Page 408 - HIVMED_v21_i1.indb

Page 8 of 13 Original Research

pre-intervention. After the introduction of the intervention In total, 276 (98.6%) mothers responded that they would
doll, almost all mothers reported that their child had played like more educational storybooks. In response to the
with the doll (n = 270; 96.4%). Most mothers reported that question of what topic they would like for future books, 281
since receiving the doll they had played with their child more mothers gave 363 suggestions, excluding ‘missing’ or ‘not
(n = 264; 94.3%). In relation to whether the doll helped foster applicable’ responses. These topics were coded and grouped
mother–child communication, mothers reported that the doll into three main categories and further broken down into
had helped them listen to their child more (n = 262; 93.6%), three sub-categories: ‘HIV and disease management’ (HIV
and to know when their child was worried (n = 256; 91.4%), and TB education and caregiving/disclosure/stigma);
or happy or excited (n = 257; 91.8%). Encouragingly, the doll ‘General health, safety and health promotion’ (health
was equally popular with both boy and girl children as no education/health promotion/sex education); and ‘Family,
gender differences were observed (p > 0.05). moral development and aspirations for the future’
(aspirations and family values/morals and social norms/
TABLE 2: Cross tabulation of parental talks on challenging topics with the use of parenting skills).
the ‘Disclosurs Hand’.
Discussion outcome Frequency Total
Boy (n = 141) Girl (n = 140) (n = 281) Table 3 shows categories of story book topics suggested by
n % n % n the mothers. The most popular topics amongst mothers
Risks of bullying from friends were those relating to ‘Family, moral development and
Did not talk before, talked during 81 57.4 69 49.3 150 aspirations’. Mothers expressed interest in learning
Talked before and talked during 54 38.3 67 47.9 121 parenting skills with topics such as ‘how to have a good
Did not talk before or during 4 2.8 3 2.1 7 relationship with children’, ‘raising children and how to
Missing 2 1.4 1 0.7 3 treat children’ and ‘talk about love as a parent’ being
Teache-child problems
Did not talk before, talked during 74 52.5 68 48.6 142 requested for future books. The second most requested
Talked before and talked during 54 38.3 64 45.7 118 category comprised topics related to ‘General health, safety
Did not talk before or during 11 7.8 7 5,0 15 and health promotion’. In this category, requests for books
Missing 2 1.4 1 0.7 3 covering health and sex education were prominent with
Physical Abuse* examples, including ‘what to do when you are sick…’,
Did not talk before, talked during 80 56.7 67 47.9 147 ‘learn about drug abuse’, ‘child abuse and rights’, ‘sexually
Talked before and talked during 50† 35.5 69† 49.3 119 transmitted diseases’ and ‘encouraging children to talk
Did not talk before or during 9 6,4 3 2.1 12
Missing 2 1.4 1 0.7 3 when they are abused’. The category with the least counts
Sexual Abuse** was ‘HIV and disease management’, which covered topics
Did not talk before, talked during 68 48.2 58 41.4 126 related to the aetiology, prevention and treatment of HIV/
Talked before and talked during 49† 34.8 72† 51.4 121 TB, maternal and family disclosure, and stigma surrounding
Did not talk before or during 21† 14,9 8† 5.7 29 illness, with parents’ requests ranging from ‘how HIV is
Missing 3 2.1 2 1.4 5 transmitted to babies’, ‘more about disclosing in the family’
†, Significant adjusted standardised residuals. and ‘any topics related to not stigmatising someone else’.
*, p < 0.05, **, p < 0.01.

TABLE 3: Maternal suggestions for additional story book topics for the family.
Categories†,‡ First responses only (n = 281) All responses (n = 375) Z( p)
n % n %
Category 1: ‘HIV and disease management’ 67/281 23.8 79/375 21.1 Z = 1.39
p = 0.16
HIV/TB education and caregiving 61 91.0 73 92.4
Disclosure 2 3.0 2 2.5
Stigma 4 6.0 4 5.1
Category 2: ‘General health, safety and health promotion’ 92/281 32.7 112/375 29.9 Z = 1.56
p = 0.12
Health education 36 39.1 39 34.8
Health promotion 22 23.9 23 20.5
Sex education 34 37.0 50 44.6
Category 3: ‘Family, moral development and aspirations for the future’ 99/281 35.2 161/375 42.9 Z = 1.81
p = 0.07
Aspirations and family values 36 36.4 55 34.2
Morals/social norms 55 55.6 89 55.3
Parenting skills 8 8.1 17 10.6
No specified topic§ 11/281 3.9 11/375 2.9
Not applicable 2/281 0.8 2/375 0.5
Missing 10/281 3.6 10/375 2.7
†, Refer to Appendix 1 for a more comprehensive table which includes example quotations.
‡, Some mothers gave more than one response, so their first response is recorded as first responses only and all responses refer to the suggested topics without accounting for order.
§, Stand-alone topic requests that could not be included in any of the other categories.

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