Characterising Maternal Sensitivity in a High Risk, Peri-urban LMIC Context: The Drakenstein Child Health Study

A prolific amount of data regarding maternal sensitivity and child development outcomes comes from high income, industrialised western contexts. Sparse attention has been paid to characterising patterns or unique expressions of sensitivity as an independent topic of study globally with a glaring dearth of comparative data from LMICs including sub-Saharan Africa. We aimed to detail maternal sensitivity within the dyadic interaction between mother and her 42-month-old child (n = 130) in a peri-urban low socioeconomic context as part of the Drakenstein Child Health Study. Ten-minute videoed interactions were coded using the Emotional Availability Scale. We found no report of psychometric properties and applicability of the EA in our context, therefore confirmatory followed by exploratory factor analysis on the four maternal subscales was conducted. EFA using scree plot and parallel analysis extracted a 3 factor model that better fit our data than the original four. Factor 1-Sensitive Engagement, Factor 2-Non-Hostile Supportive Engagement and Factor 3-Non-Intrusive Engagement aligned theoretically with the original maternal subscales. The new Sensitive Engagement subscale accounted for 25% cohort variance and mothers showed varied distribution over five categories ranging from Highly Sensitive to Highly Insensitive. Cumulatively, 59% of total variance is explained by 3 factors - Factor 2-22% and Factor 3-12%. Significantly, our cohort shows remarkably resilient sensitivity patterns and behaviours considering the extremely harsh and challenging environments in which they must raise children.