Maternal Capabilities Are Associated with Child Caregiving Behaviors Among Women in Rural Zimbabwe

ABSTRACT Background Young children require high-quality care for healthy growth and development. We defined “maternal capabilities” as factors that influence mothers’ caregiving ability (physical and mental health, social support, time, decision-making autonomy, gender norm attitudes, and mothering self-efficacy), and developed survey tools to assess them. Objectives We hypothesized that mothers with stronger capabilities during pregnancy would be more likely to practice improved care behaviors after their child was born. Methods We assessed maternal capabilities among 4667 pregnant women newly enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. Several improved child-care practices were promoted until 18 mo postpartum, the trial endpoint. Care practices were assessed by survey, direct observation, or transcription from health records during postpartum research visits. We used logistic regression to determine the predictive association between maternal capabilities during pregnancy and child-care practices. Results Mothers with more egalitarian gender norm attitudes were more likely to have an institutional delivery [adjusted OR (AOR), 2.06; 95% CI, 1.57–2.69], initiate breastfeeding within 1 h of delivery (AOR, 1.38; 95% CI, 1.03–1.84), exclusively breastfeed (EBF) from birth to 3 mo (AOR, 2.55; 95% CI, 1.95–3.35) and 3–6 mo (AOR, 1.75; 95% CI, 1.36–2.25), and, among households randomized to receive extra modules on sanitation and hygiene, have soap and water at a handwashing station (AOR, 1.76; 95% CI, 1.29–2.39). Mothers experiencing time stress were less likely to EBF from birth to 3 mo (AOR, 0.79; 95% CI, 0.66–0.93). Greater social support was associated with institutional delivery (AOR, 1.53; 95% CI, 1.37–1.98) and, among mothers randomized to receive extra complementary feeding modules, feeding children a minimally diverse diet (AOR, 1.18; 95% CI, 1.01–1.37). Depressed mothers were 37% and 33%, respectively, less likely to have an institutional delivery (AOR, 0.63; 95% CI, 0.44–0.88) and a fully immunized child (AOR, 0.67; 95% CI, 0.50–0.90). Conclusions Interventions to reduce maternal depression, time stress, inadequate social support, and inequitable gender norms may improve maternal child caregiving.

Mothering in the Context of Mental Disorder: Effect of Caregiving Load on Maternal Health in a Predominantly Hispanic Sample

BACKGROUND: Mothering in the context of mental disorders presents with multiple challenges. However, this phenomenon is poorly understood: It is not known how child caregiving affects the health of their mothers. AIMS: The purpose of this study was to examine associations between child caregiving load and health indicators in mothers receiving outpatient behavioral health services for mental or substance use disorders. METHOD: A total of 172 mothers (80% Hispanic/Latina) completed surveys on their mental and physical health, and children’s behaviors and medical problems. Child caregiving load consisted of number of children living with the mother, and presence of children’s internalizing, externalizing, or medical problems. RESULTS: Child caregiving load had significantly positive associations with mother’s psychological distress, fatigue, pain, and body mass index. Child internalizing and medical problems were associated with mothers’ poor health status. CONCLUSIONS: Hispanics/Latinos experience health disparities, and Hispanic/Latina mothers who are already at risk due to their mental disorders experience an additional health burden associated with caring for children with emotional or health problems. Psychiatric and mental health nurse practitioners should assess child caregiving impact on mothers with mental disorders and seek to mitigate their caregiving burden and maintain their health. Further research is needed to clarify child characteristics and the mechanisms associated with maternal caregiver burden, suboptimal self-care, and adverse health outcomes. Structural Ecosystems Therapy for women in Recovery (SET-R) study/Healthy Home; Clinical Trial ID NCT02702193

The Bliss and Burdens of Grandparents in Child Caregiving: The Case in Bukidnon

grandparents, child-minders, poverty, issues

Caregiving Helplessness Questionnaire (CHQ) applied to Portuguese mothers of preschool-aged children: A psychometric study

O sistema de vinculação da criança é complementado por um sistema, separado e recíproco, de prestação de cuidados parentais, que guia as respostas de proteção do cuidador em relação à criança. Disrupções neste último sistema poderão conduzir a uma prestação de cuidados desorganizada; no entanto, o conhecimento acerca da desorganização da prestação de cuidados permanece incompleta, estando o seu estudo limitado a metodologias dispendiosas. O presente estudo pretendeu analisar as qualidades psicométricas do Caregiving Helplessness Questionnaire (CHQ), uma ferramenta de screening para a desorganização da prestação de cuidados, numa amostra de 200 mães portuguesas de crianças em idade pré-escolar. A análise factorial confirmatória não confirmou a estrutura da versão original do CHQ. Uma solução de cinco fatores verificou-se como sendo a melhor, produzindo cinco escalas conceptualmente correspondentes às principais dimensões da desorganização das relações em idade pré-escolar: Mother Helpless, Mother Frightened, Child Frightened, Child Cheers Mothers e Child Caregiving. O estudo da consistência interna obteve resultados satisfatórios e a validade convergente e discriminante foi confirmada. A validade concorrente também foi estabelecida através de associações significativas entre as escalas do CHQ e variáveis dos domínios materno e da criança que têm sido conceptual e empiricamente associadas com a desorganização. Em conclusão, os resultados suportam a validade do CHQ para mães portuguesas de crianças pré-escolares, como um instrumento de screening promissor desorganização da prestação de cuidados.