A randomized controlled trial of home visits by neighborhood mentor mothers to improve children's nutrition in South Africa

Malnourished children and babies with birth weights under 2500 g are at high risk for negative outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve nutritional outcomes for young children in South Africa. One “mentor mother” was recruited from each of 37 neighborhoods in Cape Town, South Africa. Mentor mothers were trained to conduct home visits to weigh children under six years old and to support mothers to problem-solve life challenges, especially around nutrition. Households with underweight children were assigned randomly on a 2:1 ratio to the Philani program (n = 500) or to a standard care condition (n = 179); selection effects occurred and children in the intervention households weighed less at recruitment. Children were evaluated over a one-year period (n = 679 at recruitment and n = 638 with at least one follow-up; 94%). Longitudinal random effects models indicated that, over 12 months, the children in the intervention condition gained significantly more weight than children in the control condition. Mentor mothers who are positive peer deviants may be a viable strategy that is efficacious and can build community, and the use of mentor mothers for other problems in South Africa is discussed

Preschool Children and Behaviour Problems: A Prospective Study

Toddler/child behaviour problems have received relatively little previous attention. Prior studies have implicated a wide variety of factors in the aetiology of child behaviour problems but many of these factors are correlated and little is known about their independent contributions. Four broad categories of factors have been associated with child behaviour problems: (1) maternal social and economic characteristics; (2) maternal lifestyle; (3) maternal mental state/child-rearing practices; and (4) maternal and child physical health. The study took a sample of 5296 families from the Mater-University of Queensland Study of Pregnancy (MUSP) for whom 5-year prospective data are available. The major predictors of toddler behaviour problems were the mother's and child's health, and the mother's mental state. The mother's sociostructural characteristics and lifestyle made little or no additional contribution to the prediction models. It is, however, salutary to note that the majority of children who are classified as having high levels of troublesome behaviour do not fall into any of the risk categories. A variety of explanations and interpretations of the data is considered