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Tembo CP, Portsmouth L, Burns SK. Mapping the contextual mental health interventions for perinatal adolescent mothers with self-reported common mental symptoms (anxiety and depression) in sub-Saharan African countries: a scoping review. J Child Adolesc Ment Health 2024:1-18. [PMID: 38828874 DOI: 10.2989/17280583.2024.2323922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Introduction: Early preventive interventions may support adolescent mothers' mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub-Saharan African countries.Methods: The process was guided by the Joanna Briggs Institute's methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.
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Affiliation(s)
- Chimwemwe Pindani Tembo
- Saint John of God College of Health Sciences, Mzuzu Malawi
- Population Health, Curtin University, Perth, Australia
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Lyaatu I, Mosha D, Sando MM, Jeong J, Yousafzai A, PrayGod G, Evarist R, Galvin L, Kieffer MP, Kumalija E, Simpson J, Ambikapathi R, Boncyk M, Matangi E, Gunaratna NS. Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS): study protocol for a five-arm, cluster-randomized trial. Trials 2024; 25:188. [PMID: 38486278 PMCID: PMC10938806 DOI: 10.1186/s13063-022-07002-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/12/2022] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Globally, 144 million children under 5 years are undernourished and 250 million do not meet their developmental potential. Multi-input interventions, such as bundled nutrition and parenting interventions, are designed to mitigate risks for multiple child outcomes. There is limited evidence that bundled interventions have additive benefits to nutrition, growth, or development outcomes. These outcomes share common risks; therefore, designing interventions to tackle these risks using a common theory of change may optimize effectiveness. Emerging evidence suggests explicit engagement of fathers may benefit child outcomes, but few trials have tested this or included data collected from fathers. METHODS Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) is a community-based cluster-randomized controlled trial that will be implemented in the rural Mara Region, Tanzania. The trial aims (1) to test a bundled nutrition and parenting program delivered to mothers' groups, with or without fathers' groups, over 12 months on child and caregiving outcomes compared to a nutrition program alone, and (2) to test nutrition or bundled nutrition and parenting programs delivered to mothers' and fathers' groups over 12 months on child and caregiving outcomes compared to programs delivered to mothers alone. The trial comprises five arms: (1) mothers' groups receiving a nutrition program, (2) mothers' groups receiving a bundled nutrition and parenting program, (3) mothers' and fathers' groups receiving a nutrition program, (4) mothers' and fathers' groups receiving a bundled nutrition and parenting program, and (5) control receiving standard of care health services. The primary outcomes are child dietary diversity and early child development (mental and motor development). Parents with a child under 18 months will be enrolled in peer groups and receive twice monthly intervention by trained community health workers. Data will be collected from mothers, fathers, and children at baseline (pre-intervention), midline, and endline (post-intervention). DISCUSSION EFFECTS will generate evidence on the effects of bundled nutrition and parenting interventions on child nutrition, growth, and development outcomes; determine the benefits of engaging fathers on child, caregiving, and caregiver outcomes; and investigate common and unique pathways between treatments and child outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT03759821. Registered on November 30, 2018.
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Wang D, Huang CQ, Jiang RZ, Fan YJ. Associated factors of depression in primiparas with hypothyroidism during pregnancy. Medicine (Baltimore) 2024; 103:e36418. [PMID: 38306536 PMCID: PMC10843380 DOI: 10.1097/md.0000000000036418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/10/2023] [Indexed: 02/04/2024] Open
Abstract
This cross-sectional study aimed to explore the associated factors of depression in primiparas with hypothyroidism during pregnancy. The research subjects were 200 primiparas with hypothyroidism during pregnancy who were admitted to our hospital between December 2016 and December 2019. Self-rating depression scale scores were used to evaluate the depression, and the incidence of depression were examined. The data from all the subjects were collected to compare the differences between primiparas with hypothyroidism during pregnancy with and without depression. A logistic regression equation was used to analyze the influencing factors of depression in these patients. Of the 200 primiparas who took part in this study, 27 suffered from depression, accounting for 13.50%. There were differences in age, education level, economic income, sleep quality, and conjugal relations between the depressed and the nondepressed participants. When the above factors were included in the logistic regression equation, it was found that the odds ratio values for these factors were all >1, which indicated that they had an influence on maternal depression in primiparas with hypothyroidism during pregnancy. This study demonstrated that pregnancy-associated hypothyroidism in primiparas is affected by age, education level, economic income, sleep quality, and conjugal relations, all of which increase the incidence of depression. Relevant preventive measures should be provided in clinical practice to avoid the occurrence of depression.
