This article examines intersections between schooling, child marriage, and adolescent pregnancy in a longitudinal, mixed-methods study of Honduran girls. It explores (a) girls’ enrollment and dropout of school patterns and how these relate to timing of marriage and/or childbirth, (b) the factors associated with dropout, early marriage, and/or early childbearing, and (c) reenrollment patterns after marriage/childbirth. We find that household income in early adolescence predicts school dropout, early union, and early childbearing. Most girls discontinued their studies due to lack of financial resources or no longer wanting to be a student rather than due to marriage or motherhood. Only a small percentage return to school. This study can inform the timing and nature of efforts to protect girls and increase their chances of successfully completing secondary school, delaying marriage, and preventing early pregnancy.
Erin E. Murphy-Graham, Alison Klebanoff Cohen, Diana Pacheco-Montoya
BACKGROUND: The persistently high prevalence of girl-child marriage remains a public health and developmental concern in Nigeria. Despite global campaign against the practice and policy efforts by Nigerian government, the prevalence remains unabated. This study investigates the prevalence and the influence of ethnicity and religious affiliation on the girl-child marriage among female adolescents in Nigeria. METHODS: Data of 7804 girls aged 15-19 years extracted from the 2013 Nigeria Demographic and Health Survey were used. Ethnic groups were classified into five: major Northern ethnic group (Hausa/Fulani); Northern ethnic minorities; two major Southern ethnic groups (Yoruba and Igbo), and Southern ethnic minorities. The prevalence of girl-child marriage was determined for the five ethnic groups and individually for each ethnic minority group. Relationships between ethnicity and religious affiliation on girl-child marriage were explored using Cox proportional hazard regression models, adjusting for residence, education and wealth quintile. RESULTS: Child marriage was higher for the Northern majority ethnic group of Hausa/Fulani (54.8%) compared to the two major Southern ethnic groups (3.0-3.6%) and aggregated Northern ethnic minorities (25.7%) and Southern minorities (5.9%). However, overall, the less known Northern ethnic minority groups of Kambari (74.9%) and Fulfude (73.8%) recorded the highest prevalence. Compared to the major Southern ethnic group of Yoruba, the adjusted hazard ratio (AHR) of child marriage was significantly higher for Northern ethnic minorities (AHR = 2.50; 95% C.I. = 1.59-3.95) and Northern major ethnicity (AHR = 3.67, 95% C.I. = 2.33-5.77). No significant difference was recorded among Southern ethnic groups. Girls affiliated to other religions (Muslim and traditionalist) had higher child-marriage risks compared to Christians (AHR = 2.10; 95% C.I. = 1.54-2.86). CONCLUSION: Ethnicity and religion have independent associations with girl-child marriage in Nigeria; interventions must address culturally-laden social norms that vary by ethnic groups as well as religious-related beliefs.
Jacob Wale Mobolaji, Adesegun Olayiwola Fatusi, Sunday Adepoju Adedini
Investing in early childhood programs such as Brazil's Criança Feliz Program (PCF) to support low-income families in providing a nurturing care environment is critical to ensure that children reach their full developmental potential. We aimed to analyze the influence of the PCF on the nurturing care environment provided by families enrolled in the program in the Federal District, Brazil. A qualitative case study was conducted based on in-depth interviews with a purposive sampling of 22 caregivers enrolled in the PCF for at least six months. Eighteen subthemes emerged from the thematic analysis following the five components of the Nurturing Care Framework (i.e., good health, adequate nutrition, responsive care, early learning, and security and safety). Caregivers recognized the benefits of the PCF on children's mental health (good health) and reported challenges in providing adequate nutrition due to food insecurity (adequate nutrition). A bond between the home visitor and families was identified as critical to promote responsive parenting practices (responsive care). Caregivers appreciated the early stimulation activities provided during PCF home visits (opportunities for early learning). Access to social welfare programs, such as conditional cash transfer and food assistance, were facilitated through PCF multisectoral actions (safety and security). On the other hand, families reported not receiving support from PCF for issues such as breastfeeding, maternal mental health, and disciplinary practices. In summary, PCF enhanced the components of the nurturing care environment provided by families. However, their vulnerabilities and contextual implementation barriers may prevent families from fully benefiting from PCF activities.
