Commonalities in the paternal role within the family system across culturally diverse low- and middle-income countries

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While there are context- and culture-specific influences on fathering, existing literature highlights the considerable consistency regarding the child-centred approach to fathering evident across diverse contexts. This paper builds understanding of the commonalities in fathers’ roles in family systems in low- and middle-income countries (LMICs). Drawing directly on the perspectives of fathers and their family members, we highlight how the roles of fathers are shaped by factors within the family system and subsystems and the surrounding sociocultural context. Data collected during 69 co-design workshops conducted between 2021–2023 with a total of 255 parents and caregivers and 83 experts across 12 LMICs were analysed using a hybrid inductive/theoretical approach to thematic analysis guided by the principles of family systems theory. Three key themes were identified related to the paternal role: the father-family system, the father-mother subsystem, and the father-child subsystem. These themes encompassed five subthemes including fathering to provide and lead, fathering in an unbalanced system, fathering as a partner, fathering to play, and fathering to teach and transmit values. Traditional social norms placed on fathers are associated with an imbalance within the mother-father subsystem in relation to caregiving knowledge and experience, and more practically time and availability. Furthermore, systemic exclusion of fathers from parenting systems and services, and the lack of male caregiver role models, may act as enduring barriers to fathering. To encourage the active participation of fathers in caregiving, this paper proposes the development of inclusive childrearing programs and policies rooted in family systems theory. Humanities/Cultural and media studies Social science/Cultural and media studies Biological sciences/Psychology Social science/Psychology Figures Figure 1 Introduction In early childhood, fathers play an integral role in their child’s socioemotional, language, physical and cognitive development (Keown et al., 2018 ). Family systems theory emphasises that families operate as dynamic systems, consisting of both individuals and the relationships between these individuals, with each interaction operating as its own subsystem (Cox & Paley, 1997 ). A key principle of this theory is that intra-familial relationships are mutually interdependent, with family members exerting influences on one another through bidirectional, reciprocal or transactional patterns (Cox & Paley, 1997 ). This systemic perspective posits that a whole family cannot be understood without considering intra-relationships or “the effect of relationships on relationships” (Emde, 1988 , p. 354). As an example, it has been shown that sensitive and engaged fathers can buffer children from the adverse effects resulting from, for instance, maternal depression in early childhood (Vakrat et al., 2018 ). In this way, sensitive fathering supports harmonious family processes (Feldman, 2023 ). Furthermore, fathers make specific contributions to children’s resilience across developmental stages, fostering social competence and flexibility within relationships (Feldman, 2023 ). Given the emphasis on the inter-relatedness of individual components forming a family (i.e., “wholeness”) (Cox & Paley, 2003 ), it is critical to consider the roles of fathers within the family system and subsystems (e.g., father-child, father-mother) when conducting parenting research. The majority of the research underpinning family systems theories and interventions is based on Western definitions of family, including an emphasis on nuclear families. Nevertheless, the conceptualisation of the family as a system remains applicable in culturally diverse families, including in low- and middle-income countries (LMICs), when examined within the broader sociocultural context in which they exist. Indeed, culture shapes the norms, values and communication patterns within family systems, thus influencing the dynamics and functioning of familial relationships. Furthermore, the sociocultural context informs expectations of individual family members and how this then influences family processes and interactions, including in relation to parenting (Bornstein & Cheah, 2006 ). For instance, when discussing fathers across cultures, Aka fathers in West Central Africa are directly involved in childrearing from infancy, whereas Kipsigi fathers in Kenya do not hold their infants during the first year (Hewlett, 2014 ). Furthermore, fatherhood in Latino families is centred on the values of familism (i.e., prioritising family over the self, promoting warm and supportive relationships) (Campos et al., 2014 ) and caballerismo (i.e., chivalry) which together encourage the involvement of fathers in the care of children (Cabrera et al., 2012 ). The paternal role, however, is not static, but rather is influenced dynamically by personal experiences, economic and social status, cultural and societal values, childrearing goals and priorities, family-level life stressors, and varying levels of social support (Novianti et al., 2023; Parke & Cookston 2019 ; Xu et al., 2014 ). For example, poverty and its impacts on food and health security in LMICs are strongly correlated with paternal involvement as fathers are often required to sacrifice time with their families to earn an income (Jeong et al., 2016 ). As such, fathers have traditionally been responsible for the financial security of their families which often precludes their routine involvement in childrearing. For example, a study with mothers and fathers from Madagascar highlighted that work schedules, including long workdays, often limited fathers’ time with children to evenings and weekends (Rakotomanana et al., 2021). Increases in divorce and shared custody, paternity leave, labour migration, urbanisation, women’s workforce participation, and educational attainment globally have also affected family systems and the father’s role therein (Barker & Pawlak, 2011 ; Seward & Stanley-Stevens, 2013 ; Steinbach, 2019 ). While there certainly are context- and culture-specific influences on fathering, it is important to also recognise the common factors that shape the involvement of fathers in family systems (Bornstein, 2012 ). Specifically, a recent systematic review of qualitative studies conducted in low-, middle-, and high-incomes countries, found that fathering was consistently conceptualised “as requiring presence, affection, support, nurturance, and prioritizing child’s needs” (Diniz et al., 2023 , p. 2725). Indeed, the authors emphasised the considerable consistency regarding the child-centred approach to fathering evident across the included studies (Diniz et al., 2023 ). Nevertheless, the paternal role across LMICs remains grossly understudied (Li, 2020 ; Noviantiet al., 2023). Indeed, a recent systematic review outlining the roles of fathers in an early childhood context highlighted that the existing literature in this area is largely focused on Western, Educated, Industrialised, Rich and Democratic countries (WEIRD) countries neglecting perspectives from culturally diverse contexts (Diniz et al., 2021 ). Furthermore, existing literature tends to focus on the perspectives of mothers and fathers in isolation (Cabrera et al., 2018 ) or collect data about fathers exclusively via mother report (Maselko et al., 2019). This has led to overly stereotypical, potentially biased, and unidimensional portrayals of fathers which are not reflective of the dynamic and multifaceted nature of the paternal role in LMICs. Given the ever-evolving nature of fatherhood and the paternal role, this paper aims to answer the call for research that broadens the understanding of fathering that is sensitive to the influences of sociocultural context (Feldman, 2023 ). Drawing from family systems theory, we argue that fathering roles and practices are best understood through the perspectives of both mothers and fathers. This approach provides the opportunity to explore and understand the interparental processes and dynamics involved within a family system, and the potential role(s) of fathers within the family as a whole and father-child and father-mother subsystems specifically. To further elucidate the paternal role, we have also incorporated the perspectives of individuals with subject matter expertise in a range of professional fields relevant to early childhood development and family systems in our analysis. This paper uniquely builds understanding of the commonalities in the roles of fathers in family systems across 12 LMICs and how these roles are shaped by factors within the family system and subsystems and the surrounding sociocultural context. Methods Study context The Research Team at The University XXX was responsible for leading the content development for XXX Program (Author, 2023 ; Author, 2022 ). XXX Program aimed to raise awareness of the importance of healthy early childhood development and promoted positive interactions between children and parents, extended family, and trusted community members to support optimal socioemotional and cognitive development in the early years. Importantly, the content was not designed specifically for mothers but rather encouraged the involvement of a collective group of caregivers, including fathers, grandparents and other extended family members. The XXX Program was co-designed for and in collaboration with parents, other child caregivers, and early childhood experts from 12 LMICS, including Afghanistan, Cameroon, the Democratic Republic of Congo (DRC), Ethiopia, Indonesia, Kazakhstan, Kenya, Kyrgyzstan, Malaysia, Namibia, Papua New Guinea (PNG), and Uzbekistan. Across these diverse sociocultural contexts, there are a multitude of factors that shape the paternal role. Importantly, the availability of country-specific literature about fathers in each of these LMICs is highly variable, frequently presents a deficit-based perspective on father’s role in childrearing rather than a strengths-based approach, and generally lags behind social changes influencing fathering (Feldman, 2023 ). Therefore, we deliberately have not provided a summary of this evidence base to avoid perpetuating negative stereotypes about fathers. Rather, this paper analyses and synthesises qualitative data about the influences on the paternal role from the perspectives of fathers themselves and their family members as well as subject matter experts. Co-design methodology and data collection The research team utilised a standardised co-design protocol centred on collaborative workshops with parents, other child caregivers, and early childhood experts (e.g., clinical psychologist, medical specialists, early childhood educators) to inform the research and development processes, ensuring the XXX Program content was informed by the cultural, contextual, and personal needs of the target end users (Author, 2022 ). To develop and iteratively refine the content, the research team conducted collaborative co-design workshops with in-country subject matter experts and parents and other caregivers (e.g., grandparents, aunts and uncles) to appreciate the unique needs of those raising young children in each country. The workshops focused on understanding gaps in knowledge of early childhood development as well as important cultural, contextual and personal factors that influence childrearing practices in families and communities (Author, 2022 ). Notably, experts also provided vital insights regarding systemic barriers to fathering. As described in detail in Author et al. (2022), recruitment for all research activities was facilitated by the in-country partners in each respective country using their established networks and advertising mechanisms led by the Site Principal Investigator. In-country partners consisted of government and non-government organisations. The research team worked directly with the sites to discuss how best to recruit a diverse sample of participants. Whenever feasible, participants were recruited from metropolitan, regional, and rural communities, including men and women from varied demographic backgrounds. Eligibility criteria for parents and caregivers included being aged 18 years or older and caring for at least one child 5-years-old or younger inclusive of pregnancy. Experts were considered those with critical expertise in early childhood development, education, medicine, anthropology, linguistics, or public policy. As presented in Table 1 , 69 co-design workshops were conducted across the 12 LMICs. Importantly, the parents and caregivers participated in workshops separate from the experts. The workshops ranged in length from 2 to 4 hours, with length determined collaboratively with the in-country partner. The overarching agenda for these workshops was designed to inform broader research and development processes (Author, 2022 ); however, the questions drawn on in this research explored fathers’ involvement in the household and family, including specific childrearing activities such as promoting early learning, engaging in play, and transmitting values. Table 1 Number of workshops conducted in each country. Country Expert workshops Parent and caregiver workshops Total Afghanistan 1 7 8 Cameroon 2 3 5 Democratic Republic of the Congo 2 3 5 Ethiopia 2 3 5 Indonesia 1 5 6 Kazakhstan 1 4 5 Kenya 2 5 7 Kyrgyzstan 2 3 5 Malaysia 2 4 6 Namibia 2 5 7 Papua New Guinea 2 3 5 Uzbekistan 2 3 5 INSERT Table 1 The co-design workshops were supported by, and recorded via, the videoconferencing software Zoom. Verbatim transcriptions of all workshops were completed by The University of XXX. However, because the translations were often not verbatim, the content of these transcriptions at times reflected summarised translations delivered by translators. Workshops were co-facilitated by representatives from The University of XXX, XXX Foundation, and a ‘local champion’ from the in-country partner organisation, with the support of translators recruited by the in-country partner as required. The local champion did not need to have specialist credentials but rather a connection to the community and an eagerness to support the workshop objectives. Research has shown that such champions can increase the awareness of and interest in participating in research among potential participants as well as other stakeholders involved in the research process (e.g., subject matter experts) (Oduola et al., 2017 ). The workshops were hybrid in nature, with the in-country partners, translators and participants typically gathered together in person and the research team and representatives from XXX participating online (though it is noted that XXX Foundation staff were present in-person for some workshops in Ethiopia, Kazakhstan, Kenya, Kyrgyzstan, Malaysia, Namibia, and Uzbekistan). Cultural and linguistic differences between the research team and participants were mediated by a translator fluent in participants’ languages as well as by one or more representatives from the in-country partner, such as the local champion. Furthermore, the research team debriefed with the in-country partner as well as the translator whenever possible to clarify points of confusion and further discuss, review, and make sense of the experiences and information shared by participants to inform a shared understanding. Comprehensive details of the methods and prompted discussion topics have been described elsewhere (Author, 2023 ; Author, in press; Author, 2022 ). Data Analysis Interpretation of the qualitative data followed a hybrid inductive/theoretical approach to thematic analysis to identify key themes related to the research objectives guided by the principles of family systems theory (Braun & Clarke, 2006 ). This approach enabled the data to primarily guide the developing analysis (Braun et al., 2016 ) and then subsequently be informed by and mapped to the theoretical concepts related to family systems. Importantly, the authors responsible