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other·pediatrics, public health, obstetrics and gynecology, family medicine, nutrition·PMC10010090

‘Being a mother is not child's play’: The capabilities of mothers in a low‐resource setting in South Africa

Health Expectations : An International Journal of Public Participation in Health Care and Health Policy · 7 authors, 5 centres

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TL;DR

This qualitative study explored the caring capabilities of 18 mothers in a low-resource South African setting.

Full summary

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This qualitative study used in-depth interviews with 18 mothers of children aged 30 months or younger in a low-income South African township to investigate their caring capabilities during the first 1000 days. They reported joy at their children's milestones but anxiety when development lagged. A major limitation is the small, potentially biased sample, which may overrepresent mothers managing well. The findings suggest mothers bear disproportionate responsibility for child developmental health and that policy should adopt a holistic approach considering both individual agency and external structural constraints.

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other

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10010090

‘Being a mother is not child's play’: The capabilities of mothers in a low‐resource setting in South Africa

Health Expectations : An International Journal of Public Participation in Health Care and Health Policy

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ABSTRACT

Abstract Background The importance of a child's first 1000 days has now been widely accepted by the medical fraternity. Yet, we do not know much about caring practices in low‐resource settings. Aim This study aimed to investigate the caring capabilities of mothers in a low‐resource setting. Method In this study, in‐depth interviews were conducted with 18 mothers with children aged 30 months or younger to better understand the arrangements, means and ends that inform developmental health in a low‐resource setting in South Africa. The study was conducted in a low‐income area, the former black township of Mangaung in Bloemfontein. The mothers were recruited via pamphlets, and two interviews followed. Because of Covid‐19, interviews took place via mobile phones, in Sesotho, the local language in the area. Trained fieldworkers conducted, translated and transcribed the interviews. We used thematic analysis and the capabilities approach as the theoretical framework to analyse the responses from the mothers. Findings We used the following organizing themes: pregnancy and ante‐natal care, nutrition, cognitive and physical development, the home environment and access to health care. Although short‐term reactions to pregnancy were often negative, the longer‐term responses showed that the respondents have agency. Most of them could change their nutrition habits, breastfeed and receive adequate nutrition support from the public health system. Most experienced joy when their children reached milestones (cognitive and others), although they became anxious if milestones were not reached. They emphasized children's play and had dreams for their children's futures. Technology was often mentioned as playing a role in their children's development. A large proportion of the respondents had disrupted homes (because of absent or abusive fathers), but some had stable homes. Most of them showed substantial capability to overcome adverse home environments. The public health system helped them deal with their health problems and their children's health problems, although it also created anxiety in many cases. Our data show how they develop their capabilities and overcome obstacles organically in the face of resource limitations. Despite pregnancies being unexpected and unplanned and fathers being absent, the respondents accepted the pregnancy, adjusted their diets and social behaviour, showed agency by attending primary healthcare facilities and ensured that their children received the required vaccinations. Their extended families played an important role in providing care. Despite the sacrifices, the respondents expressed joy and helped their children function by eating, playing, socializing, learning and using their senses. Conclusion Our sample of mothers have the agency to adapt to the demands of parenthood and childcare and overcome adversity. Our data support the notion that mothers are held disproportionately and unfairly responsible for achieving the first 1000 days ideals. Despite considerable curtailment of their functionings and capabilities, they nevertheless showed agency to ensure their health and their children's health. A holistic approach should consider these findings in designing policy interventions for children's developmental health. Patient and Public Contribution We used paid fieldworkers to interact with the research participants.

CITATION EXPORT

Michael Pienaar, Lochner Marais, Mosaathebe Serekoane et al.. ‘Being a mother is not child's play’: The capabilities of mothers in a low‐resource setting in South Africa. Health Expectations : An International Journal of Public Participation in Health Care and Health Policy. (2023). https://doi.org/10.1111/hex.13689

AUTHORS

7 · 5 CENTRES

Michael Pienaar, Lochner Marais, Mosaathebe Serekoane, Kobus Marais, Jan Cloete, Molefi Lenka, Carla Sharp

1 Department of Paediatrics and Child Health University of the Free State Bloemfontein South Africa
2 Centre for Development Support University of the Free State Bloemfontein South Africa
3 Department of Anthropology University of the Free State Bloemfontein South Africa
4 Department of Linguistics and Language Practice University of the Free State Bloemfontein South Africa
5 Department of Psychology University of Houston Houston Texas USA