Prevalence and correlates of maternal early stimulation behaviors during pregnancy in northern Ghana: a cross-sectional survey

Abstract

Background Per UNICEF’s Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. Methods This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis. Results About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. Conclusion Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development. Trial registration Clinical Trials # NCT03665246, August 29, 2018.

Expectant mothers and fathers' knowledge of nurturing care in a developing country

“…The healthy growth and development of children, especially in the first 1,000 days of life, depends on the knowledge and resources that parents and caregivers need to be able to provide NC, the most important of all modifiable factors (6). Although the Nurturing Care Framework (NCF), in which not only development but also all the components affecting development are addressed together, and the contributions of this framework to early childhood development (ECD) have come to the fore recently, there is a gap in knowledge regarding the characteristics of the caregiver that contribute to optimal development from pregnancy to birth (7). In the literature there are many international studies (8)(9)(10)(11)(12)(13)(14)(15)(16) and national studies (17, 18) aiming to learn especially mothers' level of knowledge about ECD, however, the research investigating expectant parents' level of knowledge on this subject during pregnancy is limited (19).…”