From Uganda to Baltimore to Alexandra Township: How far can Ainsworth's theory stretch?

Introduction: After extensive observation of mother-infant dyads in two diverse contexts, Ainsworth developed the construct of maternal sensitivity to explain the nature of mother-infant interactions that lead to infant attachment security. She believed this construct to be universally applicable. Since Ainsworth's publications, her theory has been adapted and extended, particularly by theorists working in North American and Western European countries. These developments have been largely uninterrogated in relation to their universal cultural relevance, despite the fact that parenting practices differ greatly across cultural groups. Those who have begun to interrogate the cultural universality of current conceptualisation of maternal sensitivity highlight important areas of cultural disagreement. Method: This article provides a critical theoretical argument regarding the cultural universality of maternal sensitivity, extending comment to the cultural and contextual relevance of developments in its operationalisation. Results: Particular aspects of current theoretical and operational use of the construct of maternal sensitivity that are potentially culturally specific (as opposed to culturally universal) are noted, namely the inclusion of positive affect, the centrality of parent-infant play, verbal responsiveness, the inclusion of learning in parent-infant interactions and the shift towards a more proactive (rather than reactive) role for the parent in parent-infant interactions. Conclusion: This article suggests that the evolution of the concept of maternal sensitivity has failed to account for cultural differences

Guidelines for support to mothers of sexually abused children in North-West province

Background: South Africa is reported to have the highest rate of sexual assault in the world with over 40% of cases occurring among children. Children who are sexually abused have support programmes and policies to assist them in coping, but there are no support programmes for mothers or caretakers. Caretakers need support for themselves and assisting them will incrementally benefit children under their care. Often mothers of these children experience shock, anger, disbelief and suffer secondary trauma such as depression and post-traumatic stress disorder (PTSD) following their children's sexual abuse disclosure and yet there are no guidelines for support to these mothers within North-West province (NWP)Objectives: The study seeks to develop guidelines for support to mothers of sexually abused children in NWP.Methods: Concurrent convergence triangulation mixed method design was employed in this study. The population consisted of mothers of sexually abused children (SAC) (n = 17 participants for the qualitative component and n = 180 participants for the quantitative component). A sample of mothers of SAC was purposely selected.Results: The participants indicated significant levels of depression because of lack of support by stakeholders. Guidelines for support to assist mothers cope with their secondary trauma were developed based on the literature review, study findings as well as an ecological model of the impact of sexual assault on women's mental health. The results also showed extreme PTSD (47.8%), little support (38.8%), not coping (76.1%) and depression (36.1%).Conclusion: The stakeholders should consider a positive approach to support mothers whose children are sexually abused

Effect of Community Integrated Management of Childhood Illness on Mothers' Healthcare-Seeking Behaviour and Home Management of Childhood Illness in Ile Ife; South-West Nigeria: A Household Survey

Background. Care-seeking interventions; as part of community integrated management of childhood illness (CIMCI); have the potential to substantially reduce child mortality in countries where common childhood illnesses are a major problem. Prompt and appropriate care-seeking practices are important to avoid many deaths attributed to delays in or not seeking care; particularly in developing countries such as Nigeria.Objective. To assess the effect of community-level intervention on mothers' care-seeking behaviour for common childhood illnesses and related influencing factors. Methods. The study had a comparative cross-sectional design and was conducted in two local government areas (LGAs) of Osun State; South-West Nigeria. A total of 722 mothers of index children aged 5 years were selected through a multistage cluster sampling technique. Data were collected and analysed using SPSS version 16.0. Descriptive; bivariate and multivariate analyses were performed. Results. Care-seeking for children who reported illness was higher in the CIMCI-implementing LGA (90.2%) compared with 74.8% in the non-implementing LGA (p

Qualite de la relation mere enfant dans la survenue des malnutritions proteino-energetiques. A propos de 102 cas colliges a l'hopital general de Port-Boue

Introduction-objectif : La Malnutrition Proteino- Energetique (MPE) est l'un des graves problemes de sante publique des enfants; d'origine multifactorielle Cette etude avait pour objectif de determiner la part des facteurs relationnels dans la survenue de la malnutrition proteino- energetique. Patients et methodes : cette etude prospective et descriptive a ete realise au service de pediatrie de l'Hopital General de Port-Bouet du 1 er fevrier 2003 au 30 septembre 2003 (08 mois) Resultats et discussion : les nourrissons etaient les plus representes (84;3) avec une predominance masculine (55;9) (inaugurale d'une carence affective) a l'origine du kwashiorkor (83;3) certaines caracteristiques sociodemographiques du nourrisson et du petit enfant telles que l'etat de sante a la naissance; le type d'alimentation ne sont pas specifiques aux MPE. Cependant; la condition d'enfant sevre (75;5) et l'association d'un tableau depressif (83;3) a l'expression clinique de cette MPE donnent ainsi raison aux societes africaines traditionnelles pour qui; le kwashiorkor est avant tout une depression d'abandon