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Affiliation(s)
- Dan Wang
- Department of Obstetrics, Shanghai Sixth People’s Hospital, Shanghai, China
| | - Cui-Qin Huang
- Department of Obstetrics, Shanghai Sixth People’s Hospital, Shanghai, China
| | - Rong-Zhen Jiang
- Department of Obstetrics, Shanghai Sixth People’s Hospital, Shanghai, China
| | - Ya-Jing Fan
- Department of Obstetrics, Shanghai Sixth People’s Hospital, Shanghai, China
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Erzse A, Desmond C, Hofman K, Barker M, Christofides NJ. Qualitative exploration of the constraints on mothers' and pregnant women's ability to turn available services into nutrition benefits in a low-resource urban setting, South Africa. BMJ Open 2023; 13:e073716. [PMID: 37993159 PMCID: PMC10668265 DOI: 10.1136/bmjopen-2023-073716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES Despite free primary healthcare services and social protection system for mothers and children, significant nutrition inequalities occur across the globe, including in South Africa. This study aimed to explore what determines mothers' ability to access and turn available services into nutrition benefits. DESIGN An exploratory qualitative study was conducted including semistructured interviews with employees from community-based organisations and focus groups with pregnant women and mothers. Discussions focused on existing services perceived as important to nutrition, differences in mothers' ability to benefit from these services, and the underlying unmet needs contributing to these disparities. Data were analysed thematically using a novel social needs framework developed for this study where social needs are defined as the requisites that can magnify (if unmet) or reduce (if met) variation in the degree to which individuals can benefit from existing services. SETTING A resource-constrained urban township, Soweto in Johannesburg. PARTICIPANTS Thirty mothers of infants (<1 year old) and 21 pregnant women attending 5 primary healthcare facilities participated in 7 focus groups, and 18 interviews were conducted with employees from 10 community-based organisations. RESULTS Mothers identified social needs related to financial planning, personal income stability, appropriate and affordable housing, access to government services, social support and affordable healthier foods. The degree to which these needs were met determined mothers' capabilities to benefit from eight services. These were clinic-based services including nutrition advice and social work support, social grants, food aid, community savings groups, poverty alleviation projects, skills training workshops, formal employment opportunities and crèches/school feeding schemes. CONCLUSION Findings demonstrate that while current social protection mechanisms and free health services are necessary, they are not sufficient to address nutrition inequalities. Women's social needs must also be met to ensure that services are accessed and used to improve the nutrition of all mothers and their children.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Chris Desmond
- SAMRC/Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Mary Barker
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Faculty of Medicine, Southampton, UK
| | - Nicola Joan Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Draper CE, Motlhatlhedi M, Mabasa J, Headman T, Klingberg S, Pentecost M, Lye SJ, Norris SA, Nyati LH. Navigating relationship dynamics, pregnancy and fatherhood in the Bukhali trial: a qualitative study with men in Soweto, South Africa. BMC Public Health 2023; 23:2204. [PMID: 37940937 PMCID: PMC10633923 DOI: 10.1186/s12889-023-17153-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND South Africa has a complex range of historical, social, political, and economic factors that have shaped fatherhood. In the context of the Bukhali randomised controlled trial with young women in Soweto, South Africa, a qualitative study was conducted with the male partners of young women who had become pregnant during the trial. This exploratory study aimed to explore individual perceptions around relationship dynamics, their partner's pregnancy, and fatherhood of partners of young women in Soweto, South Africa. METHODS Individual, in-depth