Charles M. Super

The developmental niche: A theoretical framework for analyzing the household production of health

Recent efforts to promote child survival and development internationally have focused new attention on the importance of the household as a mediator of both environmental risks and programmatic interventions to promote better health. In this paper, we introduce a theoretical framework, the developmental niche, derived from studies of childrens behavior and development in different cultural contexts, as a tool for analyzing the household production of health. The developmental niche is conceptualized in terms of three basic components: (1) the physical and social settings of the childs everyday life; (2) culturally regulated customs of child care and child rearing; and (3) the psychology of the caretakers. The relevance of each of these components to the household production of health is illustrated through examples from research in several cultures, including Malaysia, Kenya, Bangladesh, India, and the U.S. Further discussion centers on three corollaries of the developmental niche framework that point to the interactive relationships among the three components, between the niche and the larger environment, and between the niche and the child (or any individual seen from a developmental perspective). It is suggested that this approach is useful for identifying and collecting relevant information on household-level factors that affect health outcomes, and thus for organizing more effective interventions. At a theoretical level, the developmental niche framework also facilitates understanding processes of mutual adaptation between the individual and the environment as they are filtered through the constraints of household settings, customs and caretaker psychologies.

A longitudinal study of the impact of behavioural change intervention on cleanliness, diarrhoeal morbidity and growth of children in rural Bangladesh

A community-based intervention was developed through direct participation of the target population in assessment and iterative trials to improve hygiene practices and to reduce childhood diarrhoea in lowland rural Bangladesh. A total of 185 (98%) households with children ages 0-18 months in five contiguous villages were targeted for the interventions. A comparison site was selected for a detailed observational study and for use as a control for the intervention. About 97% of all households with children ages 0-18 months were enrolled for study at the control site. Children in this age group were targeted because at this developmental stage they were most vulnerable to diarrhoeal morbidity and malnutrition (related to unhygienic practices). The intervention was implemented with the assistance of village leaders through a Clean Life campaign by local project workers and volunteer mothers who were chosen from the target households. The intervention activities started in January 1986 and lasted for 7 months. Higher adoption rates of the intervention were associated with better cleanliness status, which was related to lower diarrhoea and malnutrition rates in the intervention site. The results of between-site longitudinal analyses showed that after the intervention, the intervention site had substantially higher cleanliness scores, lower diarrhoeal morbidity, and better growth status compared to those of the control site, with differences increasing over time. The findings suggest that this type of community-based intervention can be very beneficial in modifying hygiene behaviours and lowering childhood diarrhoea and malnutrition.

Child-Environment Interactions in the Socialization of Affect

Research on the universality of facial expressions (Ekman, 1972) suggests that the socialization of affect involves interactions between situational variables and a finite repertoire of human emotions whose meanings are at least roughly synonymous among all members of the species. At the same time, Izard’s formulation (1978) of “affective-cognitive structures” shows that emotions are in reality not separable from the particular circumstances that are associated with them. The fact that it is possible to construct a list of “basic,” universally recognizable emotions derives not only from a species-specific repertoire of facial expressions, but perhaps more fundamentally from a larger set of human expressive behaviors, including laughter and crying as well as bodily movements and postures. These behaviors, for which a universal capacity exists, are also, without exception, carried out in particular circumstances. As elements in the human communicative function, they create the necessity of response from the environment while also being shaped by it. To use Lewis’s terms the contextual reality of emotional expression transforms “state” into “experience.”

Community-based trial and ethnographic techniques for the development of hygiene intervention in rural bangladesh.

Community-based three-stage iterative trials were performed to develop interventions for improving hygiene practices to reduce childhood diarrhea in rural Bangladesh. Ethnographic techniques were used to identify practices associated with diarrhea, to understand cultural beliefs and reasoning related to causes of diarrhea, and to tap community resources. Hygiene behaviors and products designed through in-home problem diagnosis went through trials sequentially at three socio-economic levels consisting of ten educated project workers, twenty-five volunteer mothers and twenty-five very low- income mothers. These levels, chosen in order to meet the needs of all including the poorest, permitted new practices which proved feasible in the workers trial to be then tried by the volunteers. The results were synthesized, with successful behavioral advice translated into simple verbal messages created to resemble locally popular proverbs, poems and folk songs. The messages and products were finalized after pretesting and revision among the very low-income group of mothers. Evaluation of the community-wide campaign showed very high rates of adoption (85%–95%) of the interventions. The involvement of target groups and their opinion leaders in the intervention development process contributed to the sense of ownership reflected in the high rate of adoption. Program organizers comprehensive understanding of practices associated with diarrhea and its cultural context, and the communitys empowerment to find local solutions are both critical to the success of such interventions.

Child care and infectious respiratory disease during the first two years of life in a rural Kenyan community

Recent research in the U.S. has demonstrated the health risks accompanying the increase in use of day care centers for infants and young children, a trend that reflects large-scale social and economic changes. The present study reports increased risk of respiratory disease in rural Kenyan children, resulting from increased exposure to unrelated young children. The shift in risk patterns accompanies sociocultural and economic trends during the 1970s: maternal participation in work groups for cash cropping and increased school attendance by other family members. Thus as in the American case, participation in modern patterns of household economics significantly influences the pattern of illness for infants and young children.

Fertility Change, Child Survival, and Child Development: Observations on a Rural Kenyan Community

Social change over the last century has had varied and dramatic effects not only on populations as a whole, but also on the survival and growth of individual children. On the one hand, improvements in medical technology and health care have reduced death rates, which in developing countries are particularly high for infants and young children. On the other hand, changes in habitat — for example from rural to urban — have had less uniformly positive effects on the environments of children and their families.