Africa Knowledge Hub for Children

Peer-reviewed articleOpenAlex5 Jun 2026

A Descriptive Analysis of Adolescent Girls Affected by Child Marriage: Empirical Evidence from Tasikmalaya, Indonesia

Child marriage is widely recognized as a violation of children’s rights, yet adolescents in many rural areas remain highly vulnerable. Data from the Indonesian Central Bureau of Statistics (BPS) in the 2024 “Indonesian Youth Statistics Report” indicate that 21.49% of young people in Indonesia marry at the age of 18 or younger, 18.55% marry within the 16–18 age group, while 2.39% marry before the age of 16. Despite extensive global research, limited empirical evidence exists on the lived experiences of adolescent girls in rural Indonesia, particularly in West Java. This study explores the experiences of adolescent girls impacted by child marriage in Sukaharja Village, Sariwangi, Tasikmalaya, Indonesia. Using a qualitative descriptive design, data were collected through in-depth interviews, participant observation, and document review. Five purposively selected adolescent girls, all of whom had undergone unregistered religious marriages, served as key informants. Data were analyzed thematically to identify key patterns and insights. Findings indicate that child marriage is linked to socioeconomic vulnerability and low educational attainment, driven by premarital pregnancy, social shame, and customary sanctions. Consequences include school dropout, lack of formal certification, social withdrawal, and uncertain futures. Community perceptions varied, influenced by local customs, social media, and limited reproductive health education. These findings highlight the need for coordinated interventions, including dissemination of Law No. 16/2019, establishment of child protection forums, and development of child-friendly village initiatives, providing evidence-based strategies to protect adolescents in rural Indonesia.

Bambang Rustanto, Tuti Kartika, Aryohaji Istyawan et al.

Peer-reviewed articleOpenAlex7 Oct 2019

Secular changes in child marriage and secondary school completion among rural adolescent girls in India

# Background Child marriage (\<18 years) and school drop-out disproportionately affect girls living in impoverished households in rural areas, with long-term economic and health consequences. Improving retention in education, and delaying age at marriage and first pregnancy have received substantial attention at the national and global level, in line with the Millennium Development Goals and the Sustainable Development Goals (SDGs) (2015-2030). # Methods We examined changes over time in economic, education and child marriage indicators among adolescents from rural households in (i) Northern Karnataka (the most deprived region of Karnataka), (ii) Karnataka state, and (iii) all India, using individualized data from four pre-existing, nationally-representative datasets (District Level Household and Facility Surveys (DLHS 2-4) (2002/4--2012/3) and the National Family Health Survey (NFHS-4) (2015-16)). # Results At the national and state level, we found large improvements in secondary educational attainment among girls and boys living in rural settings (proportion of adolescents completing age-appropriate secondary school education (all India): girls 12.4% 2002/3 vs. 31.6% 2015/6; boys 18.9% 2002/4 vs. 36.8% 2015/6). We also observed large reductions in child marriage and early child-bearing rates (proportion of married women aged 18-24 years married \<18 years: 62.4% 2002/4 vs. 23.8% 2015/6; proportion of married girls aged \<19 years who are pregnant or have children: 62.4% 2002/4 vs. 21.9% 2015/6). In addition, we found evidence of "clustered deprivations", whereby girls in rural areas from the poorest families and lowest castes continue to experience multiple forms of disadvantage, with child marriage significantly associated with scheduled caste / scheduled tribe (SC/ST) caste (odds ratio (OR)=1.25, 95% confidence interval (CI)=1.18-1.32), poorest quintile (OR=2.38, 95% CI=2.21-2.55) and illiteracy (OR=2.09, 95% CI=1.95-2.23); and not completing secondary education significantly associated with SC/ST caste (OR=1.52, 95% CI=1.45-1.59), poorest quintile (OR=4.17, 95% CI=3.90-4.46), and child marriage (OR=2.05, 95% CI=1.85-2.26). # Conclusions The results show substantial improvements in economic, educational and child marriage indicators at the state and national level over the past 14 years. The government has implemented multiple programmes and policies to address child marriage and school drop-out, and these trends suggest such efforts may be having a positive impact. If India is to achieve the SDGs, designing targeted interventions to reach those who continue to be left furthest behind is going to be key.

Tara Beattie, Prakash Javalkar, Mitzy Gafos et al.