interviews were conducted with male partners (fathers, n = 19, 25-46 years old) of Bukhali participants. A thematic approach was taken to the descriptive and exploratory process of analysis, and three final themes and subthemes were identified: (1) relationship dynamics (nature of relationship, relationship challenges); (2) pregnancy (feelings about the pregnancy, effect of the pregnancy on their relationship, providing support during pregnancy; and 3) fatherhood (view of fatherhood, roles of fathers, influences on views and motivation, challenges of fatherhood). RESULTS While most male participants were in a committed ("serious") relationship with their female partner, less than half of them were cohabiting. Most reported that their partner's pregnancy was not planned, and shared mixed feelings about the pregnancy (e.g., happy, excited, shocked, nervous), although their views about fatherhood were overwhelmingly positive. Many were concerned about how they would economically provide for their child and partner, particularly those who were unemployed. Participants identified both general and specific ways in which they provided support for their partner, e.g., being present, co-attending antenatal check-ups, providing material resources. For many, the most challenging aspect of fatherhood was having to provide financially. They seemed to understand the level of responsibility expected of them as a father, and that their involvement and presence related to love for and connection with their child. Participants' responses indicated that there were some changes in the norms around fatherhood, suggesting that there is a possibility for a shift in the fatherhood narrative in their context. CONCLUSIONS These findings suggest that the complex array of factors influencing fatherhood in South Africa continue to play out in this generation, although promising changes are evident.
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Affiliation(s)
- Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Molebogeng Motlhatlhedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jackson Mabasa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tshepang Headman
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle Pentecost
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Stephen J Lye
- Toronto and Departments of Obstetrics and Gynecology, Physiology and Medicine, Lunenfeld-Tanenbaum Research Institute, Sinai Health, University of Toronto, Toronto, ON, Canada
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Interprofessional Education Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Bulterys MA, Njuguna I, King'e M, Chebet D, Moraa H, Gomez L, Onyango A, Malavi K, Nzia G, Chege M, Neary J, Wagner AD, Lawley KA, Wamalwa D, Benki-Nugent S, John-Stewart G. Neurodevelopment of children who are HIV-exposed and uninfected in Kenya. J Int AIDS Soc 2023; 26 Suppl 4:e26149. [PMID: 37909174 PMCID: PMC10618871 DOI: 10.1002/jia2.26149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/14/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Predictors of neurodevelopment among children who are HIV-exposed uninfected (CHEU) are poorly understood. METHODS Mothers with and without HIV and their children were enrolled during 6-week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1-year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site. RESULTS At 1-year evaluation, CHEU (n = 709) and children who are HIV-unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate-to-severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: -1.38, 95% CI: -2.05, -0.71), food insecurity was associated with lower social scores (adjusted coeff: -0.37, 95% CI: -0.73, -0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: -0.76, 95% CI: -1.40, -0.13) and gross motor scores (adjusted coeff: -1.07, 95% CI: -1.81, -0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: -0.51, 95% CI: -1.01, -0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: -0.45, 95% CI: -0.87, -0.03) or a deceased or absent father (adjusted coeff: -0.81, 95% CI: -1.58, -0.05), respectively. CONCLUSIONS Biologic and social factors were associated with child neurodevelopment. Despite socio-demographic differences between CHEU and CHUU, 1-year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU.
