Mothers’ caregiving resources and practices for children under 5 years in the slums of Hyderabad, India: a cross-sectional study

Abstract

BACKGROUND: The extended care model of the United Nations Children's Fund (UNICEF) identifies knowledge/beliefs, nutritional status, mental health, control of resources/autonomy, workload/time constraints and social support as important caregiver resources for childcare. The aim of this paper is to examine the role of mothers' caregiving resources in child-care practices in slums. METHODS: A cross-sectional study was conducted in 10 slums of Hyderabad, to appraise the caregiving practices and health status of children under 5 years. Data were collected from 506 households, selected through multistage stratified random sampling, and data relating to 451 children aged 6-59 months were analysed. Four caregiving practices were studied: psychosocial stimulation, as assessed by the Home Observation Measurement of the Environment inventory; hygienic care rated by spot-check observation; and meal frequency and dietary diversity based on maternal recall. The role of the mother's caregiving resources was examined using bivariate and multivariate logistic regression analyses. RESULTS: More than 50% of the children received good psychosocial stimulation and close to 60% had good hygienic care. About 75% of the children aged 6-23 months had the recommended minimum meal frequency and 13% had the recommended dietary diversity. Mother's media exposure (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.35-3.77), participation in household budgeting (OR 2.19, CI 1.25-3.83) and husband's support (OR 2.04, CI 1.28-3.24) were predictors of psychosocial stimulation. Mother's younger age (OR 1.11, CI 1.04-1.18), poor media exposure (OR 1.95, CI 1.15-3.29), dissatisfaction with life (OR 1.84, CI 1.05-3.24), workload (OR 1.79, CI 1-3.18) and having no money for their own use (OR 1.52, CI 0.95-2.45) placed children at higher odds for receiving poor hygienic care. Leisure time (OR 2.75, CI 1.25-6.06) and participation in budgeting (OR 1.97, CI 1-3.86) were predictors of meal frequency. CONCLUSION: Mother's workload, poor media exposure, dissatisfaction with life, lack of husband's support and absence of economic autonomy are constraints to good child care in slums.