“The child has been created by two bloods”: A qualitative study on parenting in Mozambique

• In Event: Assessing cultures and context when data has already been collected: methodological approaches that (re)consider culture and context in child development

Abstract

Providing nurturing care (i.e., good health, adequate nutrition, responsive caregiving, security and safety, and opportunities for early learning) is essential for promoting early child development. However, there is limited knowledge about how mothers and fathers in low- and middle-income contexts across Africa care for their children – particularly regarding the provision of responsive caregiving and opportunities for early learning – and from whom they receive guidance and support in their caregiving roles. Using a qualitative descriptive study design, we examined the nurturing care practices and sources of parenting knowledge of mothers and fathers of young children in rural Mozambique. The present sub-study is part of a larger qualitative pilot study in the Monapo district of Nampula Province, Mozambique. We conducted a secondary analysis of qualitative data collected via in-depth interviews with 36 caregivers (32 mothers and 4 fathers; mean age = 24 years [SD = 4.2]) who were the primary caregiver of a <2½-year-old child (mean age = 10.7 months [SD = 8.3]) and resided in the same household as the child, lived within the geographic catchment area of sampled health facilities, and had visited the health facility for a child health service in the past month. Data were collected in-person by four Mozambican research assistants who also transcribed data from Makua and Portuguese to English. The English transcripts were analyzed inductively using thematic content analysis by a team of three researchers. According to our findings, both mothers and fathers engage in general caregiving (e.g., feeding, bathing, caring for child’s health, financial provision for child’s care) and stimulation (e.g., play, communication) activities. However, whereas mothers’ general caregiving activities consist of direct childcare (e.g., feeding, bathing, caring for health), fathers’ contributions were mostly described in terms of financial provision for children’s care. Other family members – primarily grandmothers and aunts – were also engaged in general caregiving activities. Mothers and fathers were both also engaged in stimulating activities such as making homemade toys for their child – although few parents directly engaged in play with their child –, talking and singing to them, and helping them name household objects. Participants shared that the gendered divisions in general caregiving roles were due to local cultural norms about the perceived parenting responsibilities of mothers and fathers. With respect to sources of parenting knowledge, caregivers – especially those with higher levels of education (i.e., some/completed secondary school) – reported multiple sources, including their own parents (mostly their mothers), friends/neighbors, and facility-based health providers, and provided more details on what type of guidance and support they received from different sources. These findings highlight the importance of adopting a holistic approach involving caregivers and their context and reveal potential strategies to strengthen caregiving and ECD in rural Mozambique and similar contexts. Potential strategies include engaging other caregivers (e.g., grandparents, siblings) in parenting programs, providing demonstrations and examples of how to engage in play with young children, and leveraging health providers as a source of guidance and support for caregivers to promote ECD.

Authors

• Marilyn N Ahun, Harvard University
  Presenting Author

• Lilia Bliznashka

• Svetlana Drivdal

• Gino Regina

• Aisha Khizar Yousafzai, Harvard TH School of Public Health

• Joshua Jeong, Harvard University