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Affiliation(s)
- Michelle A Bulterys
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Irene Njuguna
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Kenyatta National Hospital, Nairobi, Kenya
| | - Maureen King'e
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Daisy Chebet
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | | | - Laurén Gomez
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | | | | | | | - Jillian Neary
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Anjuli D Wagner
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Kendall A Lawley
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Sarah Benki-Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Departments of Pediatrics, Medicine, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Bohren MA, Hazfiarini A, Vazquez Corona M, Colomar M, De Mucio B, Tunçalp Ö, Portela A. From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001476. [PMID: 36963069 PMCID: PMC10021298 DOI: 10.1371/journal.pgph.0001476] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023]
Abstract
Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow. We conducted a scoping review to assess coverage and models of labour companionship, including quantitative studies reporting coverage of labour companionship in any level health facility globally. We searched MEDLINE, CINAHL, and Global Health from 1 January 2010-14 December 2021. We extracted data on study design, labour companionship coverage, timing and type of companions allowed, and recoded data into categories for comparison across studies. We included data from a maternal health sentinel network of hospitals in Latin America, using descriptive statistics to assess coverage among 120,581 women giving birth in these sites from April 2018-April 2022. In the scoping review, we included 77 studies from 27 countries. There was wide variation in the coverage of labour companionship: almost one-third of studies reported coverage less than 40%, and one-third of studies reported coverage between 40-80%. Husbands or partners were the most frequent companion (37.7%, 29/77), followed by family member or friend (gender not specified) (32.5%, 25/77), family member or friend (female-only) (13.0%, 10/77). Across nine sentinel hospitals in five Latin American countries, there was variation in coverage, with no companion at any time ranging from 14.9%-93.8%. Despite the well-known benefits and factors affecting implementation of labour companionship, more work is needed to improve equitable coverage. Concerted efforts are needed to engage with communities, health workers, health managers, and policy-makers to establish policies, address implementation barriers, and integrate data on coverage into perinatal records and quality processes to ensure that all women have access. Harmonized reporting of labour companionship would greatly enhance understanding at global level.
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Affiliation(s)
- Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Alya Hazfiarini
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Martha Vazquez Corona
- Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Mercedes Colomar
- The Latin American Center for Perinatology/Women´s and Reproductive Health Unit, Pan American Health Organization, Montevideo, Uruguay
| | - Bremen De Mucio
- The Latin American Center for Perinatology/Women´s and Reproductive Health Unit, Pan American Health Organization, Montevideo, Uruguay
| | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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Chung EO, Hagaman A, Bibi A, Frost A, Haight SC, Sikander S, Maselko J. Mother-in-law childcare and perinatal depression in rural Pakistan. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221141288. [PMID: 36468464 PMCID: PMC9726850 DOI: 10.1177/17455057221141288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mothers-in-law often provide key childcare support to daughters-in-law during the perinatal period that may enhance maternal mental health. Yet, poor mother-in-law/daughter-in-law relationships may be associated with maternal depression. The extent to which mother-in-law childcare involvement affects perinatal depression may differ across contexts of family conflict. OBJECTIVE We explored the relationship between mother-in-law childcare and daughter-in-law perinatal depression in rural Pakistan across contexts of family conflict. METHODS Data on 783 women came from the Bachpan Cohort, a birth cohort in Pakistan. Maternally-reported mother-in-law childcare was assessed at 3 and 12 months postpartum using a 24-h recall and categorized into no, low, and high involvement. Major depression was captured at 3 and 12 months using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV. Family conflict was captured using three items from the Life Events Checklist. Log-Poisson models were used to estimate cross-sectional associations between mother-in-law childcare and perinatal depression, stratified by family conflict. RESULTS Mother-in-law childcare was common in the first year postpartum. The association between mother-in-law childcare and perinatal depression differed by the presence of family conflict and postpartum timing. At 3 months postpartum, low and high mother-in-law childcare (vs no involvement) were associated with a lower prevalence of depression regardless of family conflict. At 12 months postpartum, among families with no conflict, low mother-in-law childcare (vs no involvement) was associated with lower perinatal depression; however, among families with conflict, high mother-in-law childcare was associated with increased perinatal depression. CONCLUSION Our findings highlight the complexities of associations between mother-in-law childcare support and perinatal depression in the first year after birth. Mother-in-law childcare in the immediate postpartum period was beneficial for mothers. Understanding the source, amount, timing, and context of social support is necessary to inform research and interventions that aim to improve maternal mental health.
