Peer-reviewed article
Father and Sibling Involvement in Home Rehabilitation: Longitudinal Effects on Infant Development and Maternal Wellbeing in Bulawayo, Zimbabwe.
Madzimbe P, Maart S, Dambi J, Corten L ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether involving fathers and siblings alongside mothers in home-based rehabilitation for infants with developmental delays improves infant development and maternal wellbeing in Bulawayo, Zimbabwe. Researchers followed 481 infants aged 3-6 months and their mothers over 3 months, comparing three groups: mothers alone, mothers with fathers, and mothers with fathers and siblings. Infants in the group with both fathers and siblings showed better cognitive development scores, and maternal mental health improved across all groups. The findings suggest that family-centred rehabilitation involving multiple caregivers may benefit both infants and mothers in low-resource settings.
Key points
- Infants in the mother-father-sibling group had significantly higher cognitive scores at baseline-adjustment compared to mother-only group
- Effects on language, motor, socioemotional and adaptive domains were smaller and less consistent than cognitive gains
- Maternal mental health improved significantly over time across all three participation groups
- Quality of life gains for mothers were small but statistically significant only in repeated-measures analysis
- Study was conducted in a low-resource urban setting with naturally occurring caregiver participation patterns
Limitations
The study was observational with naturally occurring groups rather than randomised assignment, so causation cannot be definitively established. The short 3-month follow-up period limits understanding of sustained long-term effects on infant development.
Abstract
Objective To determine whether extending home-based rehabilitation beyond the mother-only model to include fathers and siblings is associated with improved developmental outcomes in infants with neuro-developmental delay (NDD) and maternal wellbeing in an urban low-resource setting. Methods A prospective observational cohort study was conducted at two public neuro-developmental clinics in Bulawayo, Zimbabwe. Infants aged 3-6 months (N = 481) and their mothers were followed for 3 months across three naturally occurring caregiver participation groups: mother-only, mother-father and mother-father-sibling. Developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), and maternal wellbeing was measured using Global Quality of Life (QoL) and Mental Health Check-In Visual Analogue Scales. Group differences were analysed using ANCOVA, repeated-measures ANCOVA and multiple linear regression adjusting for baseline scores. Results Infants in the mother-father-sibling group demonstrated significantly higher baseline-adjusted BSID-III cognitive scores at 3 months than the mother-only group (p < 0.05), with the largest effect observed in this group. Changes in language, motor, socioemotional, and adaptive domains followed the same direction but showed smaller and less consistent effects, with limited pairwise significance after adjustment. Maternal mental health improved significantly over time across groups, while QoL showed small but statistically significant gains only on repeated-measures analysis. Conclusion Involving fathers and siblings in home-based rehabilitation was associated with selective cognitive gains in infants and better maternal mental health over 3 months. These findings provide preliminary support for the integration of father- and sibling-inclusive, family-centred rehabilitation models for paediatric neurorehabilitation in similar low- and middle-income settings.