DevelopmentProtectionINRead at source

Peer-reviewed articleOpenAlex - Early Childhood9 Oct 2023

Workforce preparation for delivery of nurturing care in low‐ and middle‐income countries: Expert consensus on critical multisectoral training needs

BACKGROUND: Services to support nurturing care through early childhood development (ECD) in low- and middle-income countries are hampered by significant workforce challenges. The global early childhood workforce is both diverse and complex, and it supports the delivery of a wide range of services in extremely diverse geographical and social settings. In the context of contemporary global goals for the universal provision of quality early childhood provision, there is an urgent need to build appropriate platforms for strengthening and supporting this workforce. However, the evidence base to support this work is severely limited. METHODS: To contribute to evidence on how to strengthen the ECD workforce in low- and middle-income countries, this study used a Delphi methodology involving three rounds of data collection with 14 global experts, to reach consensus on the most critical training needs of three key early childhood workforce groups: (i) health; (ii) community-based paraprofessionals, and (iii) educational professionals working across ECD programmes. RESULTS: The study identified a comprehensive set of shared, as well as distinct, training needs across the three groups. Shared training needs include the following: (i) nurturing dispositions that facilitate work with children and families in complex settings; (ii) knowledge and skills to support responsive, adaptable delivery of ECD programmes; and (iii) systems for ECD training and professional pathways that prioritise ongoing mentoring and support. CONCLUSIONS: The study's detailed findings help to address a critical gap in the evidence on training needs for ECD workers in low-resource contexts. They provide insights into how to strengthen content, systems, and methods of training to support intersectoral ECD work in resource-constrained contexts.

Emma Claire Pearson, Nirmala Rao, Iram Siraj et al.

DevelopmentAEIEHKGBRead at source

Peer-reviewed articleOpenAlex - Early Childhood18 Dec 2024

The Support Needs of Parents of Children With Autism Spectrum Disorder: A Qualitative Study Based on the Nurturing Care Framework

AIM: To explore the support needs of parents of children with autism spectrum disorder (ASD) in China under the guidance of the nurturing care framework (NCF). DESIGN: A descriptive qualitative study design was used. METHODS: Fourteen parents of 2-6-year-old children with autism were recruited for face-to-face individual interviews in Chongqing between July and November 2023. NVivo 12.0 software was used to manage the data, and a directed content analysis was performed to extract themes. RESULTS: Five nurturing care needs of parents of children with autism were extracted, including acquisition of health- and disorder-related knowledge and information, maintenance of psychological and physical wellbeing, desire for individualised caregiver skills training, creation of multi-agent social support network, and accessibility of high-quality and coordinated services. CONCLUSION: Parents of children with autism have multidimensional unmet nurturing care needs. It is crucial to address these needs and develop targeted family support programs with consideration of the extracted need components. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: This study implies that health education, parental empowerment and psychological support should be prioritised in future family support programs. The findings also emphasise the importance of establishing a cross-departmental coordination mechanism and building a multi-agent social support network for families of children with autism. IMPACT: This study expands our understanding on the support needs of families of children with autism and enriches the theoretical connotation of nurturing care framework, and the results may inform the development of tailored support programs for families of children with autism in China. REPORTING METHOD: The results are reported in accordance with the reporting guidelines of the Consolidated Criteria for Reporting Qualitative Studies (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient and public contribution.

Fei Li, Qinling Li, Qiao Shen et al.

DevelopmentProtectionCNRead at source

Peer-reviewed articleOpenAlex - Early Childhood11 Feb 2025

Home-based nurturing care practices for children under five with low socioeconomic position in Santo Domingo, Dominican Republic

BACKGROUND: In the Dominican Republic about 14.5% of children do not reach their full potential by age five, with children of low socioeconomic position most affected. The Nurturing Care Framework is an evidence-informed actionable framework to help children thrive, but we must first understand cultural contexts and childrearing practices that contribute to delay. This study applies the Nurturing Care Framework to explore the context of home-based care among young children in the Dominican Republic. METHODS: We conducted a sociodemographic survey and semi-structured qualitative interview with 25 mothers ages 19-42 (7 under the age of 18 at first birth) with low socioeconomic position and children under five that live in the capital city Santo Domingo. We asked in-depth questions about the Nurturing Care Framework's domains of responsive caregiving and opportunities for early learning. We used consensual coding and deductive thematic analysis to analyze transcriptions, examined convergence and divergence in themes between adolescent and adult mothers, and organized themes using concept mapping. RESULTS: A few mothers provide responsive caregiving to their child, but they are unaware of its benefit to their child's development. Adolescent mothers expressed lower confidence in their mothering skills. Across age groups, mothers did not see themselves as agents of change in their child's early learning process and allow several hours of videos each day. Mothers provide children opportunities for learning through social interaction, a possible strength among this population. With regards to security and safety, about half of mothers use corporal punishment, all but one of these is an adolescent mother. CONCLUSION: Findings highlight the need for parenting programs that build on strengths such as child-to-child social interaction and provide parents with opportunities to develop knowledge and skills to provide early learning opportunities. Interventions should target families with low socioeconomic position and adolescent mothers.