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Affiliation(s)
- Esther O Chung
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Esther O Chung, Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA,Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
| | - Amina Bibi
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan,Human Development Research Foundation, Islamabad, Pakistan
| | - Allison Frost
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah C Haight
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Siham Sikander
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan,Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Joanna Maselko
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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"Men are the head of the family, the dominant head": A mixed method study of male involvement in maternal and child health in a patriarchal setting, Western Nigeria. PLoS One 2022; 17:e0276059. [PMID: 36288340 PMCID: PMC9604958 DOI: 10.1371/journal.pone.0276059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/28/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION The importance of involving men in reproductive, maternal and child health (RMCH) programs is increasingly recognized globally. In Nigeria, most MCH services do not actively engage fathers. AIM To assess men's knowledge, involvement in MCH and the barriers in Southwest Nigeria. Predictors of good knowledge and involvement were also assessed. METHODS This was a community-based cross sectional study. Quantitative and qualitative methods were used in data collection which was done within a period of three months in 2018. Quantitative data were collected with interviewer administered questionnaires from 418 respondents who were selected by multistage sampling methodology. The topic was further explored using focus group discussion (FGD). Quantitative data were analysed using EPI-INFO version 7. Quantitative variables were summarized using means and standard deviations while multivariable analysis was carried out to determine predictors of good knowledge and involvement in MCH. A combination of deductive and inductive analysis was used for the qualitative data. RESULTS Overall, 65% of men had good knowledge of MCH while 60.8% had good involvement. Predictors of good knowledge were being a Christian (AOR 1.674, 95% CI 1.045-2.679), being of Yoruba tribe (AOR 1.753, 95% CI 1.100-2.796), having post-secondary education (AOR 1.984, 95% CI 1.002-3.928), having more under-fives in the household (AOR 2.162 95% CI 1.365-3.425) and spouse having post-secondary education (AOR 2.755, 95% CI 1.189-6.382). Predictors of good involvement in MCH include higher educational level of spouse: secondary (AOR 2.852, 95% CI 1.214-6.699), post-secondary (AOR 2.270, 95% CI 1.000-5.161) and having good knowledge of MCH (AOR 2.518, 95% CI 1.587-3.994). From the FGD, other factors which influence involvement were related to traditional/cultural orientation, time constraint and finance among others. CONCLUSION Men's knowledge and their involvement in maternal and child health were sub-optimal. For improvement, community-based intervention programmes should be designed for men and implemented, taking into consideration their traditional/cultural roles, religious orientation, busy schedules, and educational backgrounds. They should be re-oriented on their patriarchally informed belief about their perceived roles in RMCH.
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Patterns of Father Involvement and Child Development among Families with Low Income. CHILDREN 2021; 8:children8121164. [PMID: 34943359 PMCID: PMC8699948 DOI: 10.3390/children8121164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 11/17/2022]
Abstract
This study examined patterns of father involvement and their relations with social, behavioral, and cognitive development among low-income children < 5 years. Latent class analysis on data from 2650 fathers (Mage = 29.35 years) in the Supporting Healthy Marriages program revealed four father involvement patterns: (1) High positive involvement (48%); (2) engaged but harsh discipline (42%); (3) low cognitive stimulation (8%); and (4) lower involvement (2%). The low cognitive stimulation pattern was associated with greater father- and mother-reported child behavior problems and lower child socioemotional and cognitive functioning. The engaged but harsh discipline pattern was associated with more father-reported child behavior problems. These findings highlight the need for active engagement of fathers in parenting interventions to promote child development.
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