# Kinship, Nuptiality and Child Health Outcomes in a Low Income Urban Area

> **NIH NIH R01** · UNIV OF MARYLAND, COLLEGE PARK · 2022 · $508,066

## Abstract

Project Summary
Despite significant progress in improving child survival, sub-Saharan Africa continues to have some of the
worst outcomes for children’s physical growth and early childhood development. This is driven in large part by
elevated risks for children living in low-income urban communities. Whereas research has focused on
environmental factors, socioeconomic status and access to services, much less effort have gone into
understanding how rapid social transformation in marriage and the role of kin impacts children’s well-being in
these communities. In this project, we build on the success of an NICHD R21 project to develop and test the
Kinship Support Tree (KST) to assess quantity and quality of support from kin to single mothers and their
children in a slum context in Nairobi, Kenya. The proposed mixed methods, the longitudinal study develops a
new measure of union formalization to examine the relationships among kinship support, union formalization
and infant/child development outcomes. The union formalization measure will capture the process of
recognizing unions socially and/or legally. The study will be carried out in the same site as the KST project.
The site hosts a Health and Demographic Surveillance System (HDSS) which facilitates initial sample selection
and provides strong infrastructure. We will conduct rigorous cognitive testing to finalize the questions on union
formalization, validate existing relationship quality scales and pretest all instruments in the first year to inform
the survey development. We will then start with 1250 children ages 0 – 24 months with mothers aged 18-29
and collect data on the children, mothers and selected kin two times per year over 3 years. Data on kin include
geospatial indicators of residence and distance and multiple domains of kinship support. This will be
supplemented with qualitative follow up once a year on a subsample of mothers, biological fathers, and current
partners. Our analysis will focus on the direct effects of union formalization and kinship support on child
outcomes as well as on a set of intermediate outcomes known to be associated with child development. We
will use cross-lagged structural equation and growth models to examine the effects of union formalization and
kinship support on children’s physical growth and early child development (ECD) over time. We will also
assess the extent to which union formalization moderates the effect of kinship support on physical growth and
ECD outcomes and kinship support mediates the effect of union formalization on physical growth and ECD
outcomes. We will use moderated mediation models to accomplish this. The ultimate goal of the study is to
identify models of family support that offer optimum protection for vulnerable mothers and young children.

## Key facts

- **NIH application ID:** 10447168
- **Project number:** 5R01HD101613-03
- **Recipient organization:** UNIV OF MARYLAND, COLLEGE PARK
- **Principal Investigator:** Sangeetha Madhavan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $508,066
- **Award type:** 5
- **Project period:** 2020-09-19 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10447168

## Citation

> US National Institutes of Health, RePORTER application 10447168, Kinship, Nuptiality and Child Health Outcomes in a Low Income Urban Area (5R01HD101613-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10447168. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*