Gaps in Maternal Behavior, Family Support, and Early Childhood Education Participation in the Development of Children Under Five Years: A Stratified Analysis of Urban vs. Rural Settings
DOI:
https://doi.org/10.26911/thejhpb.2026.11.02.01Abstract
Background: The intensity and quality of developmental stimulation provided by mothers, families, and the early childhood education environment determine the developmental outcomes of children under five years of age. Place of residence influences the cultural practices surrounding child-rearing, access to healthcare services, and the availability of facilities that support child development. This study aims to examine maternal stimulation behaviors, family support, and participation in early childhood education on child development based on place of residence (urban vs. rural).
Subjects and Method: A cross-sectional study was conducted involving 200 respondents in urban areas and 200 in rural areas. Respondents consisted of mother-child pairs with children under five years of age, selected according to predetermined criteria. Data were measured using questionnaires and observation sheets (DDST II). Stratified tests were performed using STATA 13 software.
Results: In the rural group, positive maternal behavior and family support were significantly associated with improved developmental outcomes for children under five years of age (RR 1.94; 95%CI 1.31 to 2.87; p = 0.001 and RR 1.47; 95%CI 1.17 to 1.867; p = 0.001), while non-significant associations were found in the urban group (p = 0.256 and p = 0.069). In the urban group, children's participation in early childhood education programs was significantly associated with more optimal developmental outcomes (RR 1.59; 95%CI 1.04 to 2.43; p = 0.033), whereas a non-significant association was observed in the rural group (p = 0.546).
Conclusion: The factor of place of residence determines differences in maternal behavior, family support, and participation in early childhood education regarding child development. Health promotion intervention research aimed at enhancing maternal behavior and family support for child development needs to be designed with different methodologies based on the residential area.
Keywords:
maternal behavior, family support, early childhood education, developmental stimulation, children under fiveHow to Cite
References
Afiq M, Zafar M (2025). Impact of mother’s mass media exposure on early child-hood development in pakistan: urban vs. rural analysis. BMC Public Health. 25(1): 3747. https://doi.org/10.1186-/s12889-025-24586-z.
Brinkman SA, Hasan A, Jung H, Kinnell A, Nakajima N, Pradhan M (2017). The role of preschool quality in promoting child development: evidence from rural Indonesia. Early Child Educ Res J. 25(4): 483–505. https://doi.org/ 10.1080/1350293X.2017.1331062.
Brinkman SA, Hasan A, Jung H, Kinnell A, Pradhan M (2017). The impact of expanding access to early childhood education services in rural Indonesia. J Labor Econ. 35(S1): S305–S335. https://doi.org/10.1086/691278.
Clark H, Coll-Seck AM, Banerjee A, Peterson S, Dalglish SL, Ameratunga S, Balabanova D, et al. (2020). A future for the world’s children? a WHO–UNICEF–Lancet Commission. Lancet. 395(10224): 605–658. https://doi.¬org/10.1016/S0140-6736(19)32540-1.
Daelmans B, Manji SA, Raina N. (2021). Nurturing care for early childhood development: global perspective and guidance. Indian Pediatr. 58(1): 11–15. https://doi.org/10.1007/s13312-021-2349-5.
Emmers D, Jiang Q, Xue H, Zhang Y, Zhang Y, Zhao Y, Liu B, et al. (2021). Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis. BMJ Glob Health. 6(8): e005578. https://doi.org/10.1136/bmjgh-2021-005578.
Gil JDC, Ewerling F, Ferreira LZ, Barros AJD. (2020). Early childhood suspected developmental delay in 63 low-and middle-income countries: large within-and between-country inequalities documented using natio-nal health surveys. J Glob Health. 10(1): 010427. https://doi.org/10.7-189/jogh.10.010427.
Haslam D, Poniman C, Filus A, Sumargi A, Boediman L (2020). Parenting style, child emotion regulation and behavio¬ral problems: the moderating role of cultural values in Australia and Indo¬nesia. Marriage Fam Rev. 56(4): 320–342. https://doi.org/10.1080/01494-929.2020.1712573.
Hirve R, Adams C, Kelly CB, McAullay D, Hurt L, Edmond KM, Strobel N (2023). Effect of early childhood development interventions delivered by healthcare providers to improve cognitive outcomes in children at 0–36 months: a systematic review and meta-analysis. Arch Dis Child. 108(4): 247–257. https://doi.org/10.1136/¬archdischild-2022-324506.
Hollowell J, Belem M, Swigart T, Murray J, Hill Z. (2020). Age-related patterns of early childhood development practices amongst rural families in Burkina Faso: findings from a nationwide survey of mothers of children aged 0–3 years. Glob Health Action. 13(1): 1772560. https://doi.org/10.1080/16-549716.2020.1772560.