Adrianne Katrina Nelson, Laura Virginia Sánchez-Vincitore, Melanie Patricia Frias et al.

DevelopmentProtectionDORead at source

Peer-reviewed articleOpenAlex - Early Childhood24 Jun 2026

Delivering nurturing care for small and sick newborns in facility-based settings: A scoping review of implementation approaches

Background Early-life nurturing care (NC) interventions are crucial to shape developmental trajectories of small and sick newborns, facing adverse experiences in neonatal care units (NCUs). However, NC implementation remains inconsistent globally. This review catalogued interventions aligned with Nurturing Care Framework (NCF), described implementation strategies, and explored barriers and enablers. Methods Following Joanna Briggs Institute guidance and PRISMA-ScR, we searched four databases (PubMed, Scopus, CINAHL, and Campbell Collaboration) for English-language sources (January 2015 to April 2025). Two reviewers independently screened, selected, and charted data aligned with NCF domains, resolving disagreements with the third reviewer. Findings were synthesized using descriptive mapping and realist-informed context-mechanism-outcome configurations. Results Of 1,125 articles screened, 13 studies were selected (seven from low- and middle-income countries; 10 randomized controlled trials, three observational; five implementation research, one quality improvement). NCF components frequently addressed were safety and security (n=12), responsive caregiving (n=9), adequate nutrition (n=8), and opportunities for early learning (n=8); good health was least addressed (n=1). Interventions like non-pharmacological pain management, environmental modifications, caregiver-led practices and digital training, reduced neonatal stress, improved feeding readiness, and shortened hospital stays. Enablers included leadership commitment, trained staff, and family engagement. Barriers included environmental stressors, fragmented protocols, and staff turnover. Implementation and sustainability were inconsistently reported. Conclusion Evidence on facility-based NC for small and sick newborns is growing but remains fragmented, with limited reporting on strategies, fidelity, and sustainability. Future studies should use implementation science frameworks and prioritize workforce, infrastructure, and policy support to embed NC within NCU protocols. Registration Open Science Framework (OSF) protocol: https://osf.io/aqpyw Reporting PRISMA-ScR checklist and flow diagram are provided in the supplementary materials.

Arti Maria, Manish Pal, Manish Singh Chundawat et al.

SurvivalDevelopmentINIERead at source

OtherOpenAlex1 Jan 2025

Girls' educational pathways, child marriage and adolescent pregnancy in Kano, Nigeria

Replication code and supplementary materials for Baruwa et al. (2026), analysing girls’ education, child marriage, and adolescent pregnancy in Kano State, Nigeria using PMA Nigeria data.

William Edward Rudgard, Ololade Julius Baruwa, Broline Sagini Asuma

NGRead at source

Peer-reviewed articleOpenAlex26 Dec 2022

Adolescent boys’ and girls’ perspectives on social norms surrounding child marriage in Nepal

According to recent data, in Nepal, 38.2% of women aged 20-24 years are married by the age of 18. This analysis of CARE's Tipping Point Initiative seeks to compare Nepali adolescent boys' and girls' perceptions of empirical and normative expectations around child, early and forced marriage. A baseline survey of 1,134 adolescent girls and 1,154 adolescent boys provided 11 items for descriptive quantitative analysis. Thirty in-depth interviews and 16 focus groups were conducted with young people aged 12-16 years and analysed using modified Grounded Theory. Themes in the data produced thick descriptions of gender roles/responsibilities, employment, mobility and marriage. Comparisons by gender of normative and empirical expectations, and sanctions on child, early and forced marriage were produced. Gender roles/responsibilities underpin social norms for mobility, marriage and employment, and are connected by subthemes with a focus on responsibility for household chores, interaction between unmarried adolescents, education/financial stability, honour/reputation, and parental decision-makers). Participants agreed on gendered labour, women's employment, and parents as decision-makers. Areas of disagreement included repercussions for interactions between unmarried adolescents, girls' mobility, attributes of the ideal woman, and maintaining family honour. Programming recommendations include focusing on the inter-relatedness of boys' and girls' wellbeing, communication between girls and parents, and structural support for education Research recommendations include identifying factors underlying sexual harassment and constructs of masculinity and femininity.

