Prevalence and correlates of maternal early stimulation behaviors during pregnancy in northern Ghana: a cross-sectional survey

Expectant mothers and fathers' knowledge of nurturing care in a developing country

BACKGROUND

The Nurturing Care Framework (NCF), which has been emphasized by the World Health Organization (WHO) in recent years and is among the United Nations Sustainable Development Goals (SDGs), expresses the conditions created to promote early childhood development (ECD). These conditions aim to provide opportunities for children in the Good Health, Adequate Nutrition, Responsive Caregiving, Security and Safety, and Opportunities for Early Learning (5 Components) by caregivers, primarily from low and middle-income countries (LMICs). The aim of this study is to examine the knowledge and awareness of expectant mothers and fathers in Turkey, about the NCF.

METHODS

In this study, a cross-sectional, analytical research design was used. Nurturing Care (NC) knowledge and awareness levels of expectant mothers and fathers in the 2nd and 3rd trimesters of pregnancy were determined via the online form of "The Knowledge of Nurturing Care Inventory (KNCI)" prepared by the researchers. This form consists of 60 questions describing the 5 components mentioned above. The sample contains a total of 103 people, 91 (88.3%) women, and 12 (11.7%) men.

RESULTS

Among the findings, the highest mean of knowledge level (13.76 ± 1.22) was found in Responsive Caregiving, and the lowest mean of knowledge level (4.35 ± 1.83) was found in Opportunities for Early Learning. The general level of knowledge on NC was found to vary statistically significantly depending on gender in favor of the women [t(101) = 3.27, p < .05], depending on educational status in favor of those with university and graduate education [F(2, 100) = 3.481, p < .05], depending on participation in pregnancy school training in favor of those who attended [t(101) = 2.349, p < .05], and depending on knowledge on how to support development in favor of those who know how to support [t(101) = 2.370, p < .05].

CONCLUSIONS

As a result, expectant parents need information and support about the period when children can acquire the basic developmental milestones and about the developmental risk indicators. More research is needed to implement the NCF starting from the preconception period, especially in LMICs, so that the opportunities in early childhood (which is the time period when the brain architecture is shaped, and development is the fastest) are not missed.

Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial

BACKGROUND

Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.

METHODS

This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.

RESULTS

In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.

CONCLUSIONS

This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.