Time and Money: Extending Fathers’ Role in Economically Challenging Contexts

* Abbreviation: LMIC — : low- and middle-income countriesThe discipline of pediatrics focuses on ways to optimize the health and development of children. Increasingly this entails engaging parents, which historically has meant mothers. However, as evidenced by the recent 2016 American Academy of Pediatrics Clinical Report,1 father contributions are becoming better understood and appreciated. With evidence pointing solidly to the benefits of paternal involvement for early child development in high-income countries, in this issue of Pediatrics , Jeong et al set out to describe the prevalence of paternal stimulation in 38 low- and middle-income countries (LMIC) among children <5 years old and showed that it relates positively to the Early Childhood Development Index, which measures early child development in literacy/numeracy, physical, social-emotional, and learning contexts.2 The effect sizes of high paternal stimulation were similar in magnitude to those of mother completing primary school and an increase in wealth that delivers the family out of the poorest quintile. Furthermore, the associations between paternal stimulation and Early Childhood Development Index were more pronounced for children receiving less stimulation from others (mother or education professionals).Unfortunately, only 6% of primary caregivers reported high paternal engagement levels, and 48% of … Address correspondence to Craig Garfield, MD, MAPP, Feinberg School of Medicine, 633 St. Clair, Suite 19-059, Chicago, IL 60611. E-mail: c-garfield{at}northwestern.edu