Title: Understanding early child development in the context of socioeconomic adversity and maternal depression in Brazil and South Africa
Funder: Economic and Social Research Council

Abstract: Early child development is a complex process influenced by genetics, environment and socioeconomic factors. These interact from very early life (pregnancy) to shape multiple domains of development including growth, cognitive and language development and behaviour. My research so far has focused on disentangling some of these processes which affect early child development in both high income (UK and the Netherlands) and low and middle income countries (Brazil and South Africa) particularly in the case of adverse childhood experiences. More specifically, my work examines the effects of perinatal mental health on child development. Perinatal depression is prevalent, with about 10% of women experiencing significant depressive symptoms in high income countries (HIC) and 18-25% in low and middle income countries (LMIC). Depression during pregnancy and in the early years of life has been associated with an increased risk of delayed cognitive and language development, emotional and behavioural problems, lower academic achievement (maths) and higher rates of depression at 18 years of age. Parenting is one of the key mechanisms through which depression affects child development and more specifically inconsistent and unresponsive parenting. Children however, are not susceptible to the effects of maternal depression to the same degree. When facing socioeconomic adversity and lack of support, children born to depressed mothers are at increased risk of compromised cognitive development, behaviour and growth. As part of this fellowship I propose to extend some of my ongoing work to examine the impact of socioeconomic adversities on perinatal mental health and early child learning and behaviour. Brazil and South Africa are particularly interesting countries to extend this work to as they are both in rapid economic and social transition and both face high levels of inequality. Both countries face increasing levels of disparities amongst socioeconomic groups, which affect both economic and health outcomes. These transitions place high levels of stress on community and family life. Particularly in LMIC high levels of depressive symptoms are associated with poverty, lack of support and negative life events. Socioeconomic adversity and parental depression are both risk factors for poor development, which often co-occur. This, in combination with the higher rates of perinatal depression in LMIC, places children at increased risk of poor development. The objectives of this fellowship are to: 1.Extend my current programme of work and examine how socioeconomic adversities in the context of rapidly transitioning societies impact on perinatal mental health and early child learning and behaviour in a sample of HIV-positive mothers in Soweto, South Africa. This cohort will provide data from a sample of socioeconomically disadvantaged women, where child development will be compounded by maternal mental health and maternal HIV-infection both of which are associated with caregiving difficulties (1 paper). 2.Produce publications from ongoing work with the Pelotas birth cohorts, a set of two cohorts set 11 years apart in an urban setting in southern Brazil (2004 and 2015, 2 papers) and on the feasibility of delivering an integrated treatment package of early child stimulation and depression treatment in a rural sample of HIV-positive women and their children in South Africa (1 paper). 3.Communicate these findings through two international conferences and publications as well as through workshops targeting community workers and local NGOs in South Africa. 4.Strengthen the current collaborations and explore opportunities for fellowship applications. Travelling to both South Africa and Brazil will enable me to meet with the teams and the cohort collaborators to discuss future work.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: MENTAL HEALTH;REPRODUCTIVE HEALTH AND CHILDBIRTH