Background Rural women are highly prevalent to depression, where spouse-related factors, including extramarital affairs and poverty, intensify its likelihood of occurrence. However, women engaged with a Money-Saving Group (MSG) are financially self-dependent, which can reduce the risk of depression suffering. Despite this, there is less study among this cohort, which led us to investigate the prevalence and associated factors of depression among the Ugandan women involved in MSG. Methods This was a cross-sectional study in Uganda among rural married or cohabiting women aged 18 to 45 years engaged in MSG. The survey was carried out within a total of 153 participants (33.3 ± 6.7 years) in April 2021. Information related to socio-demographic of the participants, their spouse characteristics, and depression were collected. Results About 65.4% of the participants had depressive symptoms (based on the cutoff 10/27 at the PHQ-9). But, 8.15 times (CI: 2.83–23.44, p <0.001) and 16.69 times (CI: 4.85–57.39, p <0.001), higher risk of depression were observed, if the participants’ spouses were using an addictive substance and had been involved in an extramarital relationship, respectively. Similarly, there was an increased likelihood of depression when the participant or spouse was unemployed. Conclusion This study observed a higher prevalence of depression, which suggests paying attention to this cohort. Thus, there should be routine screening for depression among married women involved in MSG at lower-level health facilities in rural settings, especially those with spouses engaged in substance use, having an extramarital relationship, and being unemployed.

Background Depression is highly prevalent among women compared to men. Women in rural areas are more at risk of depression compared to their peers in urban areas. Some of the factors associated with depression among married women are spouse related factors including extramarital affairs and intimate partner violence (IPV).Objective To determine the prevalence of depression and factors associated with depression among married women in rural Southwestern Uganda.Methods This was a cross-sectional study in rural southwestern Uganda among married/cohabiting women aged 18 to 45 years. We used the Patient Health Questionnaire 9 (PHQ-9) to assess for depression, composite abuse scale (Revised) – Short Form (CASR-SF to measure IPV. Logistic regression was used to estimate the associations between depression and several factors including spouse extramarital affair, IPV, and sociodemographic factors.Results We enrolled 153 women, mean (standard deviation) age of 33.3 (6.7) and the majority were unemployed. The mean number of children between the couple was 4.05 (2.17). More than half (65,4%) had depressive symptoms and 64.1% had experienced intimate spouse violence. The reported spouses’ mean (SD) age was 43.4 (9.5). Almost half (49.65%) were known to be involved in an extramarital affair. There was a statically significant association between depression among women and spouse extramarital affairs (adjusted odds ratio (AOR) 24.93; 95% CI 1.25–498.34]; p-value = 0.04).Conclusion There was a high prevalence of depression and intimate partner violence among women in rural Uganda. The high prevalence was associated with spouse extramarital affairs. There should be routine screening for depression and intimate partner violence among married women at lower-level health facilities in rural settings especially those whose husbands are involved in extramarital affairs to ensure early diagnosis and access to appropriate mental health care to maintain functionality in society and family level since women are the backbone of their families.