Laura Mendes Toledo Dal’Ava dos Santos, Lídia Godoi, Beatriz de Andrade e Guimarães et al.
Early inequities in Early Childhood Development (ECD) are linked to inequalities across the five regions and within the 5570 municipalities in Brazil. We aimed to operationalize an index (IMAPI) to assess and monitor the enabling environment for nurturing care at the regional and municipal level in Brazil using existing national databases. We followed three steps to operationalize IMAPI. I) Selection of indicators. The literature review guided the identification of existing indicators to translate each domain of the Nurturing Care Framework (Good Health, Adequate Nutrition, Opportunities for Early Learning, Responsive Caregiving, and Safety and Protection). Subsequently, meetings with experts and key Brazilian stakeholders informed the identification and selection of existing data in the national databases. II) Consultation with experts. Weights for the selected indicators were defined through a process based on the SMART approach. III) Analyzing IMAPI. Statistical and machine learning methods were used to compute an overall IMAPI as well as an index for each nurturing care domain that ranges from 0 (lowest score) to 100 (highest score). Means were calculated for each region of Brazil-based on municipalities indexes. IMAPI summarizes a set of 29 indicators: good health (14 indicators), adequate nutrition (4), early learning (7), responsive caregiving (0), and security and safety (4). Adequate nutrition domain presented the lowest median indexes (ranging from 32 to 22) and it was one of the most challenging to get reliable indicators due to the low coverage of national nutritional databases. The biggest difference means (DM) between regions with the best and worst indexes were found for early learning (DM = 17, ranging), good health (DM = 15) and security and safety (DM = 11), respectively. Responsive caregiving indicators were not identified at the municipal level within the existing national databases. A final version of IMAPI for each of the 5570 Brazilian municipalities incorporating sensitive analysis is being tested. IMAPI discriminates regional and municipal enabling and constraining environments to promote ECD in Brazil which can facilitate informed policy decisions to address early inequities. Bill and Melinda Gates Foundation, CNPq, FAPDF.
Gabriela Buccini, Marcos Ennes Barreto, Alberto Sironi et al.
Abstract Research on gender‐based violence highlights the need to engage men in prevention work through social change programs that present care as a powerful antidote to violence. Implementation of such programs worldwide provides many examples of how education and support for fathers and fathers‐to‐be can promote healthy masculinities and relationships with an intimate partner and their children. This article aims to explore the findings and lessons learned from the pilot of the European Union‐funded Promotion, Awareness Raising and Engagement of men in Nurture Transformations (PARENT) project (PARENT) which sought to develop and pilot curricula adapted from the internationally tested Program P methodology. The PARENT pilot worked in four European countries to provide training activities for social, educational, and health professionals, as well as education groups for fathers and parents, with the overarching goal of preventing domestic violence through the promotion of engaged fatherhood. By reporting the results from mixed‐methods impact evaluations of pilot programs conducted with professionals and parents, this article discusses how gender‐synchronous father‐focused training can contribute to a shift toward increased positive engagement of fathers during the first 1000 days of a child's life. The article conveys the pilot's promising impact on the knowledge, attitudes, and behaviors of professionals and parents, and it examines some of the key contextual factors, limitations, and implementation approaches that plausibly contributed to the PARENT pilot outcomes, with the aim to formulate useful considerations for future scale‐up efforts or the future implementation of similar programs to engage fathers in nurturing care and violence prevention.
Tatiana Whately de Moura, Rachel Mehaffey, Annina Lubbock et al.
