Engaging Fathers in Parenting Interventions in Low- and Middle-Income Countries
About the author: The Novak Djokovic Foundation and the Center on the Developing Child at Harvard University have awarded four Harvard advanced doctoral students the Djokovic Science and Innovation Fellowship. Joshua Jeong is one of the inaugural Djokovic Fellows. For Father’s Day, Joshua shares with us his thoughts on the important role fathers have in early childhood development.
A strong body of research has highlighted parenting interventions as a key strategy for improving early childhood development (ECD) outcomes in low- and middle-income countries (LMICs). Particularly over the past decade, parenting intervention studies have expanded across sub-Saharan Africa and South Asia, and growing investments have been made by national governments to integrate and scale up early parenting programs across various sectors.
Despite this encouraging prioritization and emphasis on the importance of parenting, programs in LMICs have largely remained focused on mothers exclusively. And perhaps unintended, the terms “parents” and “caregivers” in the early childhood literature, especially in LMICs, have become used interchangeably to just reflect “mothers”.
However, it is well-documented that fathers positively influence children’s early development, above and beyond maternal contributions. For example, many studies from the U.S., U.K., and other high-income countries using large longitudinal datasets have consistently underscored the unique importance of paternal stimulation and paternal warmth and responsiveness for children’s early cognitive, language, and socioemotional development. A small but growing body of evidence from LMICs has similarly shown positive effects of fathers on ECD outcomes. So in light of this global evidence, why are fathers still sidelined and overlooked in parenting research?
While this is certainly not exhaustive or mutually exclusive, three factors might contribute to the imbalanced focus (more on mothers than fathers) in parenting research and programming in LMICs.
- Availability and accessibility of mothers – Mothers in many of these contexts (from the Caribbean to sub-Saharan Africa to South Asia) are the primary caregivers of the child. They objectively spend more time together with the child (whereas fathers are more likely out of the home longer, even residing away for work for multiple days at a time) and undertake the majority of the caregiving roles and responsibilities that it “makes sense” to target mothers for their accessibility and direct involvement with the child.
- Social and cultural norms – In many LMICs, particularly in contexts where gender inequalities are quite stark and persistent, the portrayal of men as nurturing caretakers who engage in play and stimulation may be less common and not even something that is expected or encouraged by family members and society. Perhaps unintentionally but typically not based on formative research or data collected, it has become assumed that fathers are not interested or additionally impactful for promoting child development.
- Operational and resource limitations – The primary cadre of personnel who have delivered early childhood intervention programs in LMICs has been local women volunteers or female health professionals/paraprofessionals. This raises challenges in contexts where it is less common and acceptable for men and women to engage one-on-one or in group settings with each other (in the way that female health workers have traditionally coached and engaged with mothers in home visits or community group meetings). Additionally, a major component to the success of ECD programs has been well-established curricula – which have allowed for easy adaptation across contexts. However, the overwhelming majority of these curricula and manuals have been designed exclusively for mother-child dyads. Currently we don’t yet know which content “ingredients” are necessary and effective for mother and father, holistic family focused programs.
Despite such barriers that may marginalize fathers from parenting programs, there are two notable exceptions of innovative programs in LMICs that have focused on engaging fathers and supporting co-parenting to improve ECD. In Turkey, the Mother-Child Education Foundation (ACEV) established the Father Support Program, or a 15-week course to encourage fathers to take a more positive and active role in their children’s early development. In this program, fathers meet in male groups to build parenting skills and freely discuss the challenges of fatherhood. The program is currently being implemented across Turkey and is expected to reach almost 4,000 fathers by 2018. In Uganda, researchers at McGill University and Plan International designed and evaluated a parenting intervention that engaged both mothers and fathers to promote ECD. The program consisted of 12 bi-weekly sessions (e.g., psychosocial stimulation; “love and respect” for yourself, your child, and your spouse; among other topics that were sensitive to both genders) and incorporated both fathers only group sessions as well as both mothers and fathers group sessions. This program is continuing to be implemented by Plan International in Uganda as well as other countries across sub-Saharan Africa.
It is quite clear that fathers are influential caregivers for ECD across the world. Two programs from Turkey and Uganda serve as great examples to learn from and build upon in the context of LMICs. However, many questions remain unknown regarding how to engage and integrate fathers in programs with other caregivers; and considering some of these barriers regarding availability and accessibility of fathers, social and cultural norms, and operational and resource constraints in specifically LMICs. Qualitative studies, in particular, are a great next step in terms of research needed and can unpack some of these potential challenges and elucidate strategies for engaging fathers in ECD programs moving forward. Much remains untapped regarding the opportunities that can be achieved for young children, mothers, fathers, families, and their communities by adopting more family-integrated ECD programs and services in LMICs.