Joint parental stimulation and early childhood development in 26 sub-Saharan African countries

Background Engagement in stimulation activities by both parents can have synergistic effects on early childhood development (ECD). While the role of maternal stimulation is well known, the association with paternal stimulation remains underexplored and inconsistent. The current study aimed to assess...

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Main Authors: Rockli Kim, Hwa-Young Lee, Joshua Jeong, Hyejun Chi, Yun-Jung Eom
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/9/1/e003091.full
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author Rockli Kim
Hwa-Young Lee
Joshua Jeong
Hyejun Chi
Yun-Jung Eom
author_facet Rockli Kim
Hwa-Young Lee
Joshua Jeong
Hyejun Chi
Yun-Jung Eom
author_sort Rockli Kim
collection DOAJ
description Background Engagement in stimulation activities by both parents can have synergistic effects on early childhood development (ECD). While the role of maternal stimulation is well known, the association with paternal stimulation remains underexplored and inconsistent. The current study aimed to assess the distribution of different combinations of maternal and paternal stimulation and explore their associations with ECD in the context of sub-Saharan Africa (SSA).Methods Using the Multiple Indicator Cluster Surveys and Demographic and Health Surveys from 26 SSA countries, we included 69 637 children aged 3–4 years in the analysis. The standardised ECD z-score was constructed using the ECD index. We estimated three-level linear regressions to assess its association with parental engagement in stimulation activities which was classified into four categories: mother low, father low (fewer than four activities); mother high, father low; father high, mother low; mother high, father high. Stratification analyses were conducted to examine whether the association differs by socioeconomic, geographic and learning-related variables.Results Only 4% of parents provided high stimulation jointly (both high), which was associated with higher ECD z-score compared with both parents providing low stimulation (both low), after adjusting for covariates (b=0.04, 95% CI=0.01, 0.08). The association between joint parental stimulation and ECD was greater for children from wealthier households compared with their poorer counterparts (interaction p=0.012).Conclusions Children showed better developmental status when both parents jointly provided high stimulation. Policies and interventions should target both mothers and fathers, and transform traditional norms about parenting to achieve the most optimal development outcomes of children.
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spelling doaj-art-c2673b7a30c444778babf38bdfc3e09d2025-08-20T02:13:07ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-04-019110.1136/bmjpo-2024-003091Joint parental stimulation and early childhood development in 26 sub-Saharan African countriesRockli Kim0Hwa-Young Lee1Joshua Jeong2Hyejun Chi3Yun-Jung Eom4School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea3 Convergence Science Academy, Institute of Convergence Science (ICONS), Yonsei University, Seoul, South KoreaRollins School of Public Health, Emory University, Atlanta, Georgia, USAInterdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of KoreaInterdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of KoreaBackground Engagement in stimulation activities by both parents can have synergistic effects on early childhood development (ECD). While the role of maternal stimulation is well known, the association with paternal stimulation remains underexplored and inconsistent. The current study aimed to assess the distribution of different combinations of maternal and paternal stimulation and explore their associations with ECD in the context of sub-Saharan Africa (SSA).Methods Using the Multiple Indicator Cluster Surveys and Demographic and Health Surveys from 26 SSA countries, we included 69 637 children aged 3–4 years in the analysis. The standardised ECD z-score was constructed using the ECD index. We estimated three-level linear regressions to assess its association with parental engagement in stimulation activities which was classified into four categories: mother low, father low (fewer than four activities); mother high, father low; father high, mother low; mother high, father high. Stratification analyses were conducted to examine whether the association differs by socioeconomic, geographic and learning-related variables.Results Only 4% of parents provided high stimulation jointly (both high), which was associated with higher ECD z-score compared with both parents providing low stimulation (both low), after adjusting for covariates (b=0.04, 95% CI=0.01, 0.08). The association between joint parental stimulation and ECD was greater for children from wealthier households compared with their poorer counterparts (interaction p=0.012).Conclusions Children showed better developmental status when both parents jointly provided high stimulation. Policies and interventions should target both mothers and fathers, and transform traditional norms about parenting to achieve the most optimal development outcomes of children.https://bmjpaedsopen.bmj.com/content/9/1/e003091.full
spellingShingle Rockli Kim
Hwa-Young Lee
Joshua Jeong
Hyejun Chi
Yun-Jung Eom
Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
BMJ Paediatrics Open
title Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
title_full Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
title_fullStr Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
title_full_unstemmed Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
title_short Joint parental stimulation and early childhood development in 26 sub-Saharan African countries
title_sort joint parental stimulation and early childhood development in 26 sub saharan african countries
url https://bmjpaedsopen.bmj.com/content/9/1/e003091.full
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AT yunjungeom jointparentalstimulationandearlychildhooddevelopmentin26subsaharanafricancountries