Primary Submission Category: Social/relational factors
Grandmother-mother relationship quality and caregiving practices among mothers, grandmothers, and others in rural Pakistan
Authors: Esther Chung Linda Adair Stephanie Martin Brian Pence Sean Sylvia Siham Sikander Joanna Maselko
Presenting Author: Esther Chung*
Background: Early childhood interventions primarily focus on mothers and fail to take a family systems approach to promote optimal child development. The grandmother-mother relationship is often excluded from maternal and child health research, but may have important influences on the caregiving environment. We assessed associations between grandmother-mother relationship quality and household caregiving practices.
Methods: We used data on 469 families from the Bachpan Cohort, a birth cohort study in rural Pakistan. Mothers reported on the quality of their relationship with the child’s grandmother at child age 6 years. Outcomes included caregiving engagement by mothers, grandmothers, and other family members at 6 years. We used exploratory factor analysis to define grandmother-mother relationship quality and conducted generalized linear models to assess the cross-sectional associations between grandmother-mother relationship quality factors and caregiving outcomes.
Results: We found three factors of grandmother-mother relationship quality: Trusted advisor, Caregiving support, and Conflict. Specific grandmother-mother relationship quality factors had different associations with caregiving outcomes among mothers, grandmothers, and others. Trusted advisor was associated with higher maternal caregiving engagement and lower caregiving engagement by other family members. Greater Caregiving support was associated with lower maternal caregiving engagement, but higher caregiving engagement by grandmothers and others. Lack of conflict was associated with lower grandmother caregiving engagement.
Discussion: Our findings indicate that the grandmother-mother relationship may influence caregiving practices in the household. Further longitudinal studies are needed to tease out the temporal ordering of these associations. Interventions that include multiple family members may have greater impacts on child development by creating a cohesive caregiving environment.