Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

Abstract

Background Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). Methods We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Results Baseline psychosocial data is presented for mothers (n = 634) and fathers (n = 75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. Discussion These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.

Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness

“…Maternal alcohol intake during pregnancy was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) self-reported questionnaires completed at 28-32 weeks gestation (18,19). Infants were classified as being alcohol-exposed in utero if ASSIST scored heavy exposure with high risk for alcohol-related problems.…”

Mental health predictors of breastfeeding initiation and continuation among HIV infected and uninfected women in a South African birth cohort study

“…Reliable and validated questionnaires suitable for use in South Africa were administered to participants at antenatal clinic visits between 28 and 32 weeks’ gestation as previously described 29,37 .…”

“…The prevalence of maternal mental health disorders is a significant issue in LMICs 27,28 , and among populations infected or affected by HIV 29 . Females in LMICs are more likely to be exposed to risk factors for poor mental health including trauma and HIV 27,30 .…”

The cognitive processing potential of infants: Exploring the impact of an early childhood development programme

“…Numerous psychobiological and psychosocial factors may influence development during the first years of life (Stein et al 2015). Given that the risk factor profiles of low-and middle-income countries (LMICs) differ from those of developed countries, research on risk and protective factors in these countries is essential to ensure that children reach their full cognitive potential (MurrayKolb et al 2014).…”

“…Given that the risk factor profiles of low-and middle-income countries (LMICs) differ from those of developed countries, research on risk and protective factors in these countries is essential to ensure that children reach their full cognitive potential (MurrayKolb et al 2014). Risk factors such as low socioeconomic status, an adverse family environment and a lack of adequate stimulation and learning opportunities for development have a cumulative negative impact on development (Grantham-McGregor et al 2007;Murray-Kolb et al 2014;Rademeyer & Jacklin 2013;Saloojee & Pettifor 2005;Stein et al 2015). These and other negative social influences characterise many communities in South Africa.…”