“Little children learn on their own by observing and imitating.” Caregivers’ perspectives on cognitive and socio-emotional caregiving practices for children 0-3 years in lowland Nepal

Abstract

Abstract Background Caregiving is critical to children’s survival, growth, and development. In Nepal, national surveys highlight suboptimal caregiving practices for children aged under three years. Our study aimed to understand cognitive and socio-emotional caregiving practices for children under three in Dhanusha District, Nepal, to inform community interventions to promote Early Childhood Development (ECD). Methods We used qualitative methods to explore caregivers’ perceptions and practices related to cognitive and socio-emotional caregiving for children aged under three years. We purposively selected seven village development committees and conducted seven Semi-Structured Interviews (SSIs) with mothers (n=4) and grandmothers (n=3) of children under three years as well as four Focus Group Discussions (FGDs) with mothers (n=29) in Dhanusha District, Nepal. The SSIs and FGDs were audio-recorded, transcribed in Nepali, translated into English, and analysed using the framework approach. Results Caregivers thought that young children learned new skills by observing and imitating parents and older siblings, but also that ‘real learning’ mostly occurred in school after three years of age. Socialisation processes differed by gender, as reflected in the cultural acceptance of gender-specific play activities: for example, boys were encouraged to play outside and girls to play ‘kitchen’. Mothers and grandmothers engaged in stimulating activities with their children, but these activities were not perceived as ‘learning’ opportunities and were often limited by caregivers’ heavy workloads. Caregivers described good behaviours as children following parents’ instructions. Disciplining was frequent and included verbal and physical punishments. Mothers and grandmothers had primary responsibility for childcare, and the burden of responsibility was higher in households where husbands worked abroad. Mothers aspired for their sons to attain jobs, and for their daughters to have long and happy marriages. Conclusion We found several positive caregiving practices in communities of lowland Nepal, which provide an opportunity to develop a culturally appropriate intervention to support ECD. Our findings suggest that interventions to encourage caregivers’ engagement with their children should build on existing positive caregiving practices without burdening caregivers’ daily lives. Involving fathers and grandmothers in ECD interventions in addition to mothers may be beneficial in promoting children’s development.