for coding the data [OI and CW, in consultation with AP] only engaged with the literature after the inductive analysis was complete (Braun & Clarke, 2006 ). To conduct the analysis, three authors [OI, CW, and AP] familiarised themselves with the data and independently generated initial codes using the transcript of one co-design workshop from Namibia using NVivo 14 (Lumivero, 2023 ). Following this, all three authors met to discuss their initial codes, reflect on their reading of the data, and consider emerging themes. At this initial meeting, OI took notes on the discussion in which she documented the agreed upon themes, as well as any disagreements. Then, two authors [OI and CW] independently coded the remaining data from the co-design workshops for Namibia. OI and CW reconvened, in consultation with AP, to present their findings and compare their independent coding and further nominate and discuss themes. The authors also discussed any previously unresolved disagreements and those that emerged from the second round of analysis. Again, OI took notes to document resolutions or lack thereof as well as the agreed upon revised and expanded coding framework (Braun & Clarke, 2006 ). Guided by this draft code book, OI and CW then independently coded the remaining co-design workshop data, reviewing, refining and expanding on the themes identified. Throughout this process, OI and CW met weekly to discuss any new codes or uncertainties on previously defined codes. When both authors had completed their analysis, they met again with AP to present and compare their independent codes. This final meeting allowed all authors to reflect on and resolve any unsettled discrepancies, and further define and refine the identified themes. If any discrepancies remained unresolved, AP made the final decision. The inductive themes were then re-examined through the lens of family systems theory, considering how they relate to and influence familial systems and subsystems. As a result, family systems theory was used as an overarching framework of themes by which to map the inductively derived themes which now became subthemes. The theoretical coding of the themes and subthemes was initially completed by a senior author [HL]. HL and OI subsequently met to review and finalise the list of themes and subthemes relating to the research aims and in accordance with family systems theory (Braun et al., 2016 ). Trustworthiness and rigour In this study, we employed several strategies to ensure the trustworthiness of our data (Ahmed, 2024 ). A standardised protocol guided the data collection process (Author, 2022 ). Throughout the research activities for each case, the research team engaged in routine debrief sessions to actively reflect on research processes and learnings. This provided an opportunity to engage in collective reflexivity as a research team to acknowledge potential biases and adapt to circumstances as they occurred (West, 2000 ). The inclusion of multiple data sources, namely parents, caregivers, and subject matter experts, as well as data from comprehensive country-specific literature reviews enabled data triangulation, enhancing data credibility. Finally, the research team was multidisciplinary in nature and comprised of individuals from diverse cultural and ethnic backgrounds, including representation from WEIRD countries and LMICs. Results Participants As presented in Table 2 , a total of 83 experts and 255 parents and other caregivers attended the co-design workshops across all countries. The majority of child caregivers were mothers (n = 173; 67.8%), then fathers (n = 64; 25.1%), and then other relatives (n = 18; 7.1%) such as grandparents, uncles, and aunts. As previously described in Author et al. (2023), the demographic diversity of participating parents and caregivers varied across the LMICs. For example, individuals from Indonesia, DRC, Ethiopia, Kenya, Malaysia, Namibia, and PNG tended to come from low-, lower-middle, and upper-middle income households and reported marked variability in educational levels, ranging from being unable to read or write to having completed high school or tertiary education. Participants from Afghanistan, Cameroon, Kazakhstan, Kyrgyzstan, and Uzbekistan were typically from middle-income and upper-middle income households and had completed higher education. Parents’ and caregivers’ ages ranged from 20 to 55 years and the children they cared for ranged in age from 2 months to 21 years, with the majority being younger than 5 years old. One participant reported that she was pregnant and expecting her first child. Table 2 Summary of workshop participants in each country. Country Experts Fathers Other male relatives Mothers Other female relatives Total Afghanistan 6 22 0 17 0 45 Cameroon 9 5 0 7 2 23 Democratic Republic of the Congo 6 8 0 8 1 23 Ethiopia 6 1 0 11 1 19 Indonesia 12 2 2 16 0 32 Kazakhstan 7 1 0 22 3 33 Kenya 5 9 0 23 0 37 Kyrgyzstan 4 1 1 19 1 26 Malaysia 10 3 1 17 1 32 Namibia 6 6 0 14 0 26 Papua New Guinea 8 3 1 7 4 23 Uzbekistan 4 3 0 12 0 19 Total 83 64 5 173 13 338 Data availability statement The datasets analyzed during the current study are not publicly available to protect the privacy and confidentiality of the participants but can be made available from the corresponding author on reasonable request and with appropriate ethics approval. INSERT Table 2 The in-country subject matter experts had varied professional qualifications and occupations, including early childhood development specialist, clinical psychologist, teacher, medical doctor, nurse, disability policy specialist, social scientist, social worker, as well as government representatives. Thematic analysis Figure 1 presents the evolution of the themes and sub-themes resulting from the hybrid inductive/theoretical thematic analysis. Specifically, six themes initially emerged from the inductive analysis: 1) Occupying the traditional role of the father; 2) Parenting challenges faced by fathers; 3) Fulfilling children’s basic needs; 4) Encouraging children’s skills development; 5) Fulfilling children’s higher needs; and 6) Passing on values to children. These themes were recoded in relation to family systems theory which resulted in the final three themes: the father-family system, the father-mother subsystem, the father-child subsystem. These themes encompassed five subthemes detailing the specific fathering roles highlighted during the workshops, including fathering to provide and lead, fathering in an unbalanced system, fathering as a partner, fathering to play, and fathering to teach and transmit values. INSERT FIGURE 1 Father-Family System This theme describes how the father operates within the family unit. Participants consistently highlighted the role of the father as a leader and provider. In this role, fathers were highly respected for their contributions to the family, and it was acknowledged that the need to prioritise work-based responsibilities interfered with father’s ability to contribute to childrearing activities. Fathering to provide and lead Across all 12 countries, outside influences including gender norms, societal pressures, and cultural practices heavily shaped fathers’ roles within the family system. These societal pressures and gender norms were evident when participants primarily described fathers as typically occupying ‘traditional roles’ in their caregiving. Specifically, when asked how fathers contributed to the family unit, many women in the workshops described them as “the head of the household” or “breadwinners”, meaning that fathers provided financial support to the family. Fathers agreed that their primary contribution to their families was in relation to work-related activities. “As a male, we are busy with breadwinning” (Father, Uzbekistan, 2022). “I go to work, and my wife stays at home with the children” (Father, DRC, 2022). This was echoed by mothers as stated here, “in accordance with the traditional and historical approach, fathers are seen as the breadwinner and mothers should take care of the house and the kid” (Mother, Uzbekistan, 2022). As a result, many of the participants reported fathers had little opportunity to engage in caregiving duties. Indeed, both mothers and fathers reported that fathers struggled to achieve a balance between work responsibilities and spending time with their children, with many fathers having to prioritise work to support the family. “As a father I live in another city [and] rarely meet my child working away from home” (Father, Indonesia, 2022). While work responsibilities often limited fathers’ direct engagement with young children, in some instances mothers acted on their behalf, enabling fathers’ preferences to be represented in the family’s approach to childrearing. “For me, the only person I tend to is their mum. I advise my wife [on] how I want my child to grow up and the way we should raise them. So, we discuss that and say, ‘I want us to teach him this. I want us to make him do this.’ The person I attend to is my wife apart from anyone else” (Father, PNG, 2023). We also heard from an Afghan father that, “In the morning I assign certain activities… at night I question the child about whether the tasks are completed, and they are rewarded if it is accomplished” (Father, Afghanistan, 2022). Similarly, an Uzbek mother noted, “The father would provide a general guide, and the mother implements this” (Mother, Uzbekistan, 2022). Participants consistently indicated fathers were highly respected in the household by both their children and their partners and acknowledged for their economic contributions to the family. “My husband is working from morning ‘til night and mainly I take care of the child. I am always telling especially the boy there is a need for the father’s parenting. The father’s word should be always implemented because we should respect and listen to fathers” (Mother, Kyrgyzstan, 2022). The Father-Mother Subsystem The next theme is focused on the father-mother subsystem, including factors that interfere with subsystem cohesion and the co-parenting alliance. It was observed that fathers were often involved in childcare activities that complement mothers’ actions; however, their level of involvement was frequently dictated by existing social structures and policies. Fathering in an unbalanced system The financial responsibilities that the participants noted typically fall to fathers disadvantaged them with regards to having sufficient time to develop caregiving skills and, in turn, limited the option for a shared approach to childrearing between mothers and fathers. For instance, an expert from Uzbekistan noted, “The main function fathers may be involved in is to bring their kids to the school and take the right kid home. They are sometimes so busy that they would be happy to pick up any kid” (Expert, Uzbekistan, 2022). This dynamic also deprives mothers of the opportunity to build confidence in a father’s caregiving abilities, creating an imbalance and disharmony within the father-mother system. For instance, we heard from one mother, “Dads [are] not involved in parenting. Our dad [referring to her husband] he doesn’t know even how to interact with kids” (Mother, Kazakhstan, 2023). Notably, the systemic exclusion of men from parenting programs and government policies also limits pathways by which fathers might upskill into the paternal role, potentially reinforcing mothers’ perceptions that fathers are not suitably capable of caring for children and minimizing opportunities for balance between maternal and paternal contributions. “If you look at the structural systems the male caregivers have always been left out – because the way you look at it – the way even the government refers to it is maternal child health – so there is no male there – every content is for the mother and baby –there is an assumption that the father would support in the background – but then [the] father would say, ‘I would have no role here, this is defined for the mother and the baby’” (Expert, Kenya, 2022). In this way, social structures and policies tip the scales of childrearing knowledge and experience such that fathers are disadvantaged. Importantly, experts believed fathers were more inclined to engage in childrearing activities if they knew and understood the importance of their role in their children’s development. “When you talk about the science and break it down to male caregivers – they begin to wonder why they didn’t do things differently – they begin to perceive their role in helping their children […] achieve their developmental potential as adults” (Expert, Kenya, 2022). On the other side of the scales, mothers are potentially forced into the role of being a childrearing ‘expert’. In some instances, the latter can be accompanied by an unwillingness to relinquish control over caregiving, further alienating fathers from this role as noted by the following comment, “Some dads, when they want to correct the child, the mothers are overprotective. This leads to difficult situations where the fathers leave it to the mum and the mum is overwhelmed in what she has to do” (Father, Cameroon, 2022). Nevertheless, for many mothers there was a desire for fathers to be more involved as stated here, “The father should participate, all activities should be cooperative” (Mother, Afghanistan, 2022). Fathering as a partner Notably, across all 12 LMICs, participants expressed that some fathers were able to support mothers who were overburdened by bathing, caring for ill children, feeding, and putting the children to bed. This co-parenting approach was reported to reflect a social shift in the father’s role within the family unit and was met positively by participants. One mother stated, “Nowadays, fathers take care of kids as good as mums. Fathers that bathe kids, change diapers, put [kids] to bed, so the fathers can be called mothers” (Mother, Ethiopia, 2022). We also heard, “The mother cannot manage to take care of all of [her children]. To feed, to care, to sleep – the father is helping. The mother is helping to change the clothes like a conveyor belt. The father is helping to cook, helping to feed – it is very unlikely in Kyrgyzstan” (Mother, Kyrgyzstan, 2022). In these co-parenting situations, the roles mothers and fathers took on within the family system were different but complementary. Parents across the workshops indicated that fathers often focused on more hands-on, physical activities whereas children’s emotional needs were often entrusted to the mother who was considered the ‘nurturer’. “We have different roles to play when it comes to our children. For me I spend more time with the children. I know their needs, their wants, their likes, their dislikes. For my husband he would not know as much as I do and he is more to you know fun, play with, impromptu things… for a son to have that bond like a father-son its different than for a mother-son, more emotional with the mother. But when it comes to the father it is probably more hands-on things like how to fly a kite, or how to make a tie, doing things that is different than normal” (Mother, Malaysia, 2022). Participants indicated fathers were typically expected to be the disciplinarian in the family. As we have published previously, mothers and fathers consistently reported a desire to reduce or eliminate harsh physical punishments (Author, 2023 ). However, communicating about and deciding on a mutually agreed upon approach to discipline as a mother-father subsystem requires tactful communication. “Sometimes when I am observing my husband and how he disciplines our children, I will pull him aside afterwards and give scenarios of what I have read and get him to process. [I] more or less trying to communicate in different ways to get him to see things from my perspective as a mother, not trying to comment on his way of discipline, but supporting him to be positive in his parenting methods to our kids” (Mother, PNG, 2022). The Father-Child Subsystem The final theme examines the relationships between fathers and their children and the factors that influence this family subsystem. In relation to their