Kinship, Nuptiality and Child Health Outcomes in a Low Income Urban Area

项目摘要 尽管在改善儿童存活率方面取得了重大进展，但撒哈拉以南非洲地区仍有一些 对儿童的身体发育和儿童早期发展造成最糟糕的后果。这在很大程度上是由 生活在低收入城市社区的儿童面临更高的风险。鉴于研究的重点是 环境因素、社会经济地位和获得服务的机会，投入的努力要少得多 了解婚姻中快速的社会变革和亲属的作用如何影响儿童的幸福 这些社区。在这个项目中，我们在NICHD R21项目的成功基础上开发和测试 亲属关系支持树(KST)评估亲属对单亲母亲及其子女的支持数量和质量 肯尼亚内罗毕贫民窟中的儿童。提出的混合方法，纵向研究发展了一个 一种新的联盟形式化度量来考察亲属支持、联盟形式化 和婴儿/儿童发展成果。联合形式化措施将捕获以下过程 承认社会和/或法律上的工会。这项研究将与KST项目在同一地点进行。 该网站拥有一个健康和人口监测系统(HDSS)，该系统有助于初始样本的选择 并提供强大的基础设施。我们将进行严格的认知测试，以最终确定关于联合的问题 正规化，验证现有的关系质量量表，并在第一年预先测试所有工具以通知 调查进展情况。然后，我们将从1250名0-24个月大的儿童和18-29岁的母亲开始 并在3年内每年收集两次有关儿童、母亲和选定亲属的数据。关于亲属的数据包括 居住和距离的地理空间指标以及多个亲属关系支助领域。这将是 补充每年一次对母亲、亲生父亲和现任母亲的定性随访 合伙人。我们的分析将集中在婚姻正规化和亲属关系支持对儿童的直接影响 结果以及一套已知与儿童发展有关的中间结果。我们 将使用交叉滞后结构方程和增长模型来检验联合形式化和 随着时间的推移，亲属关系对儿童的身体发育和早期儿童发展(ECD)的支持。我们还将 评估婚姻正规化在多大程度上缓和亲属关系支持对身体发育的影响 ECD结果和亲属支持在联盟形式化对身体发育和ECD的影响中起中介作用 结果。我们将使用缓和的中介模型来实现这一点。这项研究的最终目标是 确定为易受伤害的母亲和幼儿提供最佳保护的家庭支助模式。

Project Summary Despite significant progress in improving child survival, sub-Saharan Africa continues to have some of the worst outcomes for children’s physical growth and early childhood development. This is driven in large part by elevated risks for children living in low-income urban communities. Whereas research has focused on environmental factors, socioeconomic status and access to services, much less effort have gone into understanding how rapid social transformation in marriage and the role of kin impacts children’s well-being in these communities. In this project, we build on the success of an NICHD R21 project to develop and test the Kinship Support Tree (KST) to assess quantity and quality of support from kin to single mothers and their children in a slum context in Nairobi, Kenya. The proposed mixed methods, the longitudinal study develops a new measure of union formalization to examine the relationships among kinship support, union formalization and infant/child development outcomes. The union formalization measure will capture the process of recognizing unions socially and/or legally. The study will be carried out in the same site as the KST project. The site hosts a Health and Demographic Surveillance System (HDSS) which facilitates initial sample selection and provides strong infrastructure. We will conduct rigorous cognitive testing to finalize the questions on union formalization, validate existing relationship quality scales and pretest all instruments in the first year to inform the survey development. We will then start with 1250 children ages 0 – 24 months with mothers aged 18-29 and collect data on the children, mothers and selected kin two times per year over 3 years. Data on kin include geospatial indicators of residence and distance and multiple domains of kinship support. This will be supplemented with qualitative follow up once a year on a subsample of mothers, biological fathers, and current partners. Our analysis will focus on the direct effects of union formalization and kinship support on child outcomes as well as on a set of intermediate outcomes known to be associated with child development. We will use cross-lagged structural equation and growth models to examine the effects of union formalization and kinship support on children’s physical growth and early child development (ECD) over time. We will also assess the extent to which union formalization moderates the effect of kinship support on physical growth and ECD outcomes and kinship support mediates the effect of union formalization on physical growth and ECD outcomes. We will use moderated mediation models to accomplish this. The ultimate goal of the study is to identify models of family support that offer optimum protection for vulnerable mothers and young children.