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Trial Lecture – time and place
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Adjudication committee
- First opponent: Lecturer Robert Fungo, Makerere University, Uganda
- Second opponent: Professor Dawit Shawel Abebe, OsloMet - Oslo Metropolitan University, Norway
- Third member and chair of the evaluation committee: Associate professor Anette Ramm-Pettersen, University of Oslo
Chair of the Defence
Professor Geir Selbæk, University of Oslo
Principal Supervisor
Associate Professor Prudence Atukunda, University of Bergen
Summary
Early childhood represents a pivotal phase for cognitive, emotional, and physical development. However, children residing in low-resource rural environments face an elevated risk of undernutrition and associated developmental delays. Few studies have examined whether maternal education interventions can produce long-term benefits for child development and maternal mental health.
The aim of this thesis was to assess the long-term effects of a maternal education intervention on child development (cognition and attention) eight years later, identify early-life predictors of developmental outcomes, and evaluate maternal depressive symptoms six years after the intervention.
The original CHNUDEV trial was a cluster-randomized controlled study conducted in rural southwestern Uganda between 2013 and 2014, enrolling 511 mother-child pairs. The intervention provided education sessions on nutrition, hygiene, oral health, and child stimulation when children were 6-8 months old. Follow-up assessments were conducted at six and eight years post-intervention. Child cognition and attention were measured using the Kaufman Assessment Battery for Children, Second Edition and the Test of Variables of Attention. Maternal depressive symptoms were assessed using the Beck Depression Inventory-II and the Center for Epidemiological Studies Depression Scale.
Children in the intervention group had significantly higher scores on short-term memory, visual processing, fluid reasoning, and overall cognitive ability compared to children in the control group. Intervention group children also showed better attention performance. Baseline factors such as maternal education, child sex, and nutritional and developmental status were significantly associated with cognitive outcomes at eight years. Mothers in the intervention group reported fewer depressive symptoms at six years, although differences were borderline statistically significant.
Overall, the study demonstrates that a low-cost maternal education intervention can lead to sustained improvements in child development and may support better maternal mental health in low-resource settings. These findings highlight the value of integrating nutrition, hygiene, and child stimulation education into community based health programs to promote long-term benefits for both children and caregivers.
Additional information
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