Psychological outcomes and quality of life among first married women in polygynous families in Gedeo Zone, Southern Ethiopia: A mixed-approach study, 2021

Polygynous marriage remains a culturally and socially embedded institution in many parts of Ethiopia, including the Gedeo Zone, where it is sustained by tradition religious belief, and community expectations. Despite its social acceptance, increasing evidence indicates that women in such unions experience elevated psychological distress and reduced quality of life, with first- married women facing particularly pronounced emotional and social challenges. This study aimed to assess the psychological outcomes and quality of life among first married women in polygynous families in the Gedeo Zone, Southern Ethiopia, 2021.A concurrent mixed-method design was employed, combining a cross-sectional survey of 381 first married women selected through multistage sampling with 10 in depth interviews and 4 focus group discussions. Standardized instruments such as the Depression, Anxiety, and Stress Scale (DASS‑21), the Rosenberg Self‑Esteem Scale (RSES), and the WHO Quality of Life‑BREF (WHOQOL‑BREF). The quantitative data were analysed using descriptive and inferential statistical analysis aided by SPSS version 25 program. Qualitative data were transcribed verbatim and analysed thematically.Moderate to severe depressive symptoms were reported by 48.6% participants, anxiety by 55.4%, and high stress levels by 41.2%. The mean (±SD) overall quality of life score was 52.3 ± 11.6, which falls below established norms and reflects generally poor life satisfaction. Lower educational status, socio‑economic dependency, lack of emotional spousal support, and presence of inter‑spousal conflict were significantly associated with higher psychological distress (p