Caregiver knowledge, attitude and practices about early child development in Telangana, India: a cross-sectional study

Abstract

Background: Early childhood development (ECD) refers to the age-appropriate language, cognitive and socio-emotional growth in early years of life. For the very young, 0-3 years of age, parents and caregivers are the main source of stimulus and care. Poor socio-economic conditions may contribute to suboptimal parenting.Methods: We assessed caregivers’ knowledge, attitude and practice (KAP) regarding ECD in underprivileged regions of Telangana, South-India, using a structured survey, and qualitative interviews of frontline workers (FLWs).Results: A large proportion of caregivers had appropriate knowledge and practices regarding nutrition and health: colostrum (>80%), breastfeeding (>94%), growth monitoring (>90%), immunization (99%), and health-seeking for the child (98%). Regarding early stimulation, caregivers knew and believed that reading (91%), playing (94%), storytelling and singing (79%) make the child intelligent; but were unaware that these activities should be initiated before 3 years of age, thus their practice of the same was also low. They expressed their love and affection (99%) well for the child, spent time (46%) and talked to the child (59%), but were not aware this contributes to cognitive and emotional development of the child. Major challenges in effective ECD care as per FLWs included parental attitude, mothers’ agricultural work routine and language barrier.Conclusion: We observed gaps in age-appropriate early stimulation and responsive care. Several good practices are rooted in tradition, but caregivers were not completely aware of the contribution of these practices to their child’s development. Qualitative interviews with FLW show the need of culturally relevant interventions to empower caregivers regarding ECD.