Introduction: This study aimed to conduct an initial psychometric evaluation of knowledge and attitude instruments, modified from existing validated community-based Nurturing Care instruments, measuring maternal knowledge and attitudes Methods: A methodological study with a cross-sectional psychometric validation design was conducted in three consecutive phases: (1) modifications of the instrument and content validation, (2) construct validation, and (3) assessment of reliability. A total of 105 mothers of children aged 6–59 months were recruited from the tertiary pediatric ward in Yogyakarta, Indonesia. To evaluate content validity, the Item-level Content Validity Index (I-CVI) and Content Validity Ratio (CVR) were computed. Knowledge items were evaluated for item discrimination using point-biserial correlation, and the attitude construct was evaluated using Confirmatory Factor Analysis (CFA) under a four-factor model. Results: The tools demonstrated excellent content validity (I-CVI = 1.00, CVR = 1.00, and S-CVI/Ave = 1.00). The knowledge instrument comprised 16 items and demonstrated adequate item-level discrimination, with 14 of the 16 items showing point-biserial correlations (rpb = 0.319–0.547) and a KR-20 of 0.646. The attitude instrument comprised 20 items and, following model revision, showed partial support for the hypothesized four-factor structure (χ²/df = 1.867, SRMR = 0.048, CFI = 0.874, TLI = 0.837, RMSEA = 0.091), with excellent internal consistency (Cronbach's alpha = 0.885). Conclusions: The instruments provide preliminary psychometric evidence to address an important measurement gap in pediatric nursing regarding maternal knowledge and attitudes towards Nurturing Care during child hospitalization, and they require further validation in larger and more diverse samples.
Suprihatiningsih Suprihatiningsih, Ayyu Sandhi, Sri Hartini et al.
Background & objectives The provision of nurturing care during the crucial developing phase from pregnancy to three years is essential for enduring health. The Aarambh project, executed in specific districts of Central India, utilised existing Integrated Child Development Scheme (ICDS) and healthcare facilities to improve nurturing care. This study assessed the influence of loving care interventions on the skills, functionality, and support systems of anganwadi workers (AWWs) to enhance the capabilities of primary carers. Methods This qualitative study evaluated the competencies of AWWs by observing house visits and mothers' meetings in both control (Deoli, Wardha) and intervention blocks (Ralegaon, Yavatmal), Maharashtra. Comprehensive interviews were performed with AWWs, primary carers, ICDS supervisors, CDPOs, ASHAs, and parents. Results AWWs in the intervention group exhibited substantial enhancements in providing age-appropriate guidance, play, and communication activities along with effective community-based events. Interpretation & conclusions The findings of this study suggest empowerment of beneficiaries and child development through this discussed programme framework. In light of this, it is apparent that the soft skills of service providers hold paramount importance for achieving sustainable outcomes.
R. Naveen Shyam Sundar, Pranali Kothekar, Abhishek V. Raut et al.
OBJECTIVE: To estimate the effect of integrating responsive care, early learning and development monitoring into a community-based package of activities on nutrition, sanitation and hygiene, on improvements in early childhood development (ECD) outcomes. DESIGN: This was a quasi-experimental study with nonequivalent comparison groups. The study's primary outcome, ECD, was measured using the Ages and Stages Questionnaire (ASQ-3) and the Global Scales for Early Development (GSED). We also collected data on the early learning home environment, nutritional practices and caregiver depressive symptoms as secondary outcomes. SETTING: This study was conducted across twelve districts in Nampula Province, Mozambique. Half of the districts received holistic nurturing care with responsive care, early learning, nutrition, sanitation and hygiene packages (intervention) and the other half received only nutrition, sanitation and hygiene packages (comparison). PARTICIPANTS: We recruited an age-stratified random sample of 961 caregivers and their children, aged 0-23 months. RESULTS: = 0·004) in the intervention group than in the control. There were no measurable impacts on the remaining early stimulation activities or the primary outcomes of the ASQ and GSED developmental scores. CONCLUSIONS: We discuss the challenges in the integration of nurturing care interventions into existing programmes in high-vulnerability contexts, highlighting the aspects needed to achieve effective caregiver behavioural changes that can translate into improved ECD outcomes.
Filipa de Castro, Katija Momade, Jennifer Yourkavitch et al.