Grace Morrow, Kathryn M. Yount, Irina Bergenfeld et al.

ProtectionDevelopmentNPRead at source

Peer-reviewed articleOpenAlex - Early Childhood28 Dec 2025

PARENTAL FEEDING PRACTICES AND CHILDREN’S DIETARY HABITS FOR NURTURING CARE AMONG STUNTED CHILDREN IN BOGOR REGENCY, INDONESIA

The issue of stunting, although it has generally decreased, is still accompanied by an elevated risk of morbidity and mortality. The Nurturing Care approach integrates five caregiving components, one of which is adequate nutritional fulfillment. However, there are not many publications that discuss this problem, including in Indonesia. The aim of study was to examine parental feeding practices and children’s dietary habits in stunted children. A case-control design was conducted on 80 participants consist of two groups: stunted and control children aged 24-36 months. Data were collected from structured questionnaires filled out by parents. Chi-square and mann-whitney analysis with statistical significance expressed at 95% CI were used. This study identified a substantial correlation between exclusive breastfeeding and the prevalence of stunting (p=0.02). There was no relationship between the age of introducing complementary feeding and the administration of multivitamins with the incidence of stunting. The score for providing an environment with healthy food in the stunting group was significantly lower (p=0.01) compared to the control group. Furthermore, the analysis revealed no correlation between children dietary habit and the occurrence of stunting in children. It shows that the importance of parents’ role in nurturing care for stunting. Adequate parental feeding practices especially in providing a healthy food environment should be apply early to prevent stunting.

Rizana Fajrunni’mah, Dwirini Retno Gunarti, Mohamad Sadikin et al.

SurvivalDevelopmentPre/postIDRead at source

Peer-reviewed articleOpenAlex - Early Childhood1 Jan 2025

“Love, You Need to Give Your Child Love”: Mothers’ Perceptions of Nurturing Care for Young Children in South Africa

Background: Nurturing care of young children is aimed at promoting lifelong, intergenerational health and well‐being, as well as social and economic benefits. This study is aimed at qualitatively exploring maternal perceptions related to nurturing care, their access to information and support for caregiving, the home and community environments and practices, and how caregivers promote infants’ health and well‐being in Soweto, South Africa. Methods: The study employed a sequential, two‐stage process. First, three focus group discussions were conducted with a total of 19 mothers of children aged 0–24 months, which then informed 12 in‐depth interviews (four women from each focus group discussion). Focus group discussions and interviews were audio recorded and transcribed verbatim and data were analysed using thematic analysis. Results: The health and well‐being of infants were generally described in relation to their feeding and growth and how physically active they were. The need for pregnancy and caregiving information, accompanied by opportunities to discuss this with a health care worker or other women, was highlighted by participants in this study. Potentially obesogenic and non‐responsive infant and young child feeding practices were commonly reported by mothers. Responsive caregiving was described as taking care of children’s physical needs, providing them with love, and playing with them. Female matriarchs were particularly influential in providing caregiving advice and support for mothers. Naturally occurring interactions, such as talking and singing, were commonly reported practices to promote children’s development in the home. Safety concerns were ubiquitous and limited children’s play and exploration outside the home. Conclusions: This is one of few studies to explore caregivers’ perceptions of nurturing care in the South African context and the first to focus specifically on the first 1000 days. Thus, the study findings can contribute to strengthening initiatives to support caregivers to provide nurturing care for young children in South Africa and other similar contexts. Findings point to the need for better targeted information and support for mothers and other caregivers around nurturing care, especially elements related to infant and young child feeding (including responsive feeding), responsive care, early learning, and how to address safety in the home. There is also a gap in the provision of appropriate information and opportunities to engage with peers and health care workers around issues pertinent to pregnant women within current services. These deficiencies can be addressed through strengthening existing services, leveraging current platforms of care and support for pregnant women and young children, particularly through the health system.

Wiedaad Slemming, Emmanuel Cohen, Alessandra Prioreschi et al.

SurvivalDevelopmentProtectionZARead at source

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