Associations between young children’s development and their caregiver’s practices and knowledge about child development in Soweto, Johannesburg

Camden-Smith, Taryn
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Introduction: 250 million children are failing to reach their developmental potential in low- and middle- income countries. The first 1000 days of life (pregnancy and the first two years) are critical for brain and child development. Outputs of strategies that target child development include stimulating home practices (early learning opportunities such as singing/storytelling) and caregiver knowledge about child development. The status of these in caregivers of children younger than two years old and the associations of these to child development in the South African context have only been minimally explored. Therefore, the aim was to determine home practices, caregiver knowledge and child development in children aged one to 24 months in Soweto, Johannesburg and to determine if home practices and caregiver knowledge were associated with child development. Methodology: A cross-sectional study was conducted on 160 caregiver-child pairs attending well-child services at a community health centre in Johannesburg. Data was collected using a questionnaire including home practice questions, the Caregiver Knowledge of Child Development Inventory, and the Ages and Stages Questionnaire (3rd edition). Bivariate and multiple linear regressions were conducted. Results: Only one in three children are on track in all areas of development. Home practices were found to be associated with child development, such as talking to children during pregnancy (adjusted B=-67.6, p<0.05, 95%CI:-120.0,-15.2), singing (B=-17.5, p<0.05, 95%CI:-33.4,-1.7), naming/counting/drawing with children (B=-12.3, p<0.1, 95%CI:-26.4,1.8) and storytelling (B=-18.9, p<0.01, 95%CI:-31.9,-5.9). There was a high prevalence of some home practices (singing: 83%, taking children outside: 79%) but a low prevalence of others (reading/looking at pictures with children: 38%, storytelling: 30% and naming/counting/drawing with child: 24%). Caregivers had a relatively low level of knowledge about child development (mean CKCDI total score out of 40 was 21.6±5.4) and predicted milestones and stimulation activities to occur at older ages. Caregiver knowledge about child development was not associated with child development. Conclusion: In the first 1000 days of life, early learning opportunities (and not caregivers’ knowledge about child development) promote child development. Such early learning opportunities include singing, story-telling, naming/counting/drawing with children and allowing children to play with household items/homemade toys/children’s books
A research report submitted in partial fulfilment for the degree of Master of Public Health to the Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, 2022