Early Childhood Development (ECD), covering the period from birth to eight years, is a critical stage that lays the foundation for lifelong health, learning, behaviour, and socio-emotional well-being.During this phase, rapid brain development occurs, making children highly responsive to environmental influences, care-giving practices, and social interactions.Recognizing the importance of this developmental stage, the Nurturing Care Framework (NCF) was introduced in 2018 by the World Health Organization, UNICEF, and the World Bank.The framework provides a comprehensive approach to support optimal child development through five interconnected components: good health, adequate nutrition, responsive care-giving, opportunities for early learning, and security and safety.These components highlight the importance of coordinated actions by families, communities, and service systems to ensure that children grow and develop in supportive and nurturing environments.In the Indian context, improving early childhood services remains an important priority, particularly in geographically remote and socio-culturally diverse regions.The state of Meghalaya, located in the north-eastern part of the country, is characterized by hilly terrain, dispersed rural settlements, and predominantly tribal communities.These geographical and socio-cultural conditions create unique challenges in ensuring equitable access to maternal and child health services, nutrition programs, early learning opportunities, and child protection systems.Strengthening early childhood support systems in such contexts requires attention not only to infrastructure and service delivery but also to cultural practices, community participation, and local knowledge systems that influence care-giving and child-rearing practices.Promoting awareness among caregivers, strengthening the role of
Tipbhalang Marboh, S. Kavitha Maithily, K Venkatesan et al.
Masa usia dini merupakan masa golden age (masa keemasan) dimana pada masa ini anak sudah mulai peka dan sensitif dengan lingkungan sekitarnya sehingga akan dengan mudah menyerap apa yang dilihat, didengar, dan dirasakan. Usia ini merupakan pribadi unik dengan pola tumbuh kembang pada komponen fisik, kognitif, social, emosional, kreatif, linguistic dan komunikasi yang khas pada tahapan yang dilalui anak. Oleh karena itu pemberian stimulus yang tepat pada anak sangat dibutuhkan apabila menginginkan setiap aspek perkembangan tercapai secara optimal. Peran dari ibu, bapak, keluarga dan masyarakat serta lingkungan menjadi penting, mengingat pada masa ini adalah ”masa keemasan” sangat tergantung bagaimana kita memenuhi hak dasar anak akan pola asih, asah dan asuh, agar anak dapat tumbuh kembang secara optimal dan akan berpengaruh terhadap kehidupan selanjutnya. Penelitian ini bersifat deskriptif bertujuan menggambarkan pola asah asih serta asuh yang diberikan orang tua kepada anak nya pada usia dini. Hasil penelitian kepada 35 responden diperoleh (68,6%) pola asahnya baik menunjukkan bahwa orang tua dalam memberikan stimulasi untuk mengembangkan kemampuan intelektual, keterampilan, kreatifitas serta sosial anak sebagian sudah baik. Pola asih orang tua pada anak yang berkaitan dengan pemenuhan kebutuhan emosional melalui kasih saying & perhatian (88,6%) sudah baik, serta (62,9%) pola asuh yang berkaitan dengan cara merawat, membimbing serta mendidik anak dalam kehidupan sehari-hari juga sudah baik. Pola asah asih dan asuh saling berkaitan sehingga diharapkan ketiganya berjalan seimbang agar tumbuh kembang anak akan lebih optimal baik secara fisik, mental, emosional serta social. Kata Kunci: Asah, Asih, Asuh, Usia, Dini ABSTRACT Early childhood is a golden age when children begin to be sensitive to their surroundings and easily absorb what they see, hear, and feel. This age is a unique period of personal growth and development in terms of physical, cognitive, social, emotional, creative, linguistic, and communication skills that are characteristics of the stage children go through. Therefore, providing appropriate stimuli to children is essential if we want every aspect of their development to be achieved optimally. The role of mothers, fathers, families, communities, and the environment is important, considering that this period is a “golden age” that depends heavily on how we fulfill children's basic rights to love, guidance, and care so that they can grow and develop optimally, which will affect their future lives. This descriptive study aims to describe the patterns of nurturing, caring, and parenting that parents provide to their children in early childhood. The results of the study of 35 respondents show that (68.6%) of the nurturing patterns are good, indicating that parents are already good at providing stimulation to develop their children's intellectual abilities, skills, creativity, and social skills. The caring pattern of parents towards children in relation to fulfilling emotional needs through affection and attention (88.6%) was good, and (62.9%) of the parenting patterns related to caring for, guiding, and educating children in daily life were also good. Nurturing, caring, and parenting are interrelated, so it is hoped that all three will be balanced so that children's growth and development will be more optimal physically, mentally, emotionally, and socially. Keywords: Nurturing, Caring, Parenting, Age, Early
