Paternal roles in promoting child well-being: what are the challenges facing paternal involvement in child healthcare in rural South Coast Kenya?

Abstract

Introduction While it has long been accepted that mothers play a key role in child health outcomes, the role of the father is less well understood. The proposed study was nested in another study investigating the relationship between the social environment and child health, growth and development. The work took place in South Coast Kenya, Kwale County, an area characterized by low income, restricted health resources, and exposure to multiple infections, including malaria. Child health clinics are largely contained within Mother and Child Health programmes [1, 2]. This has excluded the fathers who rarely visit the health facilities. This observation made during previous studies in the area was a clear indication of little paternal involvement with their children. Through previous studies carried out in this region, community consultation groups have consistently made recommendations on how to improve the existing situation[2]. It clearly emerged that other family members, particularly fathers, need to be included in the process of addressing child health and development. Therefore, this study aimed to investigate how paternal involvement in child health services can affect child wellbeing in collectivist rural communities in South Coast Kenya. It has also highlighted their attitudes and beliefs towards parenting and how they affect child health outcomes. Objectives This study had three main objectives to investigate parenting in a rural low income setting. They included describing and comparing the maternal and paternal attitudes and perceived parenting roles and responsibilities in managing infant health, investigation of the relationship between parental psychosocial factors and child health outcomes in the two main communities (Mijikenda vs. Non-Mijikenda communities) within the study area and finally, to summarize the key factors affecting paternal inclusion or involvement in child health programmes. Methodology Two types of interviews were administered to both parents (fathers and mothers) to find out their roles, attitudes and beliefs towards parenting. The first type of interview used was a quantitative structured interview and it investigated their parenting stress. The second was a qualitative semi-structured in-depth interview and investigated the parents’ roles, beliefs, and attitudes towards parenting. Data analysis was carried out using SPSS21 Software for quantitative data and NVivo10 Software for qualitative data. The information has been used to explain the existing pattern of parental involvement in child health care programmes. Study findings The results suggested that both mothers and fathers were very happy to be parents and were willing to be involved with their child or children in promoting their well-being. Nevertheless, although the mothers agreed with the fathers’ reports that they were practically involved in supporting their children financially, decision making and providing their daily needs, they disagreed with paternal reports that fathers participated in taking their children to the hospital when sick. None of the parental characteristics was significantly associated with the child health variables measured. The extra challenges parents experience in parenting and their inability to handle their children well were associated with poor parenting styles. Their low household income and health care system factors preventing working fathers from attending clinic were also associated with low paternal involvement with their children and in the management of their children’s health. Conclusion Financial constraints and the design of the healthcare system, biased in favour of the mothers are major obstacles affecting paternal involvement with their children. The fathers in the study area are willing to take part in any activity undertaken to promote the well-being of their children and generally happy to be parents. Increased paternal involvement in the healthcare programmes may improve the wellbeing of their children and the public at large.