Times are displayed in (UTC-05:00) Central Time (US & Canada) Change
About this paper symposium
| Panel information |
|---|
| Panel 27. Solicited Content: Global South |
| Paper #1 | |
|---|---|
| Engaging fathers(to-be): adaptation and programme experience of implementing SMS4baba mhealth intervention in Kenya’s informal settlements | |
| Author information | Role |
| Dr. Vibian Angwenyi, Aga Khan University, Kenya | Presenting author |
| Richard Fletcher, The University of Newcastle, Australia | Non-presenting author |
| Paul Murimi Mwangi, Aga Khan University, Kenya | Non-presenting author |
| Margaret Kabue, Aga Khan University, Kenya | Non-presenting author |
| Rachel Odhiambo, Aga Khan University, Kenya | Non-presenting author |
| Stephen Mulupi, Aga Khan University, Kenya | Non-presenting author |
| Emmanuel Kepha Obulemire, Aga Khan University, Kenya | Non-presenting author |
| Eunice Njoroge, Aga Khan University, Kenya | Non-presenting author |
| Eunice Ombech, Aga Khan University, Kenya | Non-presenting author |
| Mercy Moraa Mokaya, Aga Khan University, Kenya | Non-presenting author |
| Moses Wesala, Aga Khan University, Kenya | Non-presenting author |
| Joyce Marangu, Aga Khan University, Kenya | Non-presenting author |
| Amina Abubakar, Aga Khan University, Kenya | Non-presenting author |
| Abstract | |
| Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial (PACTR202103514565914), in Nairobi’s informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from Australia’s SMS4dads. This mixed-methods study involved: i) translation, adaptation, and pre-test of SMS4baba through focus group discussions (n=3, 19 fathers); ii) pilot and qualitative evaluation of SMS4baba (n=22 fathers); iii) implementation and pre-post evaluation of SMS4baba to assess its feasibility, acceptability, and effect on father-wellbeing, childcare and paternal involvement (n=72 fathers). Seventy-two fathers were recruited to receive texts three times weekly from before their infant’s birth until they reached six months of age. A pre-enrolment questionnaire captured fathers’ socio-demographic characteristics and outcomes assessed through a pre-post telephonic survey. Qualitative data were analysed thematically using NVivo. Statistical analysis performed in STATA included descriptive statistics, tests of association, and regression analysis. Fathers reported high levels of engagement by reading and sharing texts and strong approval of SMS4baba messages. SMS4baba's acceptability was attributed to modest message frequency and utilising familiar language. Fathers reported examples of behaviour change in their parenting and spousal support, which challenged gendered parenting norms. Pre-post measures showed increased father involvement in childcare (Cohen’s d=2.17, 95%CI [1.7, 2.62]), infant/child attachment (Cohen’s d=0.33, 95%CI [-0.03, 0.69]), and partner support (Cohen’s d=0.5, 95%CI [0.13, 0.87]). Findings support the feasibility of utilising digital technologies to reach and engage fathers from low-resource settings in maternal and infant care over the perinatal and postnatal periods. Exploration of text messaging channels targeting fathers, to address family wellbeing in the perinatal period is warranted. | |
| Paper #2 | |
|---|---|
| Feasibility, acceptability, and preliminary outcomes of a couples-based parenting program in Tanzania | |
| Author information | Role |
| Joshua Jeong, Emory University, United States | Presenting author |
| Juliet McCann, Emory University, United States | Non-presenting author |
| Gabriel Sangarara, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Valencia Lambert, Emory University, United States | Non-presenting author |
| Julieth Joseph, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Damas Joachim, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Abstract | |
|
Nurturing care provided by mothers and fathers can benefit child development. However, few parenting programs have been designed to engage and support fathers in particular, especially in low- and middle-income countries. The objectives of this study were to assess the feasibility, acceptability, and preliminary outcomes of a father-inclusive parenting program for couples with young children in Mwanza, Tanzania. In 2023 to 2024, we undertook an extensive intervention co-development process with fathers and mothers in the community to create a multi-component curriculum to support fatherhood, positive couples’ and family relationships, and ultimately improve early child development. From July-Oct 2024, we conducted a pilot study of this new community-based group parenting program. Six communities in Mwanza, Tanzania were selected to receive the program. In each community, 10 couples