children, participants often characterised fathers as playmates, educators, and cultural and moral guides, with gender norms impacting on how this is enacted. Fathering to play Across all LMICs, the relationships fathers had with their children consistently emphasised physical activities, often shaped by typical gender roles. For instance, caregivers across the workshops described fathers as engaging and playing with their children in more traditionally ‘male’ activities, such as climbing a tree or fishing. “I have a fishpond and go with my children to work on the pond and teach them how to fish and how to maintain the fishpond” (Father, DRC, 2022). In this way, the majority of participants expressed that the father’s relationship with the child was often that of a physical playmate as noted by experts. “As a parent brought up in a paternalistic society where the beliefs are deep-seated, we see the role of childrearing as a mother’s task. But we have very special more male-oriented tasks, especially motor skills, we tend to do ourselves… to play football… to ride [a] tricycle… to climb a tree” (Expert, Kenya, 2022). The ‘playmate’ role of the father was also made evident by participants who indicated that fathers prioritised play and games with children once they arrived home from work. For instance, one mother stated, “In the evenings when their father comes [home], [he] is really very, very dedicated and involved so even though he’s very tired from work every evening he tries to play with them and play a lot of different games.” (Mother, Kazakhstan, 2023). Fathering to transmit values and educate The value of cultural knowledge and understanding was also an important influence on fathers and their relationships within the family unit. Many fathers expressed wanting to maintain and pass on the cultural knowledge of their ancestors. Similarly, they reported feeling responsible for upholding and sustaining important community cultural practices and activities (e.g., storytelling). Some fathers specifically emphasised the desire to instil values identified as being chiefly important to their culture such as sharing, respect, and proper etiquette for engaging with elders. For example, one father stated, “Culture is very important. Children that grow up in town, 70% in village, 30% in town, children need to be taught just to share, sharing is part of our culture ‘ubuntu’” (Father, Namibia, 2022). Another father highlighted important opportunities to engage children in their culture. “We tell them stories of their grandparents – of their culture. We are using stories to talk to the children. We use some functions, like funerals. Elders or parents – they take them to talk to young children about their culture and teach them about cultural things.” (Father, DRC, 2022). However, fathers described the loss of tradition in households, with languages, customs and beliefs becoming “extinct” (PNG, 2022) or becoming blended with Western ways. For instance, a father said, “In most of the parents here traditions are dying out. It is the struggle everywhere we [are] seeing the Westernising come. The same is happening here” (Father, PNG, 2022). Many fathers and mothers also felt that passing on specific ‘masculine’ values and moral reasoning skills to their children was a key aspect of the father’s role whereas the more ‘female’ attributes were the responsibility of the mother. One mother said, “They learn more independence, they become braver through the father, they are more caring and sensitive through the mother” (Mother, Malaysia, 2022). Similar to this, participants believed fathers had a responsibility to act as a role model to their children to teach them core values. One father commented, “I would like my child to be courageous and respectful” (Father, Cameroon, 2022). Another father stated, “Most important thing is acceptance of themselves and acceptance of others, teach them to respect themselves and the rights of others, where your rights end is also where the other person’s rights start. They shouldn’t be so selfish that every other day they are thinking about themselves, we must teach them to accept the situation they are in, accept what little they have…. Say ‘thank you’ and ‘sorry’ we must teach them that they should apologise. Learn to appreciate help from others. If you see someone in trouble you should give them a helping hand as tomorrow you might need that helping hand. Do what you think is right” (Father, Namibia, 2022). As part of this value transmission process, participants expressed that it was critically important for children to respect the gendered norms within their society, including recognising their father as the ‘head of the household’. “So, I always teach my children that their father has [a] special place at the table. So, when [the] father is not at home, they can sit however they want at the table, but when [the] father comes, the place should be free […] the man is very special in our family” (Mother, Kazakhstan, 2022). In this regard, the activities children were encouraged to participate in were also gendered. Meaning, traditionally ‘male’ activities were reserved for young boys and traditionally ‘female’ activities were undertaken by girls. Within this dynamic, the father served as an important role model particularly for their sons. “Most of the boys see the activities of their fathers and they do it. If their father is a carpenter, he would take sticks to build a house. When a father is in agriculture, he will try to learn that. With girls, they will learn from their mothers. You will find the boy, he is learning from his father” (Expert, DRC, 2022). “There are really, really clear gender roles and these are strengthened through how parents interact with children as well. So, you hear that in everyday conversation, girls you need to be in the kitchen, boys you need to be out there doing something. Those are still very strong in PNG” (Expert, PNG, 2022). As part of their relationship with their children, many fathers took on the role of teacher, supporting the development of skills deemed important for a child’s future success. “I am worried the child has many activities. The worry here is about how to orient my child – how to detect and orient the child to a career in a way that helps the child. If a child likes sports or mathematics, I want to know which way to orient the child” (Father, Cameroon, 2022). Some fathers specifically highlighted the importance of their children speaking multiple languages, including their mother tongue, and developing strong communication skills enabling culturally appropriate greetings and two-way conversations. Furthermore, fathers wanted their children to advance their social interactions and interpersonal relationships outside of the family unit. For example, one father stated, “Get them to talk and walk more… how would I help them to speak. To get them to speak my mother’s particular language” (Father, PNG, 2022). Taken together, participants recognised the fathers’ critical importance as role models, educators, and guardians of cultural traditions and values within the family system. Discussion In this study, a hybrid inductive/theoretical approach to thematic analysis guided by the principles of family systems theory was applied to qualitative data collected during co-design workshops conducted across 12 LMICs to create a better understanding of the commonalities in the roles of fathers in diverse contexts. The analysis identified three main themes reflecting fathers’ family-based relationships, including the father-family system, the father-mother subsystem, and the father-child subsystem. Each of these themes encompassed subthemes (five total) which highlight the common roles assumed by fathers, including as a provider and leader, co-parent, partner, playmate, and teacher and value guide. Importantly, within each theme, we explored how the sociocultural context in which the family operates directly influences the fathering roles adopted. Overwhelmingly, workshop participants from the 12 LMICs emphasised the restrictive and traditional social norms placed on fathers, whereby masculinity and fatherhood are equated to family headship, economic provision, and decision-making. While the role of provider is highly valued and respected, it is also associated with an imbalance within the mother-father subsystem in relation to caregiving knowledge and experience as well as more practically time and availability. In particular, financial responsibilities frequently force fathers to take a peripheral role in caretaking and household tasks. Existing literature in this area demonstrates that, regardless of gender, there is an agreed desire within the father-mother subsystem for the primary breadwinner to work fewer hours (Pinho et al., 2021 ). Indeed, while work responsibilities are essential to provide financial support for the family, they often reduce the quality time fathers can spend with their children in their formative years. The limited time fathers have with their children can have adverse impacts on the development and well-being of the child (Paquette et al., 2013 ) and limit the capacity of women to take on roles beyond mothering. Despite limited time available, fathers were frequently described as being involved in caregiving in various ways. Consistent with the literature, many fathers worked alongside mothers to co-parent their children and help with bathing, feeding and sleep routines (Bentley & Fox, 1991 ; Lamb & Tamis-Lemonda, 2004 ). Increased engagement in nurturing care activities reflect how the roles of fathers have shifted and changed throughout history (Lamb, 2010 ). As such, many fathers are now more involved in both the caretaking and education of their children due to changing societal norms, including the adoption of more egalitarian perspectives on gender roles (Shwalb et al., 2013 ) resulting from economic growth, educational attainment and understanding, labour market demands and social policies and representation (Ho & Lam, 2019 ). Despite increases in co-parenting and shared childrearing, many fathers still find themselves with limited opportunities to build caregiving competence which translates to reluctance by some to be directly and independently involved in childrearing. As a result, mothers can also struggle to develop confidence in fathers as capable parents and, therefore, may fail to invite them to participate in caregiving activities or closely monitoring their caregiving duties (i.e., maternal gatekeeping) (Allen & Hawkins, 1999 ). Research in this field highlights that mothers who perceive their relationship with the father to be unstable, have mental health concerns, and are more confident in their own parenting abilities are more likely to ‘close the gate’ on fathers’ involvement (Schoppe-Sullivan et al., 2015 ). Furthermore, a mother’s constant presence and involvement in caregiving duties may serve as a barrier to a father’s participation as it prevents them from becoming competent and confident in care tasks (Rose et al., 2015 ). Indeed, family systems research has demonstrated the positive link between supportive co-parenting relationships and fathers’ greater involvement as well as the opposite whereby a conflicting relationship hinders paternal involvement (Schoppe-Sullivan et al., 2015 ; Wang et al., 2022 ). Many fathers appeared to be focused on their children’s future from a young age, expressing an interest in encouraging and shaping their child’s cognitive, language, socioemotional and motor skill development. They did so by modelling desired behaviours, teaching them skills directly or encouraging them to explore their interests. Additionally, fathers often spent time engaging in more physical play-based activities with their children. Typically, both focused skill development and play activities aligned with entrenched gender roles. In this sense, as discussed in the literature, fathers became ‘play partners’, particularly with their sons, whereas mothers specialised in caretaking and nurturance roles (Lamb, 2010 ). However, simply portraying fathers as ‘playmates’ is stereotypical and unidimensional (Lamb, 2010 ), particularly as many fathers were noted to have expanded their fathering responsibilities and involvement in childrearing. Participants also felt that fathers had a responsibility to pass on important family and cultural values to children. This aligns with a recent systematic review which found fathers consistently sought to maintain the cultural values they wanted to pass on to their children (Novianti et al., 2023). These included cultural traditions and encouraging personal qualities such as bravery, honesty and respect as well as those reflective of traditional gender roles. The values and the cultural traditions within the family serve as a context for children’s future learning and how they engage with the world around them (Keifert, 2021 ). Fathers have long been valued for supporting children’s motor development, building their moral character, and promoting skill development (Feldman, 2023 ) and this was echoed by our participants. Indeed, our findings highlight that a father’s role is multifaceted, influenced by relationships within family systems but also by the sociocultural context in which fathering occurs. Social norms and structures as well as government policies (e.g. paternity leave) are shifting to increase the emphasis on the importance of the paternal role as well as to enable fathers to have greater involvement in childcare. Nevertheless, the systemic exclusion of fathers from parenting systems and services, as well as the absence of male caregiver role models, may act as enduring barriers to fathering. To overcome these barriers, research has suggested that we increase fathers’ awareness of available parenting interventions and programmes and ensure the content is inclusive of fathers and their challenges (Lechowicz et al., 2019). Indeed, future policies, services and programs focused on early childhood development must include fathers at every stage of their development, from content development to dissemination and marketing (Ancell et al., 2018 ). They must also focus on all relationships within the family, and the improvement of multiple family subsystems (Wang et al., 2022 ). Practically, it is recommended that practitioners work to improve fathers’ parenting self-efficacy and identify strategies to support and strengthen the mother-father relationship. It will also be critical to help mothers consider what is realistic to expect of fathers and how they can encourage their involvement in childrearing to avoid unintended gatekeeping (Schoppe-Sullivan et al., 2015 ). Finally, it is vital that practitioners recognise and appreciate the sociocultural and contextual factors that may be barriers to fathers’ participation in care. It is only by first acknowledging these factors that they can then devise strategies with fathers and families to sensitively navigate culture-bound conceptualisations of masculinity and fatherhood, emphasise the multifaceted roles inherent in fathering, and ultimately normalise fathers’ involvement in childrearing. Limitations This paper is not without its limitations. Given that the data analysis was conducted by researchers outside of the LMIC context, the researchers acknowledge that the perceived ‘Western’ lens risks bias in the data analysis and themes development in this paper, i.e., specifically relating to the conceptualisation of the roles’ fathers play in families. However, following inductive aspects of the thematic analysis (Braun & Clarke, 2023 ), the subjectivity of researchers is inherent in interpretive work, and so it is considered and confronted in discussions during the analysis phase. Notably, the themes presented in this paper emerged from the iterative inductive thematic analysis and emphasise the similarities in the conceptualisations of the paternal role across diverse contexts. However, we acknowledge that an in-depth cross-cultural analysis of the qualitative data is absent from this paper rendering the overall findings