Indonesia's Ministry of Education and Culture. (2021). Statistics of Early Childhood Education (ECE) 2020/ 2021 (in Indonesian language). [internet]. Retrieved from https://-repositori.kemendikdasmen.go.id/22126/.
Indonesia's Ministry of Women's Empowerment and Child Protection (2021). Profile of Indonesian Children 2021 (in Indonesian langage). [internet]. Retrieved from https://-www.kemenpppa.go.id/buku/e-book-profil-anak-indonesia-tahun-2021.
Jensen SK, Placencio-Castro M, Murray SM, Brennan RT, Goshev S, Farrar J, Yousafzai A, et al. (2021). Effect of a home-visiting parenting program to promote early childhood development and prevent violence: a cluster-randomized trial in Rwanda. BMJ Glob Health. 6(1): e003508. https://-doi.org/10.1136/bmjgh-2020-0035-08.
Johnstone A, Martin A, Cordovil R, Fjørtoft I, Iivonen S, Jidovtseff B, Lopes F, et al. (2022). Nature-based early child-hood education and children’s social, emotional and cognitive development: a mixed-methods systematic review. Int J Environ Res Public Health. 19(10). https://doi.org¬/10.3390/ijer-ph19105967.
Kim EJ, Cho MJ, Kim MJ. (2021). Mothers’ parenting stress and neighborhood characteristics in early childhood (ages 0–4). Int J Environ Res Public Health. 18(5): 2648. https://doi.org/10.3390-/ijerph18052648.
Kuntoro IA, Peterson CC, Slaughter V. (2017). Culture, parenting, and children’s theory of mind development in Indonesia. J Cross Cult Psychol. 48(9): 1389–1409. https://doi.org/-10.1177/0022022117725404.
Ministry of Health of the Republic Indonesia (2022). Indonesia Health Profile 2021 (in Indonesian language). [internet].
Nakajima N, Hasan A, Jung H, Brinkman S, Pradhan M, Kinnell A. (2019). Invest¬ing in school readiness: a comparison of different early childhood education pathways in rural Indonesia. Int J Educ Dev. 69: 22–38. https://doi.org-/10.1016/j.ijedudev.2019.05.009.
Nursanti I, Murti B, Mulyani S. (2024). Information motivation behavior skills (IMB) model in predicting maternal behavior for healthy child develop¬ment. Malays J Med Health Sci. 20(6). https://doi.org/10.47836/mjmhs20.6.5.
Nursanti I, Murti B, Mulyani S. (2025). Modeling of maternal behavior to improve the development of children under five based on social cognitive theory (SCT) and the information-motivation-behavioral skills model (IMB). Soc Sci Humanit Open. 11: 101283. https://doi.org/10.1016/j.ssa-ho.2025.101283.
Puspitasari MD, Rahmadhony A, Prasetyo S, Fadila W (2020). Early childhood parenting practices in Indonesia. Popul Rev. 59(2). https://doi.org/10.-1353/prv.2020.0006.
Riany YE, Meredith P, Cuskelly M. (2017). Understanding the influence of tradi-tional cultural values on Indo¬nesian parenting. Marriage Fam Rev. 53(3): 207–226. https://doi.org/10.1080/0-1494929.2016.1157561.
Riyadi H, Khomsan A, Anwar F, Herawati T, Hernawati N, Rahma A, Diana R, et al. (2019). Nutrition education and psy¬chosocial stimulation improves child development in rural early childhood education in Indonesia. J Food Nutr Res. 7(10): 717–724. https://doi.org/¬10.12691/jfnr-7-10-5.
Saptarini I, Rizkianti A, Arfines PP, Maisya IB. (2021). Associations between parental depression and early child-hood development in Indonesia: a cross-sectional study. J Prev Med Public Health. 54(6): 451. https://doi.-org/10.3961/jpmph.21.158.
Sinani A, Vassi A, Tsotsokou G, Nikola-kopoulou M, Kouvelas ED, Mitsacos A. (2022). Early life stress influences basal ganglia dopamine receptors and novel object recognition of adolescent and adult rats. IBRO Neurosci Rep. 12: 342–354. https://doi.org/10.1016/j.-ibneur.2022.04.008.
World Health Organization. (2020). Improving early childhood develop-ment: WHO guideline. Geneva.
Wiswanti IU, Kuntoro IA, Rizqi NPA, Halim L. (2020). Pola asuh dan budaya: studi komparatif antara masyarakat urban dan masyarakat rural Indonesia. J Psikol Sos. 18(3): 211–223. https://-doi.org/10.7454/jps.2020.21.
