Overview
Stress refers to any type of change that causes physical, emotional or psychological strain. In relation to child nutrition, stress for caregivers can result from general life stresses, parenting, as well as stresses specific to child nutrition and feeding.
Measures of stress in this toolkit more commonly assess a caregiver’s perceived overall level of stress. Two measures are widely validated tools that assess general perceived stress or symptoms of stress. Two other author-developed measures assess signs of stress or issues that may cause stress for a caregiver: economic
Overview
Caregivers’ own physical health is often measured as body mass index, hemoglobin, or illness in population-based surveys, including the DHS. It is important to include perceived health, which can be defined as their own health and energy level to do daily activities, including caregiving. Health and energy levels impact caregivers’ ability to provide nurturing care, as well as children’s health, nutrition, and development, yet there is a dearth of evidence for caregivers themselves. One study that assessed caregivers’ perceived physical health and child nutritional status found
Overview
Safety and security is one of the five components of nurturing care. Safe and secure environments for families enables a caregiver to provide care for young children. While safety and security could be assessed as safety from any experiences of domestic or child abuse and neglect, including physical, psychological, and/or sexual abuse, or violence outside the home, including armed conflict, displacement, kidnapping, environmental disasters, and personal attack (WHO 2018), the literature on a caregiver’s safety and security related to child nutrition measures intimate partner violence
Overview
Gender attitudes refers to views held by individuals regarding the roles that men and women and boys and girls should play in society. The positive relationship between gender-equitable attitudes and numerous health issues is well established;1,2 the relationship to child health, nutrition, and development is increasingly examined. For example, research in Zimbabwe found that caregivers with more equitable gender norm attitudes were more likely to exclusively breastfeed children and have better nourished children.3,4 Gender attitudes are sometimes included as an element of
Overview
Self-efficacy is an individual’s beliefs about their ability to take action or perform a behavior. Self-efficacy is an important determinant of health and nutrition behaviors and is included in several behavioral theories. The strong, positive relationship between breastfeeding self-efficacy and optimal breastfeeding practices is well established. While less studied, there is growing evidence about the positive relationship between self-efficacy and complementary feeding practices.
Measures of self-efficacy should be domain specific, as an individual’s self-efficacy differs
Overview
Social support is support accessible to an individual through social ties to other individuals, groups, and the larger community that may influence a person’s ability to cope with a problem or to practice a behavior. Social support measures can be functional or structural. Structural measures describe the existence of social relationships (e.g., marital status) and social networks. Functional measures describe the actual function served by social network members, such as the provision of advice, care, or practical help. Functional social support can be categorized as emotional,
Overview
Caregiving is time-consuming and many caregivers worldwide are overburdened and time-stressed. Interventions to improve child nutrition and family well-being often require the time of caregivers—to participate and to practice recommended behaviors. It’s essential to consider whether caregivers have (and perceive that they have) sufficient time to respond to interventions, and to avoid adding to caregivers’ time burden in ways that can negatively affect caregiver well-being and ability to provide nurturing care.
As well as actual time demands or workload, time sufficiency involves