A parental support program for mothers in Pakistan improves parenting by fathers as well

A parental support program in Pakistan that did not invite fathers nevertheless influences their parenting for the better, which in turn improves parenting by mothers and child development outcomes.

A parental support program in Pakistan that did not invite fathers to participate nevertheless influenced both mothers’ and fathers’ parenting for the better. Furthermore, a study of the program found that this improvement in fathers’ parenting predicted improved cognitive and social emotional outcomes for their children as well as more engaged parenting by the mother.

This was the first study in a low- or middle-income country to assess the role that fathers play in early childhood development parental support programs, even if the programs engage only with mothers.

The data came from part of a longer-term follow up evaluation of a wider parental support program, the Pakistan Early Childhood Development Scale-Up (PEDS), which took place in 2009-12 in rural Sindh province and involved 1,302 children. This part of PEDS, the Responsive Stimulation parental support program, started when the children were on average one month old and concluded when they were two years old. It consisted of monthly community group meetings for mothers (or other female carers), where aspects of early child development were discussed (e.g., attachment, sensitive and responsive parenting, and the mothers’ emotional well-being). Mothers also received coaching around developmentally appropriate interaction with their children. The group work allowed mothers to support one another. The parental support program also included monthly home visits which focused on communication, learning and play.

The families involved were of low socio-economic status. On average, mothers of the children had two years of education and their fathers had seven. In Sindh province overall, 42% of children under five are underweight and 48% are stunted (low height for their age). Only 7% of children under the age of five have three or more books at home.

The evaluation studied parental stimulation when the child was 12 months and 24 months old, and again at 48 months old (that is, two years after the program ended). Each mother was asked if she and/or the father had participated in six play and learning activities in the past three days. The most popular of these activities proved to be going out with the child – at 24 months, 91% of the fathers and 84% of the mothers took their children out. Then, at 48 months, child cognitive development was measured by testing the children, while social and emotional development was measured by questioning the mothers about their children’s behaviors.

From this analysis of the parental support program, four results emerged in relation to the father’s role:

• Despite not being invited to participate, fathers’ stimulation of their children improved at 12 months and 24 months.

One possible explanation proposed by the researchers is that the fathers observed the mothers interacting more with the child and did the same. Another is that the fathers became more involved because mothers learned to make play objects and were given learning materials to take home.

• Higher paternal stimulation at 48 months predicted higher scores for child social and emotional development (but not cognitive development).

High maternal stimulation at 48 months predicted both higher scores for social and emotional development and for cognitive development, unlike for fathers. Perhaps mothers were encouraging fathers to take part more in physical and social/emotional activities.

• The positive impacts of the parental support program on child development scores at 48 months were due not only to independent improvements in mothers’ and fathers’ own stimulation, but also dynamic processes between them, whereby improvements in mothers’ stimulation changed fathers’ stimulation, and vice versa.
• Higher paternal stimulation of the child at 12 and 24 months predicted higher maternal stimulation at 24 and 48 months, respectively.

Based on the results of the study in Pakistan, the researchers conclude: “Future parental support programs should more actively engage fathers in addition to mothers and evaluate the parenting practices of both parents to better understand and improve the caregiving environments and development outcomes of young children around the world.”