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Yousafzai, Aisha

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Yousafzai

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Aisha

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Yousafzai, Aisha
Author's Publications: search.filters.isAuthorOfPublication.4238de91-082c-4fe2-965b-70958337b35f

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    Effect of a Center-Based Early Childhood Care and Education Program on Child Nutritional Status: A Secondary Analysis of a Stepped-Wedge Cluster Randomized Controlled Trial in Rural Sindh, Pakistan
    (Elsevier BV, 2023-12) Ali, Nazia Binte; Yousafzai, Aisha; Siyal, Saima; Bhamani, Shelina; Sudfeld, Christopher
    Background: High-quality early childhood care and education (ECCE) programs can positively impact children's development. However, as an unintended consequence, ECCE attendance may also affect children's nutritional status. Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan. Methods: This study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5-5.5 years (LEAPS program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in three steps, and repeated cross-sectional surveys were conducted to assess the impact on children (4.5-5.5 years old) at four time points. Intention-to-treat analyses with multi-level mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes. Results: The analysis included 3,858 children with anthropometric data from four cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child HAZ (mean difference: 0.13 z-scores; 95% confidence interval (CI): 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, -0.29 WHZ (95% CI: -0.42, -0.15), -0.13 BMIZ (95% CI: -0.23, -0.03), and -0.16 MUACZ (95% CI: -0.25, -0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and WAZ was greater in the survey round during the COVID-19 lockdown. Discussion: The LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (e.g., school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development.
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    “His Mind Will Work Better With Both of Us”: A Qualitative Study on Fathers’ Roles and Coparenting of Young Children in Rural Pakistan
    (BMC, 2018-11-20) Jeong, Joshua; Siyal, Salma; Fink, Günther; Mccoy, Dana; Yousafzai, Aisha
    Background Parents are the primary providers of nurturing care for young children’s healthy early development. However, the literature on parenting in early childhood, especially in low- and middle-income countries, has primarily focused on mothers. In this study, we investigate how parents make meaning of fathers’ parenting roles with regards to their young children’s early health and development in rural Pakistan. Methods Data were collected between January and March 2017 through in-depth interviews with fathers (N = 33) and their partners (N = 32); as well as separate focus group discussions with fathers (N = 7) and mothers (N = 7). Data were analyzed using thematic content analysis. Results Parents described a distinct division of roles between fathers and mothers; and also several shared caregiving roles of fathers and mothers. Specifically, parents highlighted aspects of fathers’ coparenting and several common ways by which fathers supported their partners. We found that these gendered divisions in parenting roles were strongly embedded within a complex network of interacting factors across the individual, family, and sociocultural contexts of the study community. Conclusions Our findings suggest a more family-centered conceptualization of fatherhood during early childhood that encompasses both fathers’ direct engagement with their young children and their indirect contributions through coparenting, while recognizing a variety of contextual systems that shape paternal parenting. Future parenting interventions that reflect the lived experiences of both fathers and mothers as parents and partners may further enhance the nurturing care environments that are critical for promoting healthy early child development.