**7. Conclusion**

Depression significantly affects women during pregnancy and may lead to adverse outcomes. Screening for depression does not usually form part of antenatal care in low resource settings. Midwives in these settings may often have limited consultation time to screen for depression due to inadequate human and material resources. Antenatal depression is highly prevalent among pregnant women living with HIV. Antenatal depression also remains an important condition which negatively affects pregnant women's quality of life, but one that may respond to treatment. Numerous instruments are validated for screening antenatal depression in low resource settings although they were developed in high income countries. When screening, a short screening instrument can be used for initial screening with only positives screens being referred for more detailed screening. This would allow for a distributed workload in busy antenatal clinics. For effective screening for depression to be achieved in antenatal clinics, screening protocols for depression should be integrated into standard antenatal care. Successful implementation of the proposed screening would require implementation of relevant task shifting approaches that to effectively deliver mental healthcare in local settings. Ethical questions may arise around screening for depression during pregnancy as there is the potential that it may cause harm. However, the extent of harm from screening for depression is negligible or at times non-existent. Despite the prevailing cultural beliefs on mental disorders, screening for depression in local antenatal clinics may be feasible. Antenatal care contacts provide opportunities for screening depression and there is a need to develop protocols for early detection, treatment and preventing the adverse effects of antenatal depression in low resource settings.
