Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Rafael Pérez-Escamilla

Abstract

Objectives: A descriptive analysis to explore the risks for early childhood development (ECD) delays among children of adolescent and young adult mothers in Brazil. Methods: A secondary analysis of cross-sectional data of a representative sample of children under age 2 and their mothers from community health centers in Brasília, Brazil. The Denver Developmental Screening Test II was used to assess overall and domain-specific ECD (personal-social, fine motor, gross motor, and language). Mothers were subset into two groups based on age. Bivariate analyses and multivariable logistic regressions were used to examine the associations between maternal age and risk of ECD delay, adjusting for household, maternal, pregnancy, and infant characteristics. Frameworks were developed throughout the research process based on theoretical and scientific evidence, and guided the selection of covariables. Results: No significant differences were found in the risk of overall ECD delay between children of adolescent mothers and children of young adult mothers. Compared to adolescent mothers, young adult mothers were more likely to have >9 years of education (83.16% vs. 53.10%), to be working outside the home (17.07% vs. 7.53%), to be the head of the household (13.10% vs. 3.45%), and to have more than one child (34.36% vs. 10.27%). Adjusted logistic regression showed multiparity as an independent risk factor associated with an increased risk of overall ECD delay for all mothers in the sample (AOR=2.51; 95% CI, 1.23-5.13). Conclusion: Findings indicate that socio-economic and demographic risk factors such as lower maternal educational attainment, unemployment, lack of household support, and multiparity are associated with an increased risk of ECD delay for children under age 2 of adolescent and young adult mothers. These results call for interactions among individuals, institutions, and systems across specific socio-historic contexts to be considered when developing integrated ECD interventions targeting adolescent and young adult mothers.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2023

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