A Pilot Study of a 6-Week Parenting Program for Mothers of Pre-school Children Attending Family Health Centers in Karachi, Pakistan Yasmin Khowaja 1* , Rozina Karmaliani 1,2 , Shela Hirani 1 , Asif Raza Khowaja 3 , Ghazala Rafique 2 , Judith McFarlane 4 Abstract Background: Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-school children attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan. Methods: A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control) participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS) was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants’ attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups. Results: A total of 50 mothers (n = 25 intervention; n = 25 control) completed the 6-week program. Attrition was observed as 5/30 (17%) in the intervention arm and 2/27 (2%) in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over-reactivity. Conclusion: Parenting programs can be implemented for mothers attending FHCs in Pakistan. Mothers require positive reinforcement and constant encouragement at the participant level. Integrating such programs into primary healthcare at the population level has the potential to maximize child health benefits and to improve parenting skills at the country level. Keywords: Parenting Program, Child Maltreatment, Child Abuse, Education for Mothers Copyright: © 2016 by Kerman University of Medical Sciences Citation: Khowaja Y, Karmaliani R, Hirani S, Khowaja AR, Rafique G, McFarlane J. A pilot study of a 6-week parenting program for mothers of pre-school children attending family health centers in Karachi, Pakistan. Int J Health Policy Manag. 2016;5(2):91–97. doi:10.15171/ijhpm.2015.181 *Correspondence to: Yasmin Khowaja Email: ysak6@hotmail.com Article History: Received: 9 March 2015 Accepted: 1 October 2015 ePublished: 11 October 2015 Original Article Full list of authors’ afiliations is available at the end of the article. htp://ijhpm.com Int J Health Policy Manag 2016, 5(2), 91–97 doi 10.15171/ijhpm.2015.181 Implications for policy makers This study suggested implications for primary health practice, research, and policy for integrating parenting programs into health service delivery in Pakistan. • Sensitizing healthcare providers to the importance of parenting education could ultimately lead to better-designed maternal and child health promotion programs at the community level. The benefits of parenting classes, specifically in terms of the positive outcomes for mothers and children, need to be communicated to frontline healthcare providers working at primary health centres, such as medical doctors and paramedics. • Parenting education could be integrated into community-based programs by involving outreach community care providers. Primary health centres could potentially bridge the service-delivery gap for acute child behavioural problems or disorders by involving community care providers. For example, Lady Health Workers of the National Program are already providing basic preventive maternal and child health services, and could potentially be engaged in parenting education programs. • Further research is needed to understand the implications of policy to streamline parenting programs as part of primary healthcare delivery. Very limited knowledge is currently available and more is needed on issues such as system-capacity and healthcare providers’ willingness to participate. • Partnering with the media could strengthen arguments for introducing parenting education into the service-delivery model of healthcare by providing a voice to unheard people with stories of child abuse and maltreatment. Implications for public This study demonstrated the feasibility of offering parenting programs for mothers in 2 communities in Pakistan. Such programs provide mothers with an opportunity to learn a new set of skills, and contribute to healthy childcare practices at home and in the community. The positive parenting has the potential to improve one’s overall quality of life and to reduce behavioural problems/disorders in children. Furthermore, effective parenting improves cognitive and intellectual capabilities of young children, which ultimately results in high academic and professional performance in later years of life. Key Messages