Departments of Psychiatry and Psychology, University of Cape Town
April 1997 to April 1999
To prevent adverse child outcomes associated with socioeconomic deprivation and maternal mood disorder through community based intervention incorporating a mother-infant interaction programme.
Social adversity and maternal depression have an adverse effect on the quality of mother-infant relationships. The resultant disruption to infants' interpersonal environment has a deleterious effect on the child's emotional, social, cognitive and physical development. Mothers and infants particularly affected include those living in recently urbanized poor communities.
The project will be carried out in Khayeiitsha, a poor community outside Cape Town, South Africa. A treatment programme involving specific mother- infant interaction treatment will be evaluated within the context of a randomized controlled trial.
One hundred pregnant women will be assigned either to a Physical Care group or to a Physical Care plus Mother-Infant Interaction programme. The Mother-infant Interaction programme will involve weekly home based therapy sessions carried out by lay community workers over a period of 10 weeks post-partum, and then fortnightly for six weeks. The community workers providing the treatment will utilize a treatment manual and will receive training and ongoing supervision for the implementation of the programme.
The project is expected to demonstrate that the community workers can be trained and that their teaching leads to changes in the way mothers interact and handle their babies. In the longer term the project is expected to show positive benefits of such improved interaction on babies growth and development.
Greater improvements in (a) maternal mood, (b) the quality of the mother - infant relationship and (c) infant cognitive and emotional development, for the mother-infant interaction treatment group compared with the control condition, will be the main indicators of treatment success. The intervention is also expected to influence physical health indicators positively, with the treatment group showing more prolonged breast feeding, better physical growth and less infant mortality and morbidity.
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