Anxiety and depression are among the top contributors to disability in the Kingdom of Saudi Arabia (KSA), but little is known about their economic impact. This study estimates the economic burden of moderate to severe symptoms of anxiety and depression among adults in KSA.

A cross-sectional survey was administered via a web panel. Participants were asked to fill out the Patient Health Questionnaire-4 (PHQ-4) for themselves and on behalf of other household members to capture prevalence rates. Those who reported at least moderate symptoms of anxiety or depression filled out a longer survey with questions on healthcare utilisation and productivity losses due to symptoms. These responses were monetised using prevalence rates and population estimates to calculate per-person and total annual costs.

Prevalence estimates are based on responses from 1164 participants on behalf of 3202 Saudi adults. Of these, 269 individuals with symptoms completed the longer survey.

Prevalence of anxiety and depression; healthcare utilisation (medications, outpatient, inpatient) and productivity losses due to absenteeism and presenteeism.

In total, 26.2% reported at least moderate symptoms consistent with anxiety and/or depression. Among those with symptoms, direct healthcare costs due to anxiety and depression averaged Saudi riyal (SAR) 3431.95 per person annually. Indirect costs via absenteeism and presenteeism averaged SAR 9702.87 and SAR 24 577.28 per person assuming that anxiety and/or depression episodes last for 6 months. Summing up the healthcare costs and productivity losses yields a total annual economic burden of SAR 163.3 billion. Absenteeism accounts for 24.8% of this total (SAR 40.5 billion), presenteeism accounts for 62.8% (SAR 102.5 billion) and healthcare resource utilisation accounts for 12.4%(SAR 20.3 billion).

The overall prevalence of anxiety and depression in KSA is estimated at 26.2%. The economic burden associated with these symptoms amounts to SAR 163.3 billion or 4.1% of GDP. Absenteeism and presenteeism costs account for the vast majority of the total, but a large percentage (nearly 60%) also report emergency department visits and unplanned hospital admissions. Evidence-based interventions should be considered to address the health and economic burden of these conditions in KSA.

The postnatal period is critical for preventing maternal and neonatal morbidity and mortality. Globally, a significant proportion of maternal and neonatal deaths occur within the first 6 weeks after delivery. Timely and adequate postnatal care (PNC) can detect and manage life-threatening complications; however, service utilisation remains alarmingly low in many low- and middle-income countries, including Saudi Arabia. Addressing the behavioural and perceptual factors that influence service use is essential for improving health outcomes.

This study aimed to assess mothers’ utilisation of PNC services and examine how their health beliefs and sociodemographic characteristics influence this behaviour.

A cross-sectional study guided by the Health Belief Model (HBM) was conducted to explore predictors of PNC utilisation.

Eight primary healthcare (PHC) centres were randomly selected from 179 PHC centres distributed in the different governorates of the Jazan region of Saudi Arabia.

A total of 464 mothers were surveyed between October and December 2023 using an interviewer-administered questionnaire.

The primary outcome was PNC utilisation, defined by the number of postnatal visits. The independent variables included sociodemographic characteristics and HBM constructs (perceived susceptibility, benefits, barriers and cues to action).

In terms of PNC utilisation, 80.0% of participants had two or fewer postnatal visits, whereas 20.0% had three or more postnatal visits. Perceived barriers had the strongest influence (mean score 2.51±0.87), followed by cues to action (2.43±0.89), susceptibility (1.92±0.72) and benefits (1.86±0.64). In the multivariate analysis, perceived barriers, cues to action and perceived susceptibility were significantly associated with PNC utilisation, with adjusted ORs of 1.679 (95% CI: 1.007 to 2.799), 0.470 (95% CI: 0.256 to 0.863) and 0.405 (95% CI: 0.197 to 0.832), respectively.

PNC utilisation in the Jazan region remains suboptimal. Perceptual factors, particularly barriers and cues to action, play a central role in service use. Health interventions targeting these beliefs and improving follow-up mechanisms may help increase PNC engagement and improve maternal and infant health outcomes in Saudi Arabia.