Newborn parenting education in primary healthcare settings of Pakistan and Afghanistan: impact on confidence and interactions

Responsive caregiving (RC) during early years is essential for a child’s physical, cognitive, and socio-emotional growth, which strengthens the Parent-Child relationship. Healthcare settings can serve as a hub for promoting and scaling up responsive caregiving among parents. This study aimed to explore the impact of early childhood newborn-responsive parenting education on parental confidence and newborn-responsive interaction implemented in a healthcare setting. This sequential mixed-method arm of the study was part of broader implementation research. A total of 423 participants (324 from Pakistan and 99 from Afghanistan) from six field sites (4 in Pakistan and 2 in Afghanistan) were recruited using convenience sampling. Two fields in Pakistan and 1 in Afghanistan were assigned to the control group, and the same number were assigned to the intervention group. Data were collected using a basic demographics questionnaire, the WHO QoL scale, the Karitane Parenting Confidence Scale, and the ECD PREP newborn responsive interaction scale. Quantitative data were analyzed using SPSS, and qualitative interviews were manually analyzed. Findings showed a significant difference between intervention and control groups on parenting confidence, 34.57 ± 6.44 vs. 32.52 ± 6.3 (2.05, p < 0.001). and Newborn (NB) responsive interaction 17.89 ± 2.32 vs. 15.37 ± 4.33, with the mean difference of (2.52, p < 0.001). Parents found the intervention beneficial in terms of providing responsive parenting and developing strong parent-child attachment. Similarly, HCPs also agreed that this program enhances their skills and knowledge in responsive caregiving. The findings indicate that a continuous structured parenting education intervention in healthcare settings can improve parental practices, which can contribute to optimal child development. Therefore, this emphasizes the need for integration of parenting education programs in all levels of healthcare settings.