tentative and exploratory in nature. Despite a large sample of participants across the 12 LMICs, fathers only accounted for one-quarter of the participants. It is important to recognise that the limited involvement of fathers in this study aligns with the broader early childhood development literature. Specifically, a recent systematic review of parenting interventions found that fathers were engaged in only 7 of the 111 studies reviewed (Jeong et al., 2021 ). Nevertheless, we acknowledge that sampling bias reduces the external validity of the study results. Additionally, as the co-design workshops were facilitated using the internet, regular internet connectivity issues resulted in poor sound quality. This impacted the accuracy of transcriptions and thus, at times, verbatim transcriptions were not possible. The quality and accuracy of the data also relied on the translation which could not be verified by The University of XXX researchers. In-country partners were responsible for identifying individuals to act as translators if needed and these individuals were not required to have a formal certification. Conclusion While the role of fathers is evolving dynamically, and their involvement in childrearing is increasing, it is still limited across many LMICs as well as other countries globally. This study emphasises the importance of considering the role of fathers within the context of the broader family system, and to further understand the dynamic role they have the potential to play in early childhood development. Furthermore, fathering is shown to be contextually driven, with culturally constructed views of fatherhood and masculinity consistently influencing the involvement of men in childrearing. Sociocultural views often reinforce gendered roles within households, impacting the nature of a father’s role and caregiver involvement across societies. Furthermore, there are limited childrearing support and educational programs targeted to or inclusive of fathers that contain evidence-based content, especially in low-income areas (Trahan et al., 2021 ). To break these barriers, this paper argues that early childhood development research, programmes and policies must seek to involve fathers throughout their development and implementation (Ancell et al., 2018 ) to enhance their knowledge of and interest in childrearing activities, with the aim of benefiting childhood and family outcomes. Declarations Author Contribution The study methodology was conceptualised by HML, AP, MA, and YJCS. Data collection and analysis was performed by OI, CW, AP, and HML, with contributions from AY and GH. Scientific and ethical oversight and guidance were provided by IH, YJCS, and JT to ensure all activities were conducted responsibly and in a culturally appropriate manner. OI and CW drafted the original manuscript. All authors contributed to and have approved the final manuscript. Data availability statement The datasets analyzed during the current study are not publicly available to protect the privacy and confidentiality of the participants but can be made available from the corresponding author on reasonable request and with appropriate ethics approval. Acknowledgements The authors would like to thank all in-country partners, including the Bayat Foundation (Afghanistan), The Indonesian Breastfeeding Mothers Association and The Indonesia Child Welfare Foundation (Indonesia), Roza Otunbayeva Initiative (Kyrgyzstan), The Innovation Centre (Uzbekistan), Kalkaba Development Initiative (Cameroon), Mission in Health Care and Development (DRC), Chapa project team (Ethiopia), Shining Hope for Communities (Kenya), Development Workshop Namibia (Namibia), World Vision PNG (Papua New Guinea), Malaysia Association of Professional Early Childhood Educators (Malaysia) and JSC National Center for Education Research and Evaluation “Taldau” (Kazakhstan) for recruiting parents, caregivers and subject matter experts to participate in the co-design process. Further, we would like to thank all the parents, caregivers and experts who contributed their valuable time and knowledge to support this project. We are very appreciative of our partner, Minderoo Foundation, for their support of and contributions to this research. This research was conducted by the University of Sydney pursuant to an agreement between the University and Minderoo Foundation Limited (Minderoo). IBH is supported by a NHMRC L3 Investigator Grant (GNT2016346). Competing interests XXX is the Co-Director, Health and Policy at the XXX University of XXX. The XXX operates an early-intervention youth service at XXX under contract to headspace. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, XXX which aims to transform mental health services through the use of innovative technologies. The other authors report there are no competing interests to declare. Ethical approval statement This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by The University of Sydney Human Research Ethics Committee (HREC) (Protocol approval number: 2021/956; Date of approval: 13 January 2022). Ethics approval was obtained before the research commenced. Informed consent statement All participants (i.e., parents and caregivers) provided written informed consent prior to participation. Consents were provided between January 2022 and June 2023. Consent covered participation, eligibility, withdrawal, risks and benefits, data collection, storage, and use, consent to publish anonymous outcomes, option to receive study results, and contact details for study team and approving ethics committee. All participants were fully informed that their anonymity was assured. References Ahmed SK (2024) The pillars of trustworthiness in qualitative research. J Med Surg Public Health 2:100051. https://doi.org/10.1016/j.glmedi.2024.100051 Author (2023) Parenting app to support socio-emotional and cognitive development in early childhood: iterative codesign learnings from nine low-income and middle-income countries. BMJ Open 13(5):e071232. https://doi.org/10.1136/bmjopen-2022-071232 Allen SM, Hawkins AJ (1999) Maternal gatekeeping: mothers’ beliefs and behaviors that inhibit greater father involvement in family work . J Marriage Fam 61(1):199–212. https://doi.org/10.2307/353894 Ancell KS, Bruns DA, Chitiyo J (2018) The importance of father involvement in early childhood programs. Young Exceptional Children 21(1):22-33. https://doi.org/10.1177/10962506156213 Barker G, Pawlak R (2011) Men, families, gender equality and care work. Men in families and family policy changing the world. United Nations. Bentley KS, Fox RA (1991) Mothers and fathers of young children: Comparison of parenting styles. Psychol Rep 69(1):320-322. https://doi.org/10.2466/pr0.1991.69.1.320 Bornstein MH (2012) Cultural approaches to parenting. Parent Sci Pract 12(2-3):212–221. https://doi.org/10.1080/15295192.2012.683359 Bornstein MH, Cheah CSL (2006) The place of "culture and parenting" in the ecological contextual perspective on developmental science. In K. H. Rubin & O. B. Chung (Eds.), Parenting beliefs, behaviors, and parent-child relations: A cross-cultural perspective. Psychology Press, England, p 3–33 Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77-101. https://doi.org/10.1191/1478088706qp063oa Braun V, Clarke V (2023) Toward good practice in thematic analysis: Avoiding common problems and be (com) ing a knowing researcher. Int J Transgend Health 24(1):1-6. https://doi.org/10.1080/26895269.2022.2129597 Braun V, Clarke V, Weate P (2016) Using thematic analysis in sport and exercise research. In B. Smith & A. C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise. Routledge, England, p 191-205. Cabrera N J, Aldoney D, Tamis-LeMonda C S (2012) Latino fathers. In N. J. Cabrera & C. S. Tamis-LeMonda (Eds.), Handbook of father involvement: Multidisciplinary perspectives, Second edition. Routledge, England. https://doi.org/10.4324/9780203101414 Cabrera NJ, Volling BL, Barr R (2018) Fathers are parents, too! Widening the lens on parenting for children’s development. Child Dev Perspect 12(3):152–157. https://doi.org/10.1111/cdep.12275 Campos B, Ullman JB, Aguilera A, Dunkel Schetter C (2014) Familism and psychological health: the intervening role of closeness and social support. Cult Divers Ethn Minor Psychol 20(2):191–201. https://doi.org/10.1037/a0034094 Cox MJ, Paley B (1997) Families as systems. Annu Rev Psychol 48:243–267. https://doi.org/10.1146/annurev.psych.48.1.243 Cox MJ, Paley B (2003) Understanding families as systems. Curr Dir Psychol Sci 12(5): 193-196. https://doi.org/10.1111/1467-8721.01259 Author (2023) Designing an app for parents and caregivers to promote cognitive and socioemotional development and well-being among children aged 0 to 5 years in diverse cultural settings: scientific framework. JMIR Pediatr Parent 6(1):e38921. https://doi.org/10.2196/38921 Diniz E, Brandão T, Monteiro L, Veríssimo M (2021) Father involvement during early childhood: A systematic review of the literatureJ Fam Theory Rev 13(1):77-99. https://doi.org/10.1111/fare.12858 Diniz E, Brandão T, Veríssimo M (2023) Father involvement during early childhood: A systematic review of qualitative studies. Fam Relat 72:2710-2730. https://doi.org/10.1111/fare.12858 Emde RN (1988) The effect of relationships on relationships: A developmental approach to clinical intervention. In R. A. Hinde and J. Stevenson-Hinde (Eds.), Relationships within families: Mutual influences. Clarendon Press, England, p 354-364. Feldman R (2023) Father contribution to human resilience. Dev Psychopathol 35:2402-2419. https://doi.org/10.1017/S0954579423000354 Hewlett BS (2014) Culture, history, and sex: Anthropological contributions to conceptualizing father involvement. In Peters, H. E., Day, R. D., Peterson, G. W., & Steinmetz, S. (Ed.), Fatherhood. Routledge, England, p 59-73 Ho H, Lam YW (2019) Father involvement in East Asia: Beyond the breadwinner role? In S. B. Sheldon & T. A. Turner-Vorbeck (Eds.), The Wiley handbook of family, school, and community relationships in education. John Wiley & Sons, Inc, New Jersey, p 333-356. Author (in press) The manifestations of children’s play and the factors that influence it across 12 low- and middle-income countries. Humanit Soc Sci Commun. Jeong J, Franchett EE, Ramos de Oliveira CV, Rehmani K, Yousafzai AK (2021) Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLOS Med18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602 Jeong J, McCoy DC, Yousafzai AK, Salhi C, Fink G (2016) Paternal stimulation and early child development in low- and middle-income countries. Pediatr 138(4):e20161357. https://doi.org/10.1542/peds.2016-1357 Keifert DT (2021) Family culture as context for learning through inquiry. Cogn Instr 39(3):242-274. https://doi.org/10.1080/07370008.2021.1913162 Keown LJ, et al (2018) The role of fathers in supporting children’s development. In Sanders MR, Morawska A (Eds.), Handbook of parenting and child development across the lifespan. Springer, New York, p 121-142 Lamb ME (2010) How do fathers influence children's development? Let me count the ways. In ME Lamb (Ed.), The role of the father in child development. John Wiley & Sons, Inc, New Jersey, p 1-26 Lamb ME, Tamis-LeMonda CS (2004) The role of the father: An introduction. In ME Lamb (Ed.), The role of the father in child development. John Wiley & Sons, Inc, New Jersey, p 1-31. Author (2022) Developing a parenting app to support young children's socioemotional and cognitive development in culturally diverse low- and middle-income countries: protocol for a co-design study. JMIR Res Protoc 11(10):e39225. https://doi.org/10.2196/39225 Lechowicz ME, Jiang Y, Tully LA, Burn MT, Collins DAJ, Hawes DJ, Lenroot RK, Anderson V, Doyle FL, Piotrowska PJ, Frick PJ, Moul C, Kimonis ER, Dadds MR (2019) Enhancing father engagement in parenting programs: Translating research into practice recommendations. Aust Psychol 54 (2):83–89. https://doi.org/10.1111/ap.12361 Li X (2020) Fathers’ involvement in Chinese societies: Increasing presence, uneven progress. Child Dev Perspect14(3):150-156. https://doi.org/10.1111/cdep.12375 Lumivero (2023) NVivo (Version 14) www.lumivero.com Maselko J, Hagaman AK, Bates LM, Bhalotra S, Biroli P, Gallis JA, O'Donnell K, Sikander S, Turner EL, Rahman A (2019) Father involvement in the first year of life: Associations with maternal mental health and child development outcomes in rural Pakistan. Soc Sci Med 237:112421. https://doi.org/10.1016/j.socscimed.2019.112421 Novianti R, Suarman, Islami N (2023) Parenting in cultural perspective: A systematic review of paternal role across cultures. Journal of Ethnic and Cultural Studies 10(1):22–44. https://www.jstor.org/stable/48718233 Oduola S, Wykes T, Robotham D, Craig TK (2017) What is the impact of research champions on integrating research in mental health clinical practice? A quasiexperimental study in South London, UK. BMJ Open 7(9):e016107. https://doi.org/10.1136/bmjopen-2017-016107 Paquette D, Coyl-Shepherd DD, Newland LA (2013) Fathers and development: New areas for exploration. Early Child Dev Care 183(6):735–745. https://doi.org/10.1080/03004430.2012.723438 Parke RD, Cookston JT (2019) Fathers and families. In MH Bornstein (Ed .), Handbook of parenting: Being and becoming a parent (3rd ed ). Routledge/Taylor & Francis Group, England, p 64-136. https://doi.org/10.4324/9780429433214-3 Pinho M, Gaunt R, Gross H (2021) Caregiving dads, breadwinning mums: Pathways to the division of family roles among role-reversed and traditional parents. Marriage Fam Rev 57(4):346–374. https://doi.org/10.1080/01494929.2021.1875102 Rakotomanana H, Walters CN, Komakech JJ, Hildebrand D, Gates GE, Thomas DG, Fawbush F, Stoecker BJ (2021) Fathers’ involvement in child care activities: Qualitative findings from the highlands of Madagascar. PLoS ONE 16(3):e0247112. https://doi.org/10.1371/journal.pone.0247112 Rose J, Brady M, Yerkes MA, Coles L (2015) ‘Sometimes they just want to cry for their mum’: Couples’ negotiations and rationalisations of gendered divisions in infant care. J Fam Stud 21 (1): 38-56. https://doi.org/10.1080/13229400.2015.1010264 Schoppe-Sullivan SJ, Altenburger LE, Lee MA, Bower DJ, Kamp Dush CM (2015) Who are thegGatekeepers? Predictors of maternal gatekeeping. Parent Sci Pract 15(3):166-186. https://doi.org/10.1080/15295192.2015.1053321 Seward RR, Stanley-Stevens L (2013) Fathers, fathering, and fatherhood across cultures. In H Selin (Ed.), Parenting Across Cultures (Vol. 7). Springer Netherlands, p 459-474. https://doi.org/10.1007/978-94-007-7503-9_34 Shwalb DW, Shwalb BJ, Lamb ME (Eds.) (2013) Fathers in cultural context. Routledge/Taylor & Francis Group, England. Steinbach A (2019) Children's and parents' well-being in joint physical custody: A literature review. Fam Process 58(2):353–369. https://doi.org/10.1111/famp.12372 Trahan MH, Schneider L, Hernandez D (2021) Mobile applications for low-income U.S. fathers: A systematic review of content, comprehensiveness and user ratings. J Technol Hum Serv 39(2):111–143. https://doi.org/10.1080/15228835.2020.1828228 Vakrat A, Apter-Levy Y, Feldman R (2018) Fathering moderates the effects of maternal depression on the family process. Dev Psychopathol 30(1):27–38. https://doi.org/10.1017/S095457941700044X Wang J, Donithen RW, Schoppe-Sullivan SJ (2022) Fathers and family systems. In: Molloy S, Azzam P, Isacco A (Eds.) Handbook of the Psychology of Fatherhood. Springer, Cham. https://doi.org/10.1007/978-3-031-14498-1_3 West MA (2000) Reflexivity, revolution and innovation in work teams. In DA Johnson, ST Beyerlein (Eds.), Advances in the interdisciplinary study of work teams: Product development teams. JAI Press, Connecticut, p 1-29. Xu Y, Zhang L, Hee P (2014) Parenting practices and shyness in Chinese children. In Selin H (Eds) Parenting Across Cultures. Science Across Cultures: The History of Non-Western Science. Springer, New York, p 13-24. https://doi.org/10.1007/978-94-007-7503-9_2 Additional Declarations Competing interest reported. Professor Ian Hickie is the Co-Director, Health and Policy at the Brain and Mind Centre (BMC) University of Sydney. The BMC operates an early-intervention youth service at Camperdown under contract to headspace. