Smith Taryn J, Mbale Emmie, Zieff Michal R, Mchazime Chikondi, Jacobs Chloë A, Makaka Pious, Williams Sadeeka, Ghillia Giulia, Herr Donna, Miles Marlie, Mazubane Thandeka, Goolam Nabi Zayaan, Donald Kirsten A, Gladstone Melissa J
Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.
Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
PLOS Glob Public Health. 2025 Sep 2;5(9):e0005017. doi: 10.1371/journal.pgph.0005017. eCollection 2025.
Adequate nurturing care behaviours, including feeding practices, health-seeking and psychosocial stimulation, are crucial for the optimal health, growth and development of young children. However, several factors, recognised as maternal 'capabilities for care', can influence a mother's capability to provide adequate care, namely knowledge/beliefs, physical health and nutritional status, mental health, autonomy, reasonable workload/time availability and social support. As part of the Khula birth cohort study, we aimed to investigate if maternal capabilities for care are associated with nurturing care behaviours among mother-child dyads in Malawi (n = 122) and South Africa (n = 206). When children were 10-16 months of age, mothers competed a series of self-reported sociodemographic, child diet and health and psychosocial questionnaires. Six maternal capabilities for care were considered: haemoglobin concentration, mental health, employment, decision-making autonomy, support for childcare and social support. The nurturing care behaviours were feeding practices, complete immunisation status appropriate to chid age and psychosocial stimulation within the home environment. Regression modelling assessed associations between maternal capabilities for care and each care behaviour, adjusting for child sex, maternal age and education level and household socioeconomic status. Associations between maternal capabilities for care and nurturing care behaviours differed by care behaviour and setting. Maternal employment and decision-making as measures of autonomy, support with childcare as a measure of reasonable workload and reported social support were the maternal capabilities most consistently associated with feeding practices, complete immunisation status and stimulation practices, although the direction of associations differed between settings. Maternal haemoglobin and mental health were associated with one care behaviour each (stimulation and feeding practices, respectively). Measuring and understanding how various maternal capabilities influence caregiving across contexts is essential for empowering caregivers to provide optimal care. Interventions, programmes and policies that seek to improve child health, growth and development through enhanced nurturing care practices should strengthen multiple maternal capabilities.
充分的养育照护行为，包括喂养方式、寻求健康行为和心理社会刺激，对幼儿的最佳健康、生长和发育至关重要。然而，一些被认为是母亲“照护能力”的因素会影响母亲提供充分照护的能力，即知识/信念、身体健康和营养状况、心理健康、自主性、合理的工作量/可利用时间以及社会支持。作为库拉出生队列研究的一部分，我们旨在调查在马拉维（n = 122）和南非（n = 206）的母婴二元组中，母亲的照护能力是否与养育照护行为相关。当孩子10 - 16个月大时，母亲们完成了一系列自我报告的社会人口统计学、儿童饮食与健康以及心理社会问卷。考虑了六种母亲照护能力：血红蛋白浓度、心理健康、就业情况、决策自主性、育儿支持和社会支持。养育照护行为包括喂养方式、适合儿童年龄的完全免疫状况以及家庭环境中的心理社会刺激。回归模型评估了母亲照护能力与每种照护行为之间的关联，并对儿童性别、母亲年龄和教育水平以及家庭社会经济地位进行了调整。母亲照护能力与养育照护行为之间的关联因照护行为和环境而异。作为自主性衡量指标的母亲就业和决策、作为合理工作量衡量指标的育儿支持以及报告的社会支持是与喂养方式、完全免疫状况和刺激行为最一致相关的母亲照护能力，尽管不同环境中关联的方向有所不同。母亲的血红蛋白和心理健康分别与一种照护行为相关（分别为刺激行为和喂养方式）。衡量和理解各种母亲照护能力如何在不同情境下影响照护行为对于增强照护者提供最佳照护的能力至关重要。旨在通过加强养育照护行为来改善儿童健康、生长和发育的干预措施、项目和政策应增强多种母亲照护能力。
