Maternal Mental Health and Its Influence on Children’s Early Development : Evidence from Khyber Pakhtunkhwa, Pakistan

This paper reports on the prevalence of three facets of mental health—depression, anxiety, and parenting stress—among mothers of children ages 0–6 years in Khyber Pakhtunkhwa, Pakistan. Data from mother-child dyads were analyzed to examine differences in maternal mental health and early childhood development outcomes by maternal educational attainment, urban versus rural setting, and refugee versus non-refugee status. The analysis finds a higher prevalence of self-reported mental health concerns among refugee, less-educated, and rural mothers relative to non-refugee, more-educated, and urban mothers. Maternal mental health concerns are significantly associated with lower levels of early childhood development. This paper also analyzes how exposure to stressors such as food insecurity, financial insecurity, being impacted by flooding, community crime, discrimination, and domestic violence exacerbate both maternal mental health and child outcomes. The regression analyses indicate a significant and negative compounding interaction of maternal depression, anxiety, and parenting stress on early childhood development for younger (0–3 years) and older (3–6 years) children, even after controlling for stressors and other covariates. Policy improvements are needed that focus on at-risk communities, providing mental health services and reducing exposure to stressors within communities and households.