Grandmothers — a neglected family resource for saving newborn lives

Abstract

Across the globe, the well-being of newborns is significantly influenced by the knowledge and practices of family members, yet global health policies and interventions primarily focus on strengthening health services to save newborn lives. Predominant approaches to promote newborn survival in non-western cultures across the Global South are based on a western, nuclear family model and ignore the roles of caregivers within wider family systems, whose attitudes and practices are determined by culturally prescribed strategies. In this paper, I review evidence of a neglected facet of newborn care, the role and influence of senior women or grandmothers.Based on a family systems frame, I reviewed research from numerous settings in Africa, Asia and Latin America that provides insight into family roles related to newborn care, specifically of grandmothers. I identified primarily published studies which provide evidence of grandmothers’ role as culturally designated and influential newborn advisors to young mothers and direct caregivers. Research from all three continents reveals that grandmothers play similar core roles in newborn care while their culturally specific practices vary. This review supports two main conclusions. First, future newborn research should be conceptualised within a family systems framework that reflects the structure and dynamics of non-western collectivist cultures. Second, newborn interventions should aim not only to strengthen health services but also influential family caregivers, particularly grandmothers and the indigenous social support networks of which they are a part, in order to improve family-level newborn practices and save newborn lives.

Grandparent caregiving in Cambodian skip‐generation households: Roles and impact on child nutrition

“…Grandparents in this study played an essential role in managing and supporting their grandchildren's care, health and nutrition, while also engaging in income generation, and supporting grandchildren's personal care, supervision, moral and formal education-thereby enabling their adult children to migrate for work. This study offers evidence in support of extensive research documenting the influential role of grandmothers as advisors and caregivers on child nutrition in LMICs (Aubel, 2012(Aubel, , 2020.…”

Beyond the mother-child dyad: Is co-residence with a grandmother associated with adolescent girls’ family planning knowledge?

“…Second, while the analysis controlled for observed differences between adolescents who co-resided with a grandmother and those who did not ( Table 1 ), it is possible there were additional unmeasured differences that may confound the association between co-residence and adolescents’ family planning knowledge. Also, due to the nature of how grandmother residency was defined, we were not able to identify whether adolescents were living with their own grandmother or the grandmother of another young child in the household (though the influence of ‘grandmothers’ in the literature often refers to senior women more broadly [ 18 ]). Furthermore, knowledge of contraception, as measured in this survey and other national surveys, is not sufficiently detailed to understand the mastery of the subject.…”

“…Furthermore, recent transformations in family arrangements due to labor migration have accentuated the role of grandparents as caregivers [ 17 ]. Grandmothers play a pivotal role as advisors for young women in many non-western settings [ 18 ]. Despite their prominent role, public health programs continue to focus on the mother-child dyad, ignoring patterns of social organization that are especially important in collectivist cultures [ 19 ].…”

The male breadwinner nuclear family is not the ‘traditional’ human family, and promotion of this myth may have adverse health consequences

“…Grandparents provide a range of other types of support to their adult children and grandchildren, including direct childcare, and help with domestic work, as well as emotional support and advice. Aubel's reviews of the literature in lower-and middle-income countries illustrate the influential role that grandmothers and older women have as advisors and carers around the perinatal period and in child feeding [31,32]. Another recent literature review assessed the evidence for the impact of grandparental investment (measured by coresidence, caregiving, financial and other support) on grandchild outcomes (including physical health, socio-emotional wellbeing and cognitive development) [33].…”