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd which aims to transform mental health services through the use of innovative technologies. The other authors report there are no competing interests to declare. 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06:34:32","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":160061,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7616434/v1/f2fa51fe908e672ede31efc4.html"},{"id":96049598,"identity":"a2891532-41aa-4b3c-9986-a2d44ca43c27","added_by":"auto","created_at":"2025-11-17 06:34:32","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":186924,"visible":true,"origin":"","legend":"\u003cp\u003eResults of the hybrid inductive/theoretical thematic analysis.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7616434/v1/3b119ae8efc8f84761820535.png"},{"id":96255965,"identity":"014526d8-a5b8-4fee-b9da-6f653bd45d23","added_by":"auto","created_at":"2025-11-19 07:49:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":981275,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7616434/v1/2023be2b-913b-4d24-874c-063c53d7edd3.pdf"}],"financialInterests":"Competing interest reported. Professor Ian Hickie is the Co-Director, Health and Policy at the Brain and Mind Centre (BMC) University of Sydney. The BMC operates an early-intervention youth service at Camperdown under contract to headspace. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd which aims to transform mental health services through the use of innovative technologies. \nThe other authors report there are no competing interests to declare.","formattedTitle":"Commonalities in the paternal role within the family system across culturally diverse low- and middle-income countries","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn early childhood, fathers play an integral role in their child\u0026rsquo;s socioemotional, language, physical and cognitive development (Keown et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Family systems theory emphasises that families operate as dynamic systems, consisting of both individuals and the relationships between these individuals, with each interaction operating as its own subsystem (Cox \u0026amp; Paley, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e1997\u003c/span\u003e). A key principle of this theory is that intra-familial relationships are mutually interdependent, with family members exerting influences on one another through bidirectional, reciprocal or transactional patterns (Cox \u0026amp; Paley, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e1997\u003c/span\u003e). This systemic perspective posits that a whole family cannot be understood without considering intra-relationships or \u0026ldquo;the effect of relationships on relationships\u0026rdquo; (Emde, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e1988\u003c/span\u003e, p. 354). As an example, it has been shown that sensitive and engaged fathers can buffer children from the adverse effects resulting from, for instance, maternal depression in early childhood (Vakrat et al., \u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In this way, sensitive fathering supports harmonious family processes (Feldman, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Furthermore, fathers make specific contributions to children\u0026rsquo;s resilience across developmental stages, fostering social competence and flexibility within relationships (Feldman, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Given the emphasis on the inter-relatedness of individual components forming a family (i.e., \u0026ldquo;wholeness\u0026rdquo;) (Cox \u0026amp; Paley, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), it is critical to consider the roles of fathers within the family system and subsystems (e.g., father-child, father-mother) when conducting parenting research.\u003c/p\u003e\u003cp\u003eThe majority of the research underpinning family systems theories and interventions is based on Western definitions of family, including an emphasis on nuclear families. Nevertheless, the conceptualisation of the family as a system remains applicable in culturally diverse families, including in low- and middle-income countries (LMICs), when examined within the broader sociocultural context in which they exist. Indeed, culture shapes the norms, values and communication patterns within family systems, thus influencing the dynamics and functioning of familial relationships. Furthermore, the sociocultural context informs expectations of individual family members and how this then influences family processes and interactions, including in relation to parenting (Bornstein \u0026amp; Cheah, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). For instance, when discussing fathers across cultures, Aka fathers in West Central Africa are directly involved in childrearing from infancy, whereas Kipsigi fathers in Kenya do not hold their infants during the first year (Hewlett, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Furthermore, fatherhood in Latino families is centred on the values of familism (i.e., prioritising family over the self, promoting warm and supportive relationships) (Campos et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) and \u003cem\u003ecaballerismo\u003c/em\u003e (i.e., chivalry) which together encourage the involvement of fathers in the care of children (Cabrera et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe paternal role, however, is not static, but rather is influenced dynamically by personal experiences, economic and social status, cultural and societal values, childrearing goals and priorities, family-level life stressors, and varying levels of social support (Novianti et al., 2023; Parke \u0026amp; Cookston \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Xu et al., \u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). For example, poverty and its impacts on food and health security in LMICs are strongly correlated with paternal involvement as fathers are often required to sacrifice time with their families to earn an income (Jeong et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). As such, fathers have traditionally been responsible for the financial security of their families which often precludes their routine involvement in childrearing. For example, a study with mothers and fathers from Madagascar highlighted that work schedules, including long workdays, often limited fathers\u0026rsquo; time with children to evenings and weekends (Rakotomanana et al., 2021). Increases in divorce and shared custody, paternity leave, labour migration, urbanisation, women\u0026rsquo;s workforce participation, and educational attainment globally have also affected family systems and the father\u0026rsquo;s role therein (Barker \u0026amp; Pawlak, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Seward \u0026amp; Stanley-Stevens, \u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Steinbach, \u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile there certainly are context- and culture-specific influences on fathering, it is important to also recognise the common factors that shape the involvement of fathers in family systems (Bornstein, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Specifically, a recent systematic review of qualitative studies conducted in low-, middle-, and high-incomes countries, found that fathering was consistently conceptualised \u0026ldquo;as requiring presence, affection, support, nurturance, and prioritizing child\u0026rsquo;s needs\u0026rdquo; (Diniz et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, p. 2725). Indeed, the authors emphasised the considerable consistency regarding the child-centred approach to fathering evident across the included studies (Diniz et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Nevertheless, the paternal role across LMICs remains grossly understudied (Li, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Noviantiet al., 2023). Indeed, a recent systematic review outlining the roles of fathers in an early childhood context highlighted that the existing literature in this area is largely focused on Western, Educated, Industrialised, Rich and Democratic countries (WEIRD) countries neglecting perspectives from culturally diverse contexts (Diniz et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Furthermore, existing literature tends to focus on the perspectives of mothers and fathers in isolation (Cabrera et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) or collect data about fathers exclusively via mother report (Maselko et al., 2019). This has led to overly stereotypical, potentially biased, and unidimensional portrayals of fathers which are not reflective of the dynamic and multifaceted nature of the paternal role in LMICs.\u003c/p\u003e\u003cp\u003eGiven the ever-evolving nature of fatherhood and the paternal role, this paper aims to answer the call for research that broadens the understanding of fathering that is sensitive to the influences of sociocultural context (Feldman, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Drawing from family systems theory, we argue that fathering roles and practices are best understood through the perspectives of both mothers and fathers. This approach provides the opportunity to explore and understand the interparental processes and dynamics involved within a family system, and the potential role(s) of fathers within the family as a whole and father-child and father-mother subsystems specifically. To further elucidate the paternal role, we have also incorporated the perspectives of individuals with subject matter expertise in a range of professional fields relevant to early childhood development and family systems in our analysis. This paper uniquely builds understanding of the commonalities in the roles of fathers in family systems across 12 LMICs and how these roles are shaped by factors within the family system and subsystems and the surrounding sociocultural context.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy context\u003c/h2\u003e\u003cp\u003eThe Research Team at The University XXX was responsible for leading the content development for XXX Program (Author, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). XXX Program aimed to raise awareness of the importance of healthy early childhood development and promoted positive interactions between children and parents, extended family, and trusted community members to support optimal socioemotional and cognitive development in the early years. Importantly, the content was not designed specifically for mothers but rather encouraged the involvement of a collective group of caregivers, including fathers, grandparents and other extended family members.\u003c/p\u003e\u003cp\u003eThe XXX Program was co-designed for and in collaboration with parents, other child caregivers, and early childhood experts from 12 LMICS, including Afghanistan, Cameroon, the Democratic Republic of Congo (DRC), Ethiopia, Indonesia, Kazakhstan, Kenya, Kyrgyzstan, Malaysia, Namibia, Papua New Guinea (PNG), and Uzbekistan. Across these diverse sociocultural contexts, there are a multitude of factors that shape the paternal role. Importantly, the availability of country-specific literature about fathers in each of these LMICs is highly variable, frequently presents a deficit-based perspective on father\u0026rsquo;s role in childrearing rather than a strengths-based approach, and generally lags behind social changes influencing fathering (Feldman, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Therefore, we deliberately have not provided a summary of this evidence base to avoid perpetuating negative stereotypes about fathers. Rather, this paper analyses and synthesises qualitative data about the influences on the paternal role from the perspectives of fathers themselves and their family members as well as subject matter experts.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eCo-design methodology and data collection\u003c/h3\u003e\n\u003cp\u003eThe research team utilised a standardised co-design protocol centred on collaborative workshops with parents, other child caregivers, and early childhood experts (e.g., clinical psychologist, medical specialists, early childhood educators) to inform the research and development processes, ensuring the XXX Program content was informed by the cultural, contextual, and personal needs of the target end users (Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). To develop and iteratively refine the content, the research team conducted collaborative co-design workshops with in-country subject matter experts and parents and other caregivers (e.g., grandparents, aunts and uncles) to appreciate the unique needs of those raising young children in each country. The workshops focused on understanding gaps in knowledge of early childhood development as well as important cultural, contextual and personal factors that influence childrearing practices in families and communities (Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Notably, experts also provided vital insights regarding systemic barriers to fathering.\u003c/p\u003e\u003cp\u003eAs described in detail in Author et al. (2022), recruitment for all research activities was facilitated by the in-country partners in each respective country using their established networks and advertising mechanisms led by the Site Principal Investigator. In-country partners consisted of government and non-government organisations. The research team worked directly with the sites to discuss how best to recruit a diverse sample of participants. Whenever feasible, participants were recruited from metropolitan, regional, and rural communities, including men and women from varied demographic backgrounds. Eligibility criteria for parents and caregivers included being aged 18 years or older and caring for at least one child 5-years-old or younger inclusive of pregnancy. Experts were considered those with critical expertise in early childhood development, education, medicine, anthropology, linguistics, or public policy.\u003c/p\u003e\u003cp\u003eAs presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, 69 co-design workshops were conducted across the 12 LMICs. Importantly, the parents and caregivers participated in workshops separate from the experts. The workshops ranged in length from 2 to 4 hours, with length determined collaboratively with the in-country partner. The overarching agenda for these workshops was designed to inform broader research and development processes (Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e); however, the questions drawn on in this research explored fathers\u0026rsquo; involvement in the household and family, including specific childrearing activities such as promoting early learning, engaging in play, and transmitting values.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eNumber of workshops conducted in each country.