Investigating Maternal Psychological Distress, Caregiving Practices and Child Development in Kenya

Abstract

This thesis includes studies which assess maternal psychological distress, caregiving practices and their relationship with child development in children under the age of three from Kenya. In chapter one a description of Kenya, child development in LMICs, and a literature review of caregiving practices is presented. In chapter two the types of psychosocial stimulation used by mothers in Kenya, alongside exploring beliefs and challenges in providing stimulation were explored in a qualitative study. Findings indicated that mothers are faced with multiple challenges when trying to provide stimulation. In chapter three the prevalence of maternal psychological distress, the frequency of socioemotional and cognitive psychosocial stimulation employed by mothers and, whether maternal distress was associated with provision of psychosocial stimulation is described. Results showed maternal psychological distress was common and cognitive stimulation was less frequently employed than socioemotional stimulation. Chapter four presents the results of the study which investigated whether maternal psychological distress was associated with an increased risk to child cognitive, motor, social-emotional and adaptive behaviour development in children aged under three years. A significant association was found between a child’s social-emotional development and maternal psychological distress. However, there was no relation between a child’s cognitive, motor or adaptive development and maternal distress. The fifth chapter presents a systematic review which examined cognitive effects of psychosocial interventions in LMICs when delivered to children under 3 years. Cognitive benefits of interventions involving psychosocial stimulation were shown across studies. The final sixth chapter provides a discussion. The results of this thesis provide important evidence on the link between maternal psychological distress, psychosocial stimulation and child development in Kenya.