Therefore, this study aimed to investigate how paternal involvement in child health services may influence child well-being in collectivist rural communities in Kenya. It has also highlighted their attitudes and beliefs towards parenting and how these affect children's health outcomes.
Introduction
Insufficient information existed to understand the reasons behind the low participation of fathers in child health services. 5 . and the value of their involvement in the management of children's health, especially in the developing world.
Literature Review
To the extent that they are perceived as involved in some way with their child, fathers are part of the child's microsystem. The child's health status can be used to predict the level of paternal financial support.
Methodology
A fieldworker known to the key participants in the study was involved in the recruitment process of the participants in the sub-study. During the first contact, families were approached and the purpose of the sub-study was explained.
Results
The socio-demographic profile of the sub-study participants
As hypothesized, the fathers have a higher income than the mothers, with none of the mothers having an income of more than KES 10,001. Neither parent scored low on the stress classification used in this substudy. When the cut-off point for calculating the anemia status for children living in other areas (11g/dl) was used, only 25% of the children in the sub-study were not found to be anemic.
Using the local Health Center as a reference point, most of the families these parents came from were located within a 5 km radius. Most of the families from which these parents came were of the Islamic religion. Although most couples were legally married, the results suggest that most had been married for less than 10 years.
Qualitative data analysis of the in-depth interviews
- Roles of parents in the study area
- Attitudes of parents towards parenting in this region
- Sources of child health information available to parents in this setting
- Parental recommendations to improve the provision of child healthcare education to
- Parents’ suggestions to promote the well-being their children
- Fathers’ willingness to be involved in child health care
- Religious factors
- Cultural factors
- Potential roles of the community health workers
Despite the fact that there is intermarriage among the people, the families were classified based on the community the father came from and the results showed that the majority of the families were from the Mijikenda communities. One of the mothers interviewed happened to be a CHW and she agreed that CHWs were a tool that could be used to improve children's health status. Door-to-door campaigns and community meetings organized by local leaders were some of the ways most frequently suggested by both parents.
These were seen as some untapped means of increasing parents' knowledge about children's health. Fathers reported that current health information systems did not take into account fathers' availability and the nature of fathers' daily activities in this region. The fathers also announced that mothers should monitor their children's health so that changes will be noticed as soon as possible, and that they should take their children to the hospital in case of illness.
Quantitative analysis: Fathers’ vs. Mothers’ PSI responses
- PSI item 1: Parents’ level of doubt in their ability to provide for their children
- PSI item 2: Parents’ rating of the level of challenges they have faced in providing for
- PSI item 3: Parents’ confidence in addressing the challenges they have faced in
- PSI item 4: Level of help parents think they need in making decisions for their children
- PSI item 6: Parents’ level of happiness in parenting
- PSI item 7: Parents’ level of ability to handle their children
- PSI item 8: The level at which the parents feel that they have succeeded in parenting. 56
- PSI item 10: Parents’ rating of their overall ability to be a parent
- PSI item 11: the type of parent they imagined their children would grade them
- Summary of the PSI scores for both the mothers and fathers
PSI Item 1: Level of parents' doubt in their ability to provide for their children. Overall, parents reported greater than 80% levels of parenting happiness with fathers reporting higher levels than mothers. In general, parents reported that they did not succeed in everything they wanted their children to do.
Overall, parents reported above-average PSI scores/level of competence in handling their children, with fathers feeling more competent than mothers. PSI item 8: The degree to which parents feel they have been successful in parenting. Most parents feel that they have been average parents to their children.
Graphical representation of the parents’ PSI scores against the child health variables
The Partial Eta Squared was used to understand which parental background characteristics had a significant effect size on the parental PSI items. Parents' marital duration had an effect size of (r=0.155) on item q11 (the type of parent they thought their children would grade them on); occupation had an effect size of (r=0.146) on item q1 (the degree of parents' doubt about their ability to care for their children); income had an effect size of (r=0.088) on item q10 (parents' assessment of their overall ability to be a parent); income regularity had an effect size of (r=0.052) on item q2 (parents' assessment of the level of challenges they have faced in caring for their children); (Marital status had an effect size of (r=0.074) on item q4 (Level of help parents think they need in making decisions for their children). Household location (home) had an effect size of (r= 0.138) on q2 (parents' assessment of the level of challenges they have faced in caring for their children); family ethnicity had an effect size of (r=0.049) on item q3 (parents' confidence in tackling of the challenges they have faced in parenting); education had an effect size of (r=0.197) on item q2 (parents' assessment of the level of challenges they have faced in caring for their children); religion had an effect size of (r=0.055) on item q9 (Level of parental care (the feeling that they cannot handle everything properly with their child); while child gender had an effect size of (r=0.082) on item q7 (parents' ability to interact with their children).