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExpert workshops\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eParent and caregiver workshops\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAfghanistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCameroon\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemocratic Republic of the Congo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEthiopia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKazakhstan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKenya\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKyrgyzstan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalaysia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNamibia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePapua New Guinea\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUzbekistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eINSERT Table 1\u003c/h3\u003e\n\u003cp\u003eThe co-design workshops were supported by, and recorded via, the videoconferencing software Zoom. Verbatim transcriptions of all workshops were completed by The University of XXX. However, because the translations were often not verbatim, the content of these transcriptions at times reflected summarised translations delivered by translators. Workshops were co-facilitated by representatives from The University of XXX, XXX Foundation, and a \u0026lsquo;local champion\u0026rsquo; from the in-country partner organisation, with the support of translators recruited by the in-country partner as required. The local champion did not need to have specialist credentials but rather a connection to the community and an eagerness to support the workshop objectives. Research has shown that such champions can increase the awareness of and interest in participating in research among potential participants as well as other stakeholders involved in the research process (e.g., subject matter experts) (Oduola et al., \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The workshops were hybrid in nature, with the in-country partners, translators and participants typically gathered together in person and the research team and representatives from XXX participating online (though it is noted that XXX Foundation staff were present in-person for some workshops in Ethiopia, Kazakhstan, Kenya, Kyrgyzstan, Malaysia, Namibia, and Uzbekistan).\u003c/p\u003e\u003cp\u003eCultural and linguistic differences between the research team and participants were mediated by a translator fluent in participants\u0026rsquo; languages as well as by one or more representatives from the in-country partner, such as the local champion. Furthermore, the research team debriefed with the in-country partner as well as the translator whenever possible to clarify points of confusion and further discuss, review, and make sense of the experiences and information shared by participants to inform a shared understanding.\u003c/p\u003e\u003cp\u003eComprehensive details of the methods and prompted discussion topics have been described elsewhere (Author, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Author, in press; Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eInterpretation of the qualitative data followed a hybrid inductive/theoretical approach to thematic analysis to identify key themes related to the research objectives guided by the principles of family systems theory (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). This approach enabled the data to primarily guide the developing analysis (Braun et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) and then subsequently be informed by and mapped to the theoretical concepts related to family systems. Importantly, the authors responsible for coding the data [OI and CW, in consultation with AP] only engaged with the literature after the inductive analysis was complete (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2006\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTo conduct the analysis, three authors [OI, CW, and AP] familiarised themselves with the data and independently generated initial codes using the transcript of one co-design workshop from Namibia using NVivo 14 (Lumivero, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Following this, all three authors met to discuss their initial codes, reflect on their reading of the data, and consider emerging themes. At this initial meeting, OI took notes on the discussion in which she documented the agreed upon themes, as well as any disagreements. Then, two authors [OI and CW] independently coded the remaining data from the co-design workshops for Namibia. OI and CW reconvened, in consultation with AP, to present their findings and compare their independent coding and further nominate and discuss themes. The authors also discussed any previously unresolved disagreements and those that emerged from the second round of analysis. Again, OI took notes to document resolutions or lack thereof as well as the agreed upon revised and expanded coding framework (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Guided by this draft code book, OI and CW then independently coded the remaining co-design workshop data, reviewing, refining and expanding on the themes identified. Throughout this process, OI and CW met weekly to discuss any new codes or uncertainties on previously defined codes. When both authors had completed their analysis, they met again with AP to present and compare their independent codes. This final meeting allowed all authors to reflect on and resolve any unsettled discrepancies, and further define and refine the identified themes. If any discrepancies remained unresolved, AP made the final decision.\u003c/p\u003e\u003cp\u003eThe inductive themes were then re-examined through the lens of family systems theory, considering how they relate to and influence familial systems and subsystems. As a result, family systems theory was used as an overarching framework of themes by which to map the inductively derived themes which now became subthemes. The theoretical coding of the themes and subthemes was initially completed by a senior author [HL]. HL and OI subsequently met to review and finalise the list of themes and subthemes relating to the research aims and in accordance with family systems theory (Braun et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eTrustworthiness and rigour\u003c/h3\u003e\n\u003cp\u003eIn this study, we employed several strategies to ensure the trustworthiness of our data (Ahmed, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). A standardised protocol guided the data collection process (Author, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Throughout the research activities for each case, the research team engaged in routine debrief sessions to actively reflect on research processes and learnings. This provided an opportunity to engage in collective reflexivity as a research team to acknowledge potential biases and adapt to circumstances as they occurred (West, \u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). The inclusion of multiple data sources, namely parents, caregivers, and subject matter experts, as well as data from comprehensive country-specific literature reviews enabled data triangulation, enhancing data credibility. Finally, the research team was multidisciplinary in nature and comprised of individuals from diverse cultural and ethnic backgrounds, including representation from WEIRD countries and LMICs.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eParticipants\u003c/h2\u003e\u003cp\u003eAs presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, a total of 83 experts and 255 parents and other caregivers attended the co-design workshops across all countries. The majority of child caregivers were mothers (n\u0026thinsp;=\u0026thinsp;173; 67.8%), then fathers (n\u0026thinsp;=\u0026thinsp;64; 25.1%), and then other relatives (n\u0026thinsp;=\u0026thinsp;18; 7.1%) such as grandparents, uncles, and aunts. As previously described in Author et al. (2023), the demographic diversity of participating parents and caregivers varied across the LMICs. For example, individuals from Indonesia, DRC, Ethiopia, Kenya, Malaysia, Namibia, and PNG tended to come from low-, lower-middle, and upper-middle income households and reported marked variability in educational levels, ranging from being unable to read or write to having completed high school or tertiary education. Participants from Afghanistan, Cameroon, Kazakhstan, Kyrgyzstan, and Uzbekistan were typically from middle-income and upper-middle income households and had completed higher education. Parents\u0026rsquo; and caregivers\u0026rsquo; ages ranged from 20 to 55 years and the children they cared for ranged in age from 2 months to 21 years, with the majority being younger than 5 years old. One participant reported that she was pregnant and expecting her first child.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSummary of workshop participants in each country.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExperts\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFathers\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOther male relatives\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMothers\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eOther female relatives\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAfghanistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCameroon\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemocratic Republic of the Congo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEthiopia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKazakhstan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKenya\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKyrgyzstan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMalaysia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNamibia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePapua New Guinea\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUzbekistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e338\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eData availability statement\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eThe datasets analyzed during the current study are not publicly available to protect the privacy and confidentiality of the participants but can be made available from the corresponding author on reasonable request and with appropriate ethics approval.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eINSERT Table 2\u003c/h3\u003e\n\u003cp\u003eThe in-country subject matter experts had varied professional qualifications and occupations, including early childhood development specialist, clinical psychologist, teacher, medical doctor, nurse, disability policy specialist, social scientist, social worker, as well as government representatives.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eThematic analysis\u003c/h2\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the evolution of the themes and sub-themes resulting from the hybrid inductive/theoretical thematic analysis. Specifically, six themes initially emerged from the inductive analysis: 1) Occupying the traditional role of the father; 2) Parenting challenges faced by fathers; 3) Fulfilling children\u0026rsquo;s basic needs; 4) Encouraging children\u0026rsquo;s skills development; 5) Fulfilling children\u0026rsquo;s higher needs; and 6) Passing on values to children. These themes were recoded in relation to family systems theory which resulted in the final three themes: the father-family system, the father-mother subsystem, the father-child subsystem. These themes encompassed five subthemes detailing the specific fathering roles highlighted during the workshops, including fathering to provide and lead, fathering in an unbalanced system, fathering as a partner, fathering to play, and fathering to teach and transmit values.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eINSERT FIGURE \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/h2\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003eFather-Family System\u003c/h2\u003e\u003cp\u003eThis theme describes how the father operates within the family unit. Participants consistently highlighted the role of the father as a leader and provider. In this role, fathers were highly respected for their contributions to the family, and it was acknowledged that the need to prioritise work-based responsibilities interfered with father\u0026rsquo;s ability to contribute to childrearing activities.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eFathering to provide and lead\u003c/h2\u003e\u003cp\u003eAcross all 12 countries, outside influences including gender norms, societal pressures, and cultural practices heavily shaped fathers\u0026rsquo; roles within the family system. These societal pressures and gender norms were evident when participants primarily described fathers as typically occupying \u0026lsquo;traditional roles\u0026rsquo; in their caregiving. Specifically, when asked how fathers contributed to the family unit, many women in the workshops described them as \u0026ldquo;the head of the household\u0026rdquo; or \u0026ldquo;breadwinners\u0026rdquo;, meaning that fathers provided financial support to the family. Fathers agreed that their primary contribution to their families was in relation to work-related activities. \u0026ldquo;As a male, we are busy with breadwinning\u0026rdquo; (Father, Uzbekistan, 2022). \u0026ldquo;I go to work, and my wife stays at home with the children\u0026rdquo; (Father, DRC, 2022). This was echoed by mothers as stated here, \u0026ldquo;in accordance with the traditional and historical approach, fathers are seen as the breadwinner and mothers should take care of the house and the kid\u0026rdquo; (Mother, Uzbekistan, 2022). As a result, many of the participants reported fathers had little opportunity to engage in caregiving duties. Indeed, both mothers and fathers reported that fathers struggled to achieve a balance between work responsibilities and spending time with their children, with many fathers having to prioritise work to support the family. \u0026ldquo;As a father I live in another city [and] rarely meet my child working away from home\u0026rdquo; (Father, Indonesia, 2022).\u003c/p\u003e\u003cp\u003eWhile work responsibilities often limited fathers\u0026rsquo; direct engagement with young children, in some instances mothers acted on their behalf, enabling fathers\u0026rsquo; preferences to be represented in the family\u0026rsquo;s approach to childrearing.\u003c/p\u003e\u003cp\u003e\u0026ldquo;For me, the only person I tend to is their mum. I advise my wife [on] how I want my\u003c/p\u003e\u003cp\u003echild to grow up and the way we should raise them. So, we discuss that and say, \u0026lsquo;I want us to teach him this. I want us to make him do this.\u0026rsquo; The person I attend to is my wife apart from anyone else\u0026rdquo; (Father, PNG, 2023).\u003c/p\u003e\u003cp\u003eWe also heard from an Afghan father that, \u0026ldquo;In the morning I assign certain activities\u0026hellip; at night I question the child about whether the tasks are completed, and they are rewarded if it is accomplished\u0026rdquo; (Father, Afghanistan, 2022). Similarly, an Uzbek mother noted, \u0026ldquo;The father would provide a general guide, and the mother implements this\u0026rdquo; (Mother, Uzbekistan, 2022).\u003c/p\u003e\u003cp\u003eParticipants consistently indicated fathers were highly respected in the household by both their children and their partners and acknowledged for their economic contributions to the family.\u003c/p\u003e\u003cp\u003e\u0026ldquo;My husband is working from morning \u0026lsquo;til night and mainly I take care of the child. I am always telling especially the boy there is a need for the father\u0026rsquo;s parenting. The father\u0026rsquo;s word should be always implemented because we should respect and listen to fathers\u0026rdquo; (Mother, Kyrgyzstan, 2022).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eThe Father-Mother Subsystem\u003c/h2\u003e\u003cp\u003eThe next theme is focused on the father-mother subsystem, including factors that interfere with subsystem cohesion and the co-parenting alliance. It was observed that fathers were often involved in childcare activities that complement mothers\u0026rsquo; actions; however, their level of involvement was frequently dictated by existing social structures and policies.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eFathering in an unbalanced system\u003c/h2\u003e\u003cp\u003eThe financial responsibilities that the participants noted typically fall to fathers disadvantaged them with regards to having sufficient time to develop caregiving skills and, in turn, limited the option for a shared approach to childrearing between mothers and fathers. For instance, an expert from Uzbekistan noted, \u0026ldquo;The main function fathers may be involved in is to bring their kids to the school and take the right kid home. They are sometimes so busy that they would be happy to pick up any kid\u0026rdquo; (Expert, Uzbekistan, 2022). This dynamic also deprives mothers of the opportunity to build confidence in a father\u0026rsquo;s caregiving abilities, creating an imbalance and disharmony within the father-mother system. For instance, we heard from one mother, \u0026ldquo;Dads [are] not involved in parenting. Our dad [referring to her husband] he doesn\u0026rsquo;t know even how to interact with kids\u0026rdquo; (Mother, Kazakhstan, 2023).