ initially consisted of 25 questions (20 related to neurotic symptoms, 4 to psychotic symptoms and one asking about fits (convulsion)). Because of validation problems of SRQ-25, we used SRQ-20 for this study; a version validated in many countries including Ethiopia. This version of the instrument was used in previous Ethiopian community-based studies [25–28], and validated for use among perinatal women in Ethiopia [29]. A cut-off score of ≥6 was shown to have convergent validity [29]. We used the same cut-off point in this study. We employed interviewer administered method using the Amharic Version of the questionnaire. Besides, we utilized a quantitative questionnaire consisting of socioeconomic and demographic, health service utilization, reproductive characteristics of mothers.