A critical evaluation of a community based mother-infant intervention project with special emphasis on infant attachment

Master Thesis

1999

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University of Cape Town

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This dissertation critically evaluates a community based mother-infant intervention project in Hanover Park, a deprived area of Cape Town, characterised by poverty, gangsterism and high levels of unemployment. The aim of the project was to assess the impact of an intervention programme in preventing child abuse and neglect and promoting more nurturing parent-child relationships. The sample was drawn from clinic records at the Hanover Park Mid-Obstetric Unit. Twenty-five mother-infant dyads were initially chosen based on high levels of stress and assigned to the intervention group. A control group was subsequently chosen, also drawn from clinic records as well as being matched with the intervention group. Subjects in the intervention group received weekly visits for a two-year period from family support workers, all of whom lived in Hanover Park. The intervention was based on the Healthy Start Programme as developed in Hawaii. A basic socio-demographic questionnaire was administered at the beginning of the project. Mothers were assessed for postnatal depression using the Edinburgh Postnatal . Depression Scale. Anthropometric data was collected throughout the project. At the end of the two-year intervention, infants were assessed using the Griffiths Scales of Mental Development and Ainsworth's Strange Situation. The results were statistically analysed for relationships and differences according to group. Findings revealed that there were no significant differences between the intervention group and the control group on any of the outcome measures. A trend was detected with the Strange Situation results and a power analysis was conducted in order to determine requisite sample size for significance to have been achieved. The result of this algorithm were that for significance to have been achieved (assuming the trend were to continue) a sample size of 74 in each group would have been required. A discussion is presented in terms of the implications of the findings for the utilisation of the Strange Situation measure in a diverse cultural context such as South Africa, as well as the broader cultural implications for the study of attachment in future studies. A detailed methodological and theoretical critique of the Hanover Park Project is also presented in order to glean important lessons for future intervention studies, and more particularly for a treatment-trial which is at present being conducted in Khayelitsha.
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Bibliography: leaves 61-88.

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