\u003c/p\u003e\u003cp\u003eNotably, the systemic exclusion of men from parenting programs and government policies also limits pathways by which fathers might upskill into the paternal role, potentially reinforcing mothers\u0026rsquo; perceptions that fathers are not suitably capable of caring for children and minimizing opportunities for balance between maternal and paternal contributions.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;If you look at the structural systems the male caregivers have always been left out \u0026ndash; because the way you look at it \u0026ndash; the way even the government refers to it is maternal child health \u0026ndash; so there is no male there \u0026ndash; every content is for the mother and baby \u0026ndash;there is an assumption that the father would support in the background \u0026ndash; but then [the] father would say, \u0026lsquo;I would have no role here, this is defined for the mother and the baby\u0026rsquo;\u0026rdquo; (Expert, Kenya, 2022).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn this way, social structures and policies tip the scales of childrearing knowledge and experience such that fathers are disadvantaged. Importantly, experts believed fathers were more inclined to engage in childrearing activities if they knew and understood the importance of their role in their children\u0026rsquo;s development.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;When you talk about the science and break it down to male caregivers \u0026ndash; they begin to wonder why they didn\u0026rsquo;t do things differently \u0026ndash; they begin to perceive their role in helping their children [\u0026hellip;] achieve their developmental potential as adults\u0026rdquo; (Expert, Kenya, 2022).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOn the other side of the scales, mothers are potentially forced into the role of being a childrearing \u0026lsquo;expert\u0026rsquo;. In some instances, the latter can be accompanied by an unwillingness to relinquish control over caregiving, further alienating fathers from this role as noted by the following comment, \u0026ldquo;Some dads, when they want to correct the child, the mothers are overprotective. This leads to difficult situations where the fathers leave it to the mum and the mum is overwhelmed in what she has to do\u0026rdquo; (Father, Cameroon, 2022). Nevertheless, for many mothers there was a desire for fathers to be more involved as stated here, \u0026ldquo;The father should participate, all activities should be cooperative\u0026rdquo; (Mother, Afghanistan, 2022).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eFathering as a partner\u003c/h2\u003e\u003cp\u003eNotably, across all 12 LMICs, participants expressed that some fathers were able to support mothers who were overburdened by bathing, caring for ill children, feeding, and putting the children to bed. This co-parenting approach was reported to reflect a social shift in the father\u0026rsquo;s role within the family unit and was met positively by participants. One mother stated, \u0026ldquo;Nowadays, fathers take care of kids as good as mums. Fathers that bathe kids, change diapers, put [kids] to bed, so the fathers can be called mothers\u0026rdquo; (Mother, Ethiopia, 2022). We also heard,\u003c/p\u003e\u003cp\u003e\u0026ldquo;The mother cannot manage to take care of all of [her children]. To feed, to care, to sleep \u0026ndash; the father is helping. The mother is helping to change the clothes like a conveyor belt. The father is helping to cook, helping to feed \u0026ndash; it is very unlikely in Kyrgyzstan\u0026rdquo; (Mother, Kyrgyzstan, 2022).\u003c/p\u003e\u003cp\u003eIn these co-parenting situations, the roles mothers and fathers took on within the family system were different but complementary. Parents across the workshops indicated that fathers often focused on more hands-on, physical activities whereas children\u0026rsquo;s emotional needs were often entrusted to the mother who was considered the \u0026lsquo;nurturer\u0026rsquo;.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;We have different roles to play when it comes to our children. For me I spend more time with the children. I know their needs, their wants, their likes, their dislikes. For my husband he would not know as much as I do and he is more to you know fun, play with, impromptu things\u0026hellip; for a son to have that bond like a father-son its different than for a mother-son, more emotional with the mother. But when it comes to the father it is probably more hands-on things like how to fly a kite, or how to make a tie, doing things that is different than normal\u0026rdquo; (Mother, Malaysia, 2022).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eParticipants indicated fathers were typically expected to be the disciplinarian in the family. As we have published previously, mothers and fathers consistently reported a desire to reduce or eliminate harsh physical punishments (Author, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, communicating about and deciding on a mutually agreed upon approach to discipline as a mother-father subsystem requires tactful communication.\u003c/p\u003e\u003cp\u003e\u0026ldquo;Sometimes when I am observing my husband and how he disciplines our children, I will pull him aside afterwards and give scenarios of what I have read and get him to process. [I] more or less trying to communicate in different ways to get him to see things from my perspective as a mother, not trying to comment on his way of discipline, but supporting him to be positive in his parenting methods to our kids\u0026rdquo; (Mother, PNG, 2022).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eThe Father-Child Subsystem\u003c/h2\u003e\u003cp\u003eThe final theme examines the relationships between fathers and their children and the factors that influence this family subsystem. In relation to their children, participants often characterised fathers as playmates, educators, and cultural and moral guides, with gender norms impacting on how this is enacted.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eFathering to play\u003c/h2\u003e\u003cp\u003eAcross all LMICs, the relationships fathers had with their children consistently emphasised physical activities, often shaped by typical gender roles. For instance, caregivers across the workshops described fathers as engaging and playing with their children in more traditionally \u0026lsquo;male\u0026rsquo; activities, such as climbing a tree or fishing. \u0026ldquo;I have a fishpond and go with my children to work on the pond and teach them how to fish and how to maintain the fishpond\u0026rdquo; (Father, DRC, 2022). In this way, the majority of participants expressed that the father\u0026rsquo;s relationship with the child was often that of a physical playmate as noted by experts.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;As a parent brought up in a paternalistic society where the beliefs are deep-seated, we see the role of childrearing as a mother\u0026rsquo;s task. But we have very special more male-oriented tasks, especially motor skills, we tend to do ourselves\u0026hellip; to play football\u0026hellip; to ride [a] tricycle\u0026hellip; to climb a tree\u0026rdquo; (Expert, Kenya, 2022).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe \u0026lsquo;playmate\u0026rsquo; role of the father was also made evident by participants who indicated that fathers prioritised play and games with children once they arrived home from work. For instance, one mother stated, \u0026ldquo;In the evenings when their father comes [home], [he] is really very, very dedicated and involved so even though he\u0026rsquo;s very tired from work every evening he tries to play with them and play a lot of different games.\u0026rdquo; (Mother, Kazakhstan, 2023).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eFathering to transmit values and educate\u003c/h2\u003e\u003cp\u003eThe value of cultural knowledge and understanding was also an important influence on fathers and their relationships within the family unit. Many fathers expressed wanting to maintain and pass on the cultural knowledge of their ancestors. Similarly, they reported feeling responsible for upholding and sustaining important community cultural practices and activities (e.g., storytelling). Some fathers specifically emphasised the desire to instil values identified as being chiefly important to their culture such as sharing, respect, and proper etiquette for engaging with elders. For example, one father stated, \u0026ldquo;Culture is very important. Children that grow up in town, 70% in village, 30% in town, children need to be taught just to share, sharing is part of our culture \u0026lsquo;ubuntu\u0026rsquo;\u0026rdquo; (Father, Namibia, 2022). Another father highlighted important opportunities to engage children in their culture.\u003c/p\u003e\u003cp\u003e\u0026ldquo;We tell them stories of their grandparents \u0026ndash; of their culture. We are using stories to talk to the children. We use some functions, like funerals. Elders or parents \u0026ndash; they take them to talk to young children about their culture and teach them about cultural things.\u0026rdquo; (Father, DRC, 2022).\u003c/p\u003e\u003cp\u003eHowever, fathers described the loss of tradition in households, with languages, customs and beliefs becoming \u0026ldquo;extinct\u0026rdquo; (PNG, 2022) or becoming blended with Western ways. For instance, a father said, \u0026ldquo;In most of the parents here traditions are dying out. It is the struggle everywhere we [are] seeing the Westernising come. The same is happening here\u0026rdquo; (Father, PNG, 2022).\u003c/p\u003e\u003cp\u003eMany fathers and mothers also felt that passing on specific \u0026lsquo;masculine\u0026rsquo; values and moral reasoning skills to their children was a key aspect of the father\u0026rsquo;s role whereas the more \u0026lsquo;female\u0026rsquo; attributes were the responsibility of the mother. One mother said, \u0026ldquo;They learn more independence, they become braver through the father, they are more caring and sensitive through the mother\u0026rdquo; (Mother, Malaysia, 2022). Similar to this, participants believed fathers had a responsibility to act as a role model to their children to teach them core values. One father commented, \u0026ldquo;I would like my child to be courageous and respectful\u0026rdquo; (Father, Cameroon, 2022). Another father stated,\u003c/p\u003e\u003cp\u003e\u0026ldquo;Most important thing is acceptance of themselves and acceptance of others, teach them to respect themselves and the rights of others, where your rights end is also where the other person\u0026rsquo;s rights start. They shouldn\u0026rsquo;t be so selfish that every other day they are thinking about themselves, we must teach them to accept the situation they are in, accept what little they have\u0026hellip;. Say \u0026lsquo;thank you\u0026rsquo; and \u0026lsquo;sorry\u0026rsquo; we must teach them that they should apologise. Learn to appreciate help from others. If you see someone in trouble you should give them a helping hand as tomorrow you might need that helping hand. Do what you think is right\u0026rdquo; (Father, Namibia, 2022).\u003c/p\u003e\u003cp\u003eAs part of this value transmission process, participants expressed that it was critically important for children to respect the gendered norms within their society, including recognising their father as the \u0026lsquo;head of the household\u0026rsquo;.\u003c/p\u003e\u003cp\u003e\u0026ldquo;So, I always teach my children that their father has [a] special place at the table. So, when [the] father is not at home, they can sit however they want at the table, but when [the] father comes, the place should be free [\u0026hellip;] the man is very special in our family\u0026rdquo; (Mother, Kazakhstan, 2022).\u003c/p\u003e\u003cp\u003eIn this regard, the activities children were encouraged to participate in were also gendered. Meaning, traditionally \u0026lsquo;male\u0026rsquo; activities were reserved for young boys and traditionally \u0026lsquo;female\u0026rsquo; activities were undertaken by girls. Within this dynamic, the father served as an important role model particularly for their sons.\u003c/p\u003e\u003cp\u003e\u0026ldquo;Most of the boys see the activities of their fathers and they do it. If their father is a carpenter, he would take sticks to build a house. When a father is in agriculture, he will try to learn that. With girls, they will learn from their mothers. You will find the boy, he is learning from his father\u0026rdquo; (Expert, DRC, 2022).\u003c/p\u003e\u003cp\u003e\u0026ldquo;There are really, really clear gender roles and these are strengthened through how parents interact with children as well. So, you hear that in everyday conversation, girls you need to be in the kitchen, boys you need to be out there doing something. Those are still very strong in PNG\u0026rdquo; (Expert, PNG, 2022).\u003c/p\u003e\u003cp\u003eAs part of their relationship with their children, many fathers took on the role of teacher, supporting the development of skills deemed important for a child\u0026rsquo;s future success.\u003c/p\u003e\u003cp\u003e\u0026ldquo;I am worried the child has many activities. The worry here is about how to orient my child \u0026ndash; how to detect and orient the child to a career in a way that helps the child. If a child likes sports or mathematics, I want to know which way to orient the child\u0026rdquo; (Father, Cameroon, 2022).\u003c/p\u003e\u003cp\u003eSome fathers specifically highlighted the importance of their children speaking multiple languages, including their mother tongue, and developing strong communication skills enabling culturally appropriate greetings and two-way conversations. Furthermore, fathers wanted their children to advance their social interactions and interpersonal relationships outside of the family unit. For example, one father stated, \u0026ldquo;Get them to talk and walk more\u0026hellip; how would I help them to speak. To get them to speak my mother\u0026rsquo;s particular language\u0026rdquo; (Father, PNG, 2022). Taken together, participants recognised the fathers\u0026rsquo; critical importance as role models, educators, and guardians of cultural traditions and values within the family system.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e In this study, a hybrid inductive/theoretical approach to thematic analysis guided by the principles of family systems theory was applied to qualitative data collected during co-design workshops conducted across 12 LMICs to create a better understanding of the commonalities in the roles of fathers in diverse contexts. The analysis identified three main themes reflecting fathers\u0026rsquo; family-based relationships, including the father-family system, the father-mother subsystem, and the father-child subsystem. Each of these themes encompassed subthemes (five total) which highlight the common roles assumed by fathers, including as a provider and leader, co-parent, partner, playmate, and teacher and value guide. Importantly, within each theme, we explored how the sociocultural context in which the family operates directly influences the fathering roles adopted.