Physical and Psychological Factors Influencing Maternal Non-Compliance with Immunization Schedule

"The study examined the physical and psychological variables influencing maternal non-compliance with immunization schedules of children 0-2 years. The descriptive survey research design was used for the study. A questionnaire tagged ""Maternal Non-compliance with Immunization Schedule Questionnaire (MNCWISQ) was used for data collection. Three hypotheses were tested; using pearson product moment correlation. The study established that there was a significant relationship between physical factors (location of immunization services/access to immunization centres/distance to immunization centres) and non-compliance with immunization schedule (r- .47; df = 298; p.05). Psychological factor (mothers' knowledge about immunization) was also found to be significantly associated with non compliance with immunization schedule (r"

Risk factors associated with sexual violence towards girls in Swaziland

Objective:To explore risk factors for sexual violence in childhood in a nationally representative sample of females aged 13 to 24 years in Swaziland. Methods During a household survey respondents were asked to report any experiences of sexual violence before the age of 18 years. The association between childhood sexual violence and several potential demographic and social risk factors was explored through bivariate and multivariate logistic regression. Findings Participants totalled 1244. Compared with respondents who had been close to their biological mothers as children; those who had not been close to her had higher odds of having experienced sexual violence (crude odds ratio; COR: 1.89; 95CI: 1.14-3.14); as did those who had had no relationship with her at all (COR: 1.93; 95CI: 1.34-2.80). In addition; greater odds of childhood sexual violence were noted among respondents who were not attending school at the time of the survey (COR: 2.26; 95CI: 1.70-3.01); who were emotionally abused as children (COR: 2.04; 95CI: 1.50-2.79); and who knew of another child who had been sexually assaulted (COR: 1.77; 95CI: 1.31-2.40) or was having sex with a teacher (COR: 2.07; 95CI: 1.59-2.69). Childhood sexual violence was positively associated with the number of people the respondent had lived with at any one time (COR: 1.03; 95CI: 1.01-1.06). Conclusion Inadequate supervision or guidance and an unstable environment put girls at risk of sexual violence. Greater educational opportunities and an improved mother-daughter relationship could help prevent it

Maternal Depression and Anxiety among Children with Mental Health Problems

Objective: The investigation sought to examine depression and anxiety levels in mothers of children with mental health problems. Method: A case control design was employed and self-reports of depressive and anxiety symptoms were measured in a group of women whose children were receiving mental health care; as well as a community control group and a group of women receiving outpatient psychiatric care. Results: No significant differences were noted in depressive and anxiety symptoms between the mothers of children with mental health problems and the community controls; although both of these groups showed significantly lower levels of depression and anxiety than the psychiatric patient group. These findings were not influenced by demographic variables. Conclusions: The findings are contrary to those of high income countries where mothers of children with mental health problems show higher levels of depression and anxiety. This disparity may be due to the sampling and mental health service usage patterns in low-income countries where mothers who seek mental health care for their children probably constitute a specific group of people who have awareness of mental health problems and available services. As a result their own mental health is likely to be better

The Experiences of First-Time Mothers with Colic Infants who Seek Help from Medical Professionals

The purpose of this study was to describe the experiences of first-time mothers with colic infants. The research design was qualitative; exploratory; descriptive and contextual. Data were collected by means of in-depth; semistructured; phenomenological interviews and a descriptive analysis was done. The results show that the real experience of having a baby did not meet mothers' expectations. Furthermore; colic babies were anxiety-provoking and mothers struggled with feelings of failure. They searched for an explanation for the colic; but felt disillusioned with the medical profession. Mothers exhibited a need for a containing figure. They also reflected on their relationship with their mothers. Mothers felt ambivalent towards their babies and marital relationships became strained. Lastly; mothers renegotiated their identity. Based on the results; suggestions for mental health professions were made with regard to providing parent-child therapy; support for the mother and strengthening the marital relationship. The importance of psychological interventions was emphasised as a source of support for these mothers

