Early childhood exposure to non-violent discipline and physical and psychological aggression in low- and middle-income countries: National, regional, and global prevalence estimates

Cuartas, Jorge; McCoy, Dana Charles; Rey‐Guerra, Catalina; Britto, Pia Rebello; Beatriz, Elizabeth; Salhi, Carmel

doi:10.1016/j.chiabu.2019.03.021

Cited by 109 publications

(68 citation statements)

References 30 publications

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“…In our sample, three fourths of children were exposed to violent discipline and nearly half were exposed to inadequate care with rates of both negative parenting practices significantly higher among mothers with poor mental health status. The overall high rates of harsh disciplinary practices for all children in our study were not surprising, as these practices have been shown to be common in Rwanda and other sub-Saharan African countries [55]. This higher rate among mothers with poor mental health is supported by other studies demonstrating the increased risk of child abuse and neglect among mothers with mental health problems [56].…”

Section: Discussionsupporting

confidence: 78%

Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda

Abimana

Karangwa

Hakizimana

et al. 2020

BMC Pregnancy Childbirth

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Background Global investments in neonatal survival have resulted in a growing number of children with morbidities surviving and requiring ongoing care. Little is known about the caregivers of these children in low- and middle-income countries, including maternal mental health which can further negatively impact child health and development outcomes. We aimed to assess the prevalence and factors associated with poor maternal mental health in mothers of children born preterm, low birthweight (LBW), and with hypoxic ischemic encephalopathy (HIE) at 24–47 months of age in rural Rwanda. Methods Cross-sectional study of children 24–47 months born preterm, LBW, or with HIE, and their mothers discharged from the Neonatal Care Unit (NCU) at Kirehe Hospital between May 2015–April 2016 or discharged and enrolled in a NCU follow-up program from May 2016–November 2017. Households were interviewed between October 2018 and June 2019. Mothers reported on their mental health and their child’s development; children’s anthropometrics were measured directly. Backwards stepwise procedures were used to assess factors associated with poor maternal mental health using logistic regression. Results Of 287 total children, 189 (65.9%) were born preterm/LBW and 34.1% had HIE and 213 (74.2%) screened positive for potential caregiver-reported disability. Half (n = 148, 51.6%) of mothers reported poor mental health. In the final model, poor maternal mental health was significantly associated with use of violent discipline (Odds Ratio [OR] 2.29, 95% Confidence Interval [CI] 1.17,4.45) and having a child with caregiver-reported disability (OR 2.96, 95% CI 1.55, 5.67). Greater household food security (OR 0.80, 95% CI 0.70–0.92) and being married (OR = 0.12, 95% CI 0.04–0.36) or living together as if married (OR = 0.13, 95% CI 0.05, 0.37) reduced the odds of poor mental health. Conclusions Half of mothers of children born preterm, LBW and with HIE had poor mental health indicating a need for interventions to identify and address maternal mental health in this population. Mother’s poor mental health was also associated with negative parenting practices. Specific interventions targeting mothers of children with disabilities, single mothers, and food insecure households could be additionally beneficial given their strong association with poor maternal mental health.

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Section: Discussionsupporting

confidence: 78%

Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda

Abimana

Karangwa

Hakizimana

et al. 2020

BMC Pregnancy Childbirth

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“…[33] We also combined data from the UNDP's HDI for the year when each country's survey was conducted to characterize country-level wellbeing. The HDI is a composite measure of life expectancy, education, and per capita income, [34] and has been found to correlate with maternal engagement in cognitive and socioemotional stimulation [7] and other parental practices [35] in LMICs. Additional country-level data included: Gini index, [36] percentage of urban population, and unemployment rate [37], and country region and income group as determined by the World Bank.…”

Section: Methodsmentioning

confidence: 99%

Maternal, paternal, and other caregivers’ stimulation in low- and- middle-income countries

et al. 2020

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Background and objectives Globally, studies have shown associations between maternal stimulation and early child development. Yet, little is known about the prevalence of paternal and other caregivers' stimulation practices, particularly in low-and-middle-income countries (LMICs). Methods Data from the Multiple Indicators Cluster Survey (MICS) and the Demographic and Health Survey (DHS) were combined across 62 LMICs (2010-2018). The sample included 205,150 mothers of children aged 3 and 4 years. High levels of stimulation were defined as caregiver engagement in at least 4 out of 6 possible activities with the child. The proportion of mothers, fathers, and other caregivers providing high levels of stimulation was calculated by country, region, and for the whole sample. Socioeconomic disparities within and between countries were estimated. Results On average, 39.8% (95% CI 37.4 to 42.2) of mothers, 11.9% (95% CI 10.1 to 13.8) of fathers, and 20.7% (95% CI 18.4 to 23.0) of other adult caregivers provided high levels of stimulation. Stimulation varied by region, country income group, and Human Development Index (HDI), with higher levels of maternal and paternal-but not other caregivers'-stimulation in high-income and high-HDI countries. Within countries, stimulation levels were, on average, lower in the poorest relative to the richest households, and some but not all countries exhibited differences by child sex (i.e., boys vs. girls) or area (i.e., urban vs. rural).

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“…As far as we know, this is the first study with the ACT Program that analyses the mediation process to explain the changes in children's behavior problems, including all variables in a single model, and that explored the moderator effect of child behavior problems at baseline. Importantly, we accomplish both of these tasks within Brazil, a rapidly developing middle-income country facing high rates of violence and income inequality (UNICEF, 2017), in which it is estimated that half of young children are exposed to psychological or physical aggression by their caregivers (Cuartas et al, 2019). In doing so, we aim to expand the existing evidence base on positive parenting programs to consider developmental mechanisms in a relatively understudied but globally salient setting.…”

mentioning

confidence: 99%

Unpacking the Impacts of a Universal Parenting Program on Child Behavior

Altafim

McCoy²,

Linhares

2021

Child Development

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This study examined the theory of change of the ACT Raising Safe Kids parenting program, including whether intervention effects on children's behavior problems were explained by improvements in mothers' reported parenting practices, as well as whether baseline child behavior problems moderated these relations. Adult mothers of 3-to 8-year-old Brazilian children were assigned to the intervention (n = 97) or control (n = 46) groups. Results showed that the intervention improved mothers' perceptions of their parenting practices (positive discipline, emotional and behavioral regulation, and communication). Intervention-induced reductions in children's internalizing and externalizing behavior problems were mediated by improvements in mothers' emotional and behavioral regulation. Program effects were strongest for children with high levels of baseline behavior problems.

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Early childhood exposure to non-violent discipline and physical and psychological aggression in low- and middle-income countries: National, regional, and global prevalence estimates

Cited by 109 publications

References 30 publications

Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda

Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda

Maternal, paternal, and other caregivers’ stimulation in low- and- middle-income countries

Unpacking the Impacts of a Universal Parenting Program on Child Behavior

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