with a child under aged 2 years were enrolled, for a total sample of 60 couples (60 fathers and 60 mothers). The program included 15-sessions that were delivered weekly and covered various topics including responsive caregiving, early learning, nutrition, caregiver mental health, couples’ relationships, and gender roles. For this pilot evaluation, we assessed feasibility in terms of fathers’ and mothers’ enrollment, retention, and attendance. We assessed acceptability in terms of quality rating scores provided by participants, facilitators, and program staff after each session as well as through qualitative in-depth interviews conducted with participants. We administered surveys with fathers at baseline and endline to assess pre-post changes in various outcomes, including fathers’ stimulation, discipline, partner support, couples’ communication, parenting stress, and gender attitudes. Additionally, 35 qualitative interviews were conducted at endline with not only fathers but also mothers and facilitators to triangulate perspectives about initial changes in individual- and family-level outcomes and explore potential program mechanisms of change. Preliminary results from the routine monitoring data indicated feasibility and acceptability of the program among both fathers and mothers. Most fathers attended at least 60% of the sessions, with employment-related activities as the main barrier. Data analyzed thus far supported specific improvements in paternal and maternal parenting, couples’ relationship quality, and caregiver mental health, thereby confirming our theory of change and the key hypothesized program mechanisms. In the final presentation, we will expand on these findings and include the detailed pre-post quantitative and qualitative results that were collected at endline. We will discuss study implications in terms of refinements to the intervention content, delivery strategy, and evaluation approach. These lessons will guide program planning and improvement in preparation for the cluster-randomized controlled trial that will be conducted next year. |
|
| Paper #3 | |
|---|---|
| Father engagement in the pilot hybrid human-digital positive parenting program within Malaysia's KEMAS preschool system | |
| Author information | Role |
| Hal Cooper, University of Oxford, United Kingdom | Presenting author |
| Farah Zeehan Mohd Nadzri, Universiti Putra Malaysia, Malaysia | Non-presenting author |
| Rumaya Juhari, Universiti Putra Malaysia, Malaysia | Non-presenting author |
| Muslihah Hasbullah, Universiti Putra Malaysia, Malaysia | Non-presenting author |
| Jamie M Lachman, University of Oxford, United Kingdom | Non-presenting author |
| Seema Vyas, University of Oxford, United Kingdom | Non-presenting author |
| Zainal Madon, Universiti Putra Malaysia, Malaysia | Non-presenting author |
| Frances Gardner, University of Oxford, United Kingdom | Non-presenting author |
| Abstract | |
| A persistent challenge in parenting programs is the traditionally low engagement rates among fathers, often attributed to barriers such as time constraints, cultural expectations, and inadequately targeted outreach efforts. The present study employed a mixed-methods approach of a pilot cluster randomised control trial. We explored parent engagement in the Naungan Kasih Positive Parenting Program, delivered through a hybrid human-digital model within Malaysia’s KEMAS Preschool System. The programme includes both fathers and mothers involving 208 parents (Nmothers=142, Nfathers=66). This abstract covers analyses on data from the fathers only (N=66). All participants underwent a four-week programme that involved a) an introductory in-person session for caregivers and b) an interactive chatbot intervention named ParentText that delivers personalized, gamified, and scheduled or on-demand messages in text, audio, and visual formats on positive parenting, enhancement of learning through play and violence prevention content to caregivers of children aged between four and six years. The contents of the chatbot were developed to suit the needs of the target group within the cultural context and preschool environment in Malaysia. The ParentText chatbot consists of six goals, each with multiple modules that require approximately five minutes to finish. The goals are 1) Improve my Relationship with my Child; 2) Support my Child's Development, 3) Prepare my Child for Success in School; 4) Give my Child Structure; 5) Support Positive Child Behaviour, and 6) Keep my Child Safe and Healthy. Through random assignment, the parents were also assigned to have either additional WhatsApp support group and/or a second in-person session. Contrary to the conventional notion of low father participation, the