Parents' Lived Experience of Providing Kangaroo Care to their Preterm Infants

Premature and low birthweight infants pose particular challenges to health services in South Africa. While there is good evidence to demonstrate the benefits of kangaroo care in low birthweight infants; limited research has been conducted locally on the experiences of parents who provide kangaroo care to their preterm infants. This phenomenological study explores the lived experience of parents who provided their preterm infants with kangaroo care at a tertiary-level maternity centre in the Western Cape. In-depth interviews were conducted with six parents: four mothers and two fathers. Data was analysed using an adaptation of the approaches described by Colaizzi (1978:48-71) and Hycner (1985:280-294). To ensure trustworthiness; the trustworthiness criteria described by Guba and Lincoln (1989:242-243) were applied. Kangaroo care is a phased process; each phase bringing a unique set of experiences. The eight themes that emerged are described: unforeseen; unprepared and uncertain - the experience of birth; anxiety and barriers; an intimate connection; adjustments; roles and responsibilities; measuring success; a network of encouragement and support; living-in challenges; and living with the infant outside of hospital. Challenges facing health care providers are described and recommendations for information about kangaroo care and support for parents are made

Level of maternal education and performance of Black, South African infants on the 1996 Griffiths Mental Development Scales

Objective: The study compared the performance on the Griffiths Mental Development Scales of Black; South African infants with mothers who had twelve or more years of education and who were professionally employed with infants of mothers with fewer than twelve years of education and who were employed in non-professional jobs. Method: The sample consisted of 40 infants (aged 13-16 months); to whom the Griffiths Mental Development Scales was administered. Results: The infants with professional mothers performed significantly better than their counterparts with non-professional mothers on the General Quotient; as well as on the Locomotor Scale. While maternal level of education did not appear to distinguish between infants in terms of social; fine motor; language; hearing; processing speed or practical reasoning; it did discriminate in terms of gross-motor functioning. Conclusion: It is suggested that; as the infant develops; the skills assessed by the Griffiths Scales; which are initially differentiated; become increasingly interrelated. Consequently; poor gross-motor skills; which may be more likely in infants from a low socio-economic status; may have far-reaching implications. Thus; it is important to consider maternal level of education and the socio-economic status background of the infant; as this may influence overall performance on the Scales

Guidelines to Facilitate the Nursing Accompaniment of Mothers with in a Neonatal Intensive Care Unit

To be the mother of a premature infant in a neonatal intensive care unit can sometimes be overwhelming. The hospital environment and the sound made by the life support apparatus in the unit may be terrifying for persons who are unfamiliar with this environment. An observation of the researcher; who practises in a neonatal intensive care unit; was that mothers were often very distressed after the admission of their infants. It also appeared as if health care practitioners were failing to provide for the needs of these mothers. The objectives of the research on which this article is based were: firstly; to acknowledge and describe the experiences of the mothers with regard to the hospitali- sation of their infants in the neonatal intensive care unit and secondly; to utilise the information obtained to develop guidelines to assist registered nurses accompanying mothers throughout their infants' stay in the neonatal intensive care unit. The conclusion was reached that mothers whose infants are admitted to the neonatal intensive care unit have a need for compassionate accompaniment by registered nurses during the period of hospitalisation of their infants

Factors Influencing the Utilisation of Prevention of Mother-to-Child-Transmission (PMTCT) Services by Pregnant Women in the Eastern Cape; South Africa

"The aim of the study was to identify factors influencing the utilisation of Prevention of Mother-to-Child Transmission (PMTCT) in a resource poor setting in South Africa. A sample of 186 pregnant women (29.6HIV positive and 70.4HIV negative) in four clinics in a rural district in the Eastern Cape were interviewed as part of the PMTCT programme after they had received their HIV test results. Regarding infrastructure; most women lacked transport to and communication with a health facility. More than 90felt that they had received adequate information on most of the components of the PMTCT programme. About 90of the women were satisfied with the HIV counselling they had received. Most women (54) felt they would receive support during their pregnancy mainly from their mothers; and/or husband/partner (50). Most pregnant women (92) preferred to give birth in hospital; while 8prefer to deliver at home; mostly with the assistance of a traditional birth attendant (TBA). Two-thirds of the HIV positive women stated they would feed their babies with formula milk only. Community attitudes towards people living with HIV/AIDS were mostly perceived as negative. Factors influencing the utilisation of PMTCT (that is the acceptance of antiretroviral therapy to HIV positive women; facility-based delivery; and adherence to ""take-home"" ART identified for mother and newborn); included: (1) HIV counselling by health care staff; (2) physical access to a health facility; (3) family and community support; (4) stigma; (5) delivery preference; and (6) infant feeding preferences."