Title: Examining Social Networks of Infant and Young Child Caregiving in Uganda and its Association with Maternal Depression
Description: Despite the growing global momentum and commitment to addressing child malnutrition over the past few decades, undernutrition in children remains a global health crisis, particularly in low- and middle-income countries (LMICs), and leads to deleterious physical and cognitive effects on children. The maternal social network has been linked to child development and health outcomes, partially through its effect on maternal depression, which in turn affects maternal behavior and child health. However, there is limited research in LMICs broadly and in Uganda specifically on the infant/young child caregiving social network, the social network through which mothers receive infant/young child caregiving assistance. This mixed-methods dissertation study piloted and refined a measure to capture this infant/young child caregiving social network in northern Uganda, and then examined sample descriptive data and the associations between networks’ characteristics and maternal depression using a social network analysis (SNA) approach.

We also qualitatively examined challenges, barriers, and facilitators to infant and young child caregiving social support. Results found the social network measure to be feasible, acceptable, and comprehensible, and refinements were added to further increase clarity and suitability to the cultural context. Quantitative analyses found higher maternal depression severity to be significantly correlated with lower support on several network characteristics including the average number of caregiving tasks people assisted with, the number of people helping with advanced tasks, and the network density. Further exploration showed that higher network density was also correlated with higher number of tasks alters assisted with. Qualitative results found that mothers often experienced multiple ongoing challenges and barriers in their relationships, such as chronic spousal abuse and financial restriction, and highlighted a lack of systemic support and interventions to address these challenges. We also found several facilitators that helped mothers obtain much needed caregiving support, such as through their older children or Food for the Hungry, a non-profit organization.

Though larger future studies are needed to corroborate findings, results of the study may inform interventions for maternal depression and child nutrition/health, identifying possible targets such as network density and highlighting the importance of addressing specific chronic barriers to caregiving social support. Lastly, we also developed a measure that may be used in future studies to examine caregiving networks as a mechanism of change in existing interventions.