The highest effect sizes of family background characteristics on the mother's PSI items were as follows: their duration of marriage had an effect size (0.077) on item q9 (Level of parental feeling that they cannot handle everything well about their child), occupation had an effect size (0.115) at item q6 (parents' level of happiness in parenting); income had a size effect (r=0.104) on item q4 (Level of help parents think they need in making decisions for their children); regularity of income did not affect the size of the mother's PSI, marital status had a size effect (r=0.089) on item q11 (the type of parents they imagined their children would evaluate); home location had an effect size (r=0.108) on item q6 (parents' level of parenting happiness); family ethnicity had an effect size (r=0.026) on item q10 (Parents' assessment of their overall ability to be a parent education). Marital status had an effect size (r=0.088) on item q11 (the type of parents they imagined their children would rate them as): religion had an effect size (r=0.077) on item q1 (level of parental doubt about their ability to provide for their children); and finally, the gender of the child had an effect size (r=0.054) on item q11 (the type of parents they imagined their children would rate). In summary, all family background characteristics had small effect sizes on all paternal and maternal PSI scores EXCEPT maternal income regularity, which had no effect size (r=0.000) on any maternal PSI item.
Parents’ background characteristics vs. child health variables
- The associations between parental characteristics and child health outcomes
- The differences between the parents’ roles, beliefs and attitudes of the parents in
- Paternal involvement with their children in this community
- Factors affecting paternal participation or involvement with their children
None of the background characteristics were significantly associated with child health outcome variables used in the substudy. This section summarizes the results for each of the main objectives after using the qualitative and the quantitative methods to study fathers'.. involvement in the management of children's health. When the qualitative and quantitative results were triangulated, the majority of results obtained using the two methods differed, while only a few agreed.
Quantitatively, none of the associations between the parents' characteristic and child health variables were statistically significant. While the majority of the quantitative results were not as expected, the qualitative results showed that the parents' level of education, marriage, occupation and income were perceived by them as having a positive effect on the management of child health. They were willing to be involved in managing the health of their children, but this was not possible due to their prevailing economic hardships, limited sources of income and the lack of resources in the area.
Discussion, Conclusion and Recommendations
The association between parental characteristics and child health variables
Previous studies show that maternal employment would have a negative impact on children's health due to the shorter time they spend with their children[33, 53]. Parental Stress: Based on the findings from the other studies, parental stress has a negative impact on the proper management of child well-being[9, 38]. Maternal stress: The results of this study revealed a weak negative correlation between mother's parenting stress and child's recorded sick visits, and a weak positive correlation with the other child health variables used in this substudy (hfa, wfa and hb and vaccination status).
This was contrary to the findings of previous studies which have shown that increased maternal stress negatively and adversely affects the health of the child[75, 76]. When the relationship between religion and child health variables was explored, the results suggested that there was no significant relationship between religion and any of the child health variables measured in this substudy. However, the results showed a weak negative correlation between religion and some of the child health variables used, except for the child's recorded sick visits.
The differences between the parental roles, beliefs and attitudes in managing child health
This study has a major shortcoming of not utilizing assessments of the multitude of factors that influence the fathers' involvement in the study area. The attendance of the fathers in such social gatherings is said to be more than that of the mothers. During most of the time, I feel that my child loves me and wants to be next to me.
I feel that I am successful most of the time when I try to get my child to do or not do something. - In the past 12 months, any of the following events have happened to your immediate family. Concept: Parent enjoys parenting). most times when I try to get my child to do or not do something.
I handle things well on the whole 5 . of the parents' ability to provide for the child's needs). The aim is to examine the role of fathers in promoting their children's well-being in order to identify the key areas to improve their engagement in child health care.
