Objective: To find out fathers’ involvement in the treatment of growth disorders.
Methods: The systematic review comprised search on Scopus, CINAHL, ScienceDirect, SpringerLink, ProQuest and Google Scholar databases for studies published in English language between January 2017 and March 2022 and described fathers’ roles in handling stunting in children. The keywords used along with Boolean operators included father, paternal, involvement, engagement, role, stunting, and growth disorder. The studies shortlisted were subjected to charting and narrative analyses.
Results: Of the 699 studies initially found, 13(1.85%) were analysed in detail. Four factors identified were economic support, instrumental support, nurturing the children, and health risk behaviour. Strategies to increase fathers’ involvement related to internal and external barriers.
Conclusion: Fathers’ role is crucial in handling growth disorder in children. Growth disorder management strategies need to involve fathers and mothers by considering the identified barriers and potential facilitators.
Keywords: Child, Mothers, Gender, Health risk, Nutrition. (JPMA 73: S-158 [Suppl. 2]; 2023)
Stunting is a worldwide problem and commonly implies poor parental functioning.1 Stunting is an impaired growth condition in children’s body and brain due to prolonged malnutrition.2 Stunted children grow to inadequate height in relation to their age which affects the brain accordingly so that their cognitive potential is not accomplished.
Indonesia was ranked third in terms of prevalence of stunting in the South-East Asia Region (SEAR).3 The Ministry of Health Republic of Indonesia (MoHRI) in 2018 stated that stunting in children aged 12-59 months in Indonesia in 2013 was 37.2%, whereas in 2018 it was 30.8%.3
Studies have identified significant association of the role of parental functioning.1 family factors4 and maternal roles5 with growth disorder in children aged <5. Parental functioning is essential for children’s development and growth along with their knowledge.6 Father’s involvement promotes positive health behaviour in the family context7 but a comprehensive review of father’s involvement in handling growth disorder has not been conducted. The current systematic review was planned to fill the gap by exploring fathers’ involvement in the treatment of growth disorders in children aged <5.
Materials and Methods
The systematic review comprised search on Scopus, CINAHL, ScienceDirect, SpringerLink, ProQuest and Google Scholar databases for studies published in English language between January 2017 and March 2022 and described fathers’ roles in handling stunting in children. The review used narrative synthesis and was done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines8. The key words used were growth disorder, stunting, father’s role, and children under five.
Data related to authors, year of study, participants, study design, methods and results was extracted from each study. Quality assessment was done using the Critical Appraisal Skills Programme (CASP) checklist to assess the risk of bias in the studies analysed.
Of the 699 studies initially found, 13(1.85%) were analysed in detail (Figure).2,9-20
There were 11(84.6%) cross-sectional studies, while 1(7.7%) study each had a qualitative and retrospective quantitative design. Further, 5(38.4%) studies had been conducted in Indonesia, 2(15.4%) each in India and Bangladesh, and 1(7.7%) each in Kyrgyzstan, Madagascar, Ethiopia, and Myanmar (Table).
Fathers’ involvement in knowledge about preventing growth disorder was a key factor.10,13,18,19 The informal and formal social networks of fathers could reduce health hardships.10 Fathers’ engagement in developmentally-supportive stimulation could prevent stunting in children14 and their capability to care for the family15 as well as their attitude towards gender-equality were critical factors.9 Fathers’ health behaviour, such as smoking, could increase the risk of stunting in children.12,16 Fathers with low occupational status improved caretaker capacity, improved parenting skills, integrated community development, and decreased domestic violence and gender discrimination.21
The finding that fathers’ attitude toward gender equality may in a key factor in terms of family’s overall nutrition, health and education pattern9 is in line with a previous study.22
Fathers’ roles as caregivers, educators, supervisors, disciplinarians, protectors, and supporters significantly influence the prevalence and prevention of stunting. Fathers’ involvement in nurturing and raising the child with the mothers as a shared responsibility could increase fathers’ engagement in the relevant activities.
Fathers’ health behaviour, such as smoking, consumes a significant proportion of their incomes which could be better utilised in managing nutritious food for the family, especially the children growing up.23 Fathers’ smoking behaviour has been associated with stunting in children.24
Fathers should be targeted along with mothers during health education sessions related to prevention of stunting and growth disorders.
Limitation: The current review was not registered with the international prospective register of systematic reviews PROSPERO).
Acknowledgment: We are grateful to the Faculty of Nursing, Universitas Jember, for facilitating the research.
Conflict of Interest: None
Source of Funding: None.
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