Stimulation Interventions and Parenting in Low- and Middle-Income Countries: A Meta-analysis

Jeong, Joshua; Pitchik, Helen O.; Yousafzai, Aisha K.

doi:10.1542/peds.2017-3510

Cited by 101 publications

(102 citation statements)

References 38 publications

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“…Stimulation interventions have been implemented effectively at scale with mothers in diverse cultural settings (e.g., Colombia, Jamaica, Pakistan), demonstrating positive impacts on maternal practices and ECD. [55] An emerging body of research in LMICs has also demonstrated the effectiveness of father involvement interventions for promoting paternal stimulation and early child development outcomes. For example, a parenting intervention in Vietnam encouraged fathers to responsively interact with their infants and work together with the mother as part of a parenting team.…”

Section: Plos Onementioning

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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Section: Plos Onementioning

confidence: 99%

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

et al. 2020

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“…Little is known about the long-term impact of ESB during pregnancy on child development. However, we know that stimulation-focused interventions for caregivers are effective in creating more nurturing home environments, improving mother-child interactions, and increasing maternal knowledge (38). Responsive caregiving is a continuum and further research is needed to better understand its role throughout different stages of early childhood development.…”

Section: Resultsmentioning

confidence: 99%

Prevalence and Correlates of Maternal Early Stimulation Behaviors during Pregnancy in Northern Ghana: A Cross-Sectional Survey

Mackness¹,

Gallis

Owusu

et al. 2020

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Background: Per UNICEF’s Nurturing Care Framework, early child development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. Methods: This cross-sectional study used data from a cluster randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors were the primary outcome and was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and talking to her belly about family. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis.Results: About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. Conclusion: Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development.Trial registration: Clinical Trials # NCT03665246, September 11, 2018

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“…A generalized estimating equations (GEE) modi ed Poisson model was used for bivariate and multivariable analyses, taking into account clustering by using an exchangeable working correlation (32). The Kauermann-Carroll bias correction was used to account for potential small-sample bias in the standard errors, since the trial had fewer than 40 clusters (33,34). For the bivariate model, the correlation between the early stimulation factor score and each covariate was evaluated.…”

Section: Data Management and Analysismentioning

confidence: 99%

Prevalence and Correlates of Maternal Early Stimulation Behaviors during Pregnancy in Northern Ghana: A Cross-Sectional Survey

Mackness¹,

Gallis

Owusu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Per UNICEF’s Nurturing Care Framework, early child development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. Methods: This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis.Results: About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. Conclusion: Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development.Trial registration: Clinical Trials # NCT03665246, September 11, 2018

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Stimulation Interventions and Parenting in Low- and Middle-Income Countries: A Meta-analysis

Abstract: Early childhood stimulation interventions improve several distinct aspects of maternal parenting. Improvements in parenting capacities may serve as key mechanisms by which these programs benefit ECD outcomes.

Cited by 101 publications

References 38 publications

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

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

Prevalence and Correlates of Maternal Early Stimulation Behaviors during Pregnancy in Northern Ghana: A Cross-Sectional Survey

Prevalence and Correlates of Maternal Early Stimulation Behaviors during Pregnancy in Northern Ghana: A Cross-Sectional Survey

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