findings reveal high levels of involvement, primarily driven by the flexibility of the hybrid model, which allowed fathers to balance program participation with work and personal commitments. Fathers who received the additional WhatsApp support group reported higher completions of goals and modules in the programme. Fathers reported increased confidence in their parenting abilities, improved communication and relationship with their children, and a stronger sense of connection to their role in early childhood development. These positive results underscore the potential of hybrid human-digital models to significantly boost father engagement in parenting programs, particularly in cultural contexts where male participation has traditionally been low. | |
| Paper #4 | |
|---|---|
| Fathers’ engagement in a parenting program mainly for mothers: a mixed-methods evaluation in rural Kenya | |
| Author information | Role |
| Juliet McCann, Emory University, United States | Presenting author |
| Joshua Jeong, Emory University, United States | Non-presenting author |
| Michael Ochieng, B&M Consult, Kenya | Non-presenting author |
| Abstract | |
|
Parenting programs predominantly target one caregiver of the child or most commonly the child’s mother. However, fathers are also important caregivers whose engagement in interventions can benefit child development. Moments that Matter (MTM) is a multicomponent parenting program that leveraging existing community and faith-based platforms to promote nurturing care and healthy early childhood development (ECD). MTM is currently being implemented in six countries across sub-Saharan Africa. Specifically in Kenya, the MTM intervention targets primarily female primary caregivers (i.e., mothers) with children aged 0-3 years and engaged them through monthly home visits and monthly community group meetings that are delivered by trained volunteers from the community as well as trained faith leaders over an 18-month program period. Male caregivers are also encouraged to attend the home visits and group sessions as possible. MTM addresses various topics relating to nurturing care, including early learning, responsive caregiving, nutrition, health, violence prevention, positive family relationships, and the importance of male caregiver engagement. We conducted a cluster-randomized controlled trial to evaluate the effectiveness of the MTM parenting intervention on primary caregiver and early child development outcomes. In October 2023, 595 primary caregivers (91% mothers, 8% grandmothers, 1% other) with a child 0-18 months of age were enrolled across 51 villages in Nyamira and Vihiga counties in rural Western Kenya. As part of the endline evaluation, we designed a sub-study within this original cluster-randomized trial and enrolled the primary male caregivers within study households. We administered surveys with male caregivers and measured their program exposure and participation as well as their parenting-related outcomes (e.g., paternal stimulation, discipline, parenting attitudes). In addition to the quantitative evaluation, we conducted a qualitative implementation evaluation to explore the barriers and facilitators to father involvement in the program and potential strategies for increasing fathers’ engagement in the future. Overall, relatively few fathers participated in the MTM program. Despite the limited program engagement of fathers, several stakeholders highlighted positive impacts of the program on fathers’ attitudes and practices pertaining to family caregiving. Key barriers to fathers’ program engagement included restrictive gender norms and perceived opportunity costs. Stakeholders suggested several strategies for better reaching fathers, including providing financial incentives and flexible scheduling of sessions. In the final presentation, we will also include the quantitative results comparing parenting-related outcomes among fathers in households that were invited to the MTM program versus those in the control group. Overall, our results suggest that parenting programs that are primarily intended for mothers do not necessarily improve fathers’ outcomes. Gender-responsive program adaptations and implementation strategies are likely to increase the potential engagement of not only female but also male caregivers to in turn more comprehensively promote program impacts on child health, nutrition, and development. |
|
⇦ Back to session
Engaging fathers in parenting interventions in LMICs: implementation approaches and program impacts on paternal caregiving
Submission Type
Paper Symposium
Description
| Session Title | Engaging fathers in parenting interventions in LMICs: implementation approaches and program impacts on paternal caregiving |