Evaluating the impact of support services on health and behavioral outcomes among adolescent mothers and their children in Mexico and Chile
- Author(s): Kagawa, Rose
- Advisor(s): Fernald, Lia CH
- et al.
Globally, 16 million children, about 11% of all births, are born to women aged 15 to 19 each year. Young mothers and their children bear a heavier burden of poor health and social outcomes compared to families in which the mother began childbearing later in life. The majority of teenage births occur in low- and middle-income countries. However, most research on interventions to improve outcomes among teenage mothers and their children is completed in high-income, Western countries. The social, economic and cultural contexts surrounding adolescent pregnancy and parenthood vary widely across countries. As a result, it is important to assess whether programs and policies that appear effective in high-income, Western countries maintain their effectiveness in other settings, where the majority of early childbearing occurs.
The goal of this dissertation is to identify programs and policies that improve outcomes for adolescent mothers and their children. The first paper explores what it means to be an adolescent mother in rural Mexico by comparing indicators of socioeconomic status, maternal wellbeing and parenting practices of adolescent and older mothers, documenting social perceptions of young motherhood, and understanding young mothers’ perceptions of motherhood using quantitative and qualitative methods. The second paper uses a cluster-randomized controlled trial of a parenting education program, Educación Inical, in Mexico to assess whether the estimated effect of the parenting program on parenting behaviors and child cognitive development varies by the age at which the mother began childbearing. The final paper explores the association between having a child in center-based child care and parenting stress and child behavior among adolescent mothers and their children in Chile.
The studies presented here find no evidence of improved outcomes among adolescent parents or their children of a parenting education program or center-based child care support. As such, interventions that have shown promise in Western countries and among populations not limited by age at first birth may not be easily transferable to young mothers in other settings. This research highlights an important gap in understanding how best to support adolescent mothers and their children. These studies also point to the need for research that clarifies adolescent mothers’ sources of adversity and opportunity in varying cultural, social and economic settings in order to appropriately target programs and policies. Additionally, it is critical that research on the impact of programs and policies that are hypothesized to improve outcomes for adolescent mothers and their children take place in locations where the majority of adolescent pregnancy and parenting occurs. Understanding what works to improve outcomes for adolescent mothers and their children across a range of contexts is necessary to meet the needs of millions of families who reside outside of where the evidence base has traditionally focused.