\u003c/p\u003e\u003cp\u003eOverwhelmingly, workshop participants from the 12 LMICs emphasised the restrictive and traditional social norms placed on fathers, whereby masculinity and fatherhood are equated to family headship, economic provision, and decision-making. While the role of provider is highly valued and respected, it is also associated with an imbalance within the mother-father subsystem in relation to caregiving knowledge and experience as well as more practically time and availability. In particular, financial responsibilities frequently force fathers to take a peripheral role in caretaking and household tasks. Existing literature in this area demonstrates that, regardless of gender, there is an agreed desire within the father-mother subsystem for the primary breadwinner to work fewer hours (Pinho et al., \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Indeed, while work responsibilities are essential to provide financial support for the family, they often reduce the quality time fathers can spend with their children in their formative years. The limited time fathers have with their children can have adverse impacts on the development and well-being of the child (Paquette et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) and limit the capacity of women to take on roles beyond mothering.\u003c/p\u003e\u003cp\u003eDespite limited time available, fathers were frequently described as being involved in caregiving in various ways. Consistent with the literature, many fathers worked alongside mothers to co-parent their children and help with bathing, feeding and sleep routines (Bentley \u0026amp; Fox, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e1991\u003c/span\u003e; Lamb \u0026amp; Tamis-Lemonda, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Increased engagement in nurturing care activities reflect how the roles of fathers have shifted and changed throughout history (Lamb, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). As such, many fathers are now more involved in both the caretaking and education of their children due to changing societal norms, including the adoption of more egalitarian perspectives on gender roles (Shwalb et al., \u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) resulting from economic growth, educational attainment and understanding, labour market demands and social policies and representation (Ho \u0026amp; Lam, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite increases in co-parenting and shared childrearing, many fathers still find themselves with limited opportunities to build caregiving competence which translates to reluctance by some to be directly and independently involved in childrearing. As a result, mothers can also struggle to develop confidence in fathers as capable parents and, therefore, may fail to invite them to participate in caregiving activities or closely monitoring their caregiving duties (i.e., maternal gatekeeping) (Allen \u0026amp; Hawkins, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e1999\u003c/span\u003e). Research in this field highlights that mothers who perceive their relationship with the father to be unstable, have mental health concerns, and are more confident in their own parenting abilities are more likely to \u0026lsquo;close the gate\u0026rsquo; on fathers\u0026rsquo; involvement (Schoppe-Sullivan et al., \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Furthermore, a mother\u0026rsquo;s constant presence and involvement in caregiving duties may serve as a barrier to a father\u0026rsquo;s participation as it prevents them from becoming competent and confident in care tasks (Rose et al., \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Indeed, family systems research has demonstrated the positive link between supportive co-parenting relationships and fathers\u0026rsquo; greater involvement as well as the opposite whereby a conflicting relationship hinders paternal involvement (Schoppe-Sullivan et al., \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Wang et al., \u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMany fathers appeared to be focused on their children\u0026rsquo;s future from a young age, expressing an interest in encouraging and shaping their child\u0026rsquo;s cognitive, language, socioemotional and motor skill development. They did so by modelling desired behaviours, teaching them skills directly or encouraging them to explore their interests. Additionally, fathers often spent time engaging in more physical play-based activities with their children. Typically, both focused skill development and play activities aligned with entrenched gender roles. In this sense, as discussed in the literature, fathers became \u0026lsquo;play partners\u0026rsquo;, particularly with their sons, whereas mothers specialised in caretaking and nurturance roles (Lamb, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). However, simply portraying fathers as \u0026lsquo;playmates\u0026rsquo; is stereotypical and unidimensional (Lamb, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), particularly as many fathers were noted to have expanded their fathering responsibilities and involvement in childrearing.\u003c/p\u003e\u003cp\u003eParticipants also felt that fathers had a responsibility to pass on important family and cultural values to children. This aligns with a recent systematic review which found fathers consistently sought to maintain the cultural values they wanted to pass on to their children (Novianti et al., 2023). These included cultural traditions and encouraging personal qualities such as bravery, honesty and respect as well as those reflective of traditional gender roles. The values and the cultural traditions within the family serve as a context for children\u0026rsquo;s future learning and how they engage with the world around them (Keifert, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFathers have long been valued for supporting children\u0026rsquo;s motor development, building their moral character, and promoting skill development (Feldman, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and this was echoed by our participants. Indeed, our findings highlight that a father\u0026rsquo;s role is multifaceted, influenced by relationships within family systems but also by the sociocultural context in which fathering occurs. Social norms and structures as well as government policies (e.g. paternity leave) are shifting to increase the emphasis on the importance of the paternal role as well as to enable fathers to have greater involvement in childcare. Nevertheless, the systemic exclusion of fathers from parenting systems and services, as well as the absence of male caregiver role models, may act as enduring barriers to fathering. To overcome these barriers, research has suggested that we increase fathers\u0026rsquo; awareness of available parenting interventions and programmes and ensure the content is inclusive of fathers and their challenges (Lechowicz et al., 2019). Indeed, future policies, services and programs focused on early childhood development must include fathers at every stage of their development, from content development to dissemination and marketing (Ancell et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). They must also focus on all relationships within the family, and the improvement of multiple family subsystems (Wang et al., \u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePractically, it is recommended that practitioners work to improve fathers\u0026rsquo; parenting self-efficacy and identify strategies to support and strengthen the mother-father relationship. It will also be critical to help mothers consider what is realistic to expect of fathers and how they can encourage their involvement in childrearing to avoid unintended gatekeeping (Schoppe-Sullivan et al., \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Finally, it is vital that practitioners recognise and appreciate the sociocultural and contextual factors that may be barriers to fathers\u0026rsquo; participation in care. It is only by first acknowledging these factors that they can then devise strategies with fathers and families to sensitively navigate culture-bound conceptualisations of masculinity and fatherhood, emphasise the multifaceted roles inherent in fathering, and ultimately normalise fathers\u0026rsquo; involvement in childrearing.\u003c/p\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis paper is not without its limitations. Given that the data analysis was conducted by researchers outside of the LMIC context, the researchers acknowledge that the perceived \u0026lsquo;Western\u0026rsquo; lens risks bias in the data analysis and themes development in this paper, i.e., specifically relating to the conceptualisation of the roles\u0026rsquo; fathers play in families. However, following inductive aspects of the thematic analysis (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), the subjectivity of researchers is inherent in interpretive work, and so it is considered and confronted in discussions during the analysis phase. Notably, the themes presented in this paper emerged from the iterative inductive thematic analysis and emphasise the similarities in the conceptualisations of the paternal role across diverse contexts. However, we acknowledge that an in-depth cross-cultural analysis of the qualitative data is absent from this paper rendering the overall findings tentative and exploratory in nature.\u003c/p\u003e\u003cp\u003eDespite a large sample of participants across the 12 LMICs, fathers only accounted for one-quarter of the participants. It is important to recognise that the limited involvement of fathers in this study aligns with the broader early childhood development literature. Specifically, a recent systematic review of parenting interventions found that fathers were engaged in only 7 of the 111 studies reviewed (Jeong et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Nevertheless, we acknowledge that sampling bias reduces the external validity of the study results.\u003c/p\u003e\u003cp\u003eAdditionally, as the co-design workshops were facilitated using the internet, regular internet connectivity issues resulted in poor sound quality. This impacted the accuracy of transcriptions and thus, at times, verbatim transcriptions were not possible. The quality and accuracy of the data also relied on the translation which could not be verified by The University of XXX researchers. In-country partners were responsible for identifying individuals to act as translators if needed and these individuals were not required to have a formal certification.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWhile the role of fathers is evolving dynamically, and their involvement in childrearing is increasing, it is still limited across many LMICs as well as other countries globally. This study emphasises the importance of considering the role of fathers within the context of the broader family system, and to further understand the dynamic role they have the potential to play in early childhood development. Furthermore, fathering is shown to be contextually driven, with culturally constructed views of fatherhood and masculinity consistently influencing the involvement of men in childrearing. Sociocultural views often reinforce gendered roles within households, impacting the nature of a father\u0026rsquo;s role and caregiver involvement across societies. Furthermore, there are limited childrearing support and educational programs targeted to or inclusive of fathers that contain evidence-based content, especially in low-income areas (Trahan et al., \u003cspan citationid=\"CR86\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). To break these barriers, this paper argues that early childhood development research, programmes and policies must seek to involve fathers throughout their development and implementation (Ancell et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) to enhance their knowledge of and interest in childrearing activities, with the aim of benefiting childhood and family outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eThe study methodology was conceptualised by HML, AP, MA, and YJCS. Data collection and analysis was performed by OI, CW, AP, and HML, with contributions from AY and GH. Scientific and ethical oversight and guidance were provided by IH, YJCS, and JT to ensure all activities were conducted responsibly and in a culturally appropriate manner. OI and CW drafted the original manuscript. All authors contributed to and have approved the final manuscript.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analyzed during the current study are not publicly available to protect the privacy and confidentiality of the participants but can be made available from the corresponding author on reasonable request and with appropriate ethics approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank all in-country partners, including the Bayat Foundation (Afghanistan), The Indonesian Breastfeeding Mothers Association and The Indonesia Child Welfare Foundation (Indonesia), Roza Otunbayeva Initiative (Kyrgyzstan), The Innovation Centre (Uzbekistan), Kalkaba Development Initiative (Cameroon), Mission in Health Care and Development (DRC), Chapa project team (Ethiopia), Shining Hope for Communities (Kenya), Development Workshop Namibia (Namibia), World Vision PNG (Papua New Guinea), Malaysia Association of Professional Early Childhood Educators (Malaysia) and \u0026nbsp;JSC National Center for Education Research and Evaluation \u0026ldquo;Taldau\u0026rdquo; (Kazakhstan) for recruiting parents, caregivers and subject matter experts to participate in the co-design process. Further, we would like to thank all the parents, caregivers and experts who contributed their valuable time and knowledge to support this project. We are very appreciative of our partner, Minderoo Foundation, for their support of and contributions to this research.\u003c/p\u003e\n\u003cp\u003eThis research was conducted by the University of Sydney pursuant to an agreement between the University and Minderoo Foundation Limited (Minderoo).\u0026nbsp;IBH is supported by a NHMRC L3 Investigator Grant (GNT2016346).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXXX is the Co-Director, Health and Policy at the XXX University of XXX. The XXX operates an early-intervention youth service at XXX under contract to headspace. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, XXX which aims to transform mental health services through the use of innovative technologies. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe other authors report there are no competing interests to declare.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in line with the principles of the Declaration of Helsinki. This study was approved by The University of Sydney Human Research Ethics Committee (HREC) (Protocol approval number: 2021/956; Date of approval: 13 January 2022). Ethics approval was obtained before the research commenced. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants (i.e., parents and caregivers) provided written informed consent prior to participation. Consents were provided between January 2022 and June 2023. Consent covered participation, eligibility, withdrawal, risks and benefits, data collection, storage, and use, consent to publish anonymous outcomes, option to receive study results, and contact details for study team and approving ethics committee. All participants were fully informed that their anonymity was assured.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAhmed SK (2024) The pillars of trustworthiness in qualitative research. J Med Surg Public Health 2:100051. https://doi.org/10.1016/j.glmedi.2024.100051\u003c/li\u003e\n\u003cli\u003eAuthor (2023) Parenting app to support socio-emotional and cognitive development in early childhood: iterative codesign learnings from nine low-income and middle-income countries. BMJ Open 13(5):e071232. https://doi.org/10.1136/bmjopen-2022-071232\u003c/li\u003e\n\u003cli\u003eAllen SM, Hawkins AJ (1999) Maternal gatekeeping: mothers\u0026rsquo; beliefs and behaviors that inhibit greater father involvement in family work\u003cem\u003e.\u003c/em\u003e J Marriage Fam 61(1):199\u0026ndash;212. https://doi.org/10.2307/353894 \u003c/li\u003e\n\u003cli\u003eAncell KS, Bruns DA, Chitiyo J (2018) The importance of father involvement in early childhood programs. Young Exceptional Children 21(1):22-33. https://doi.org/10.1177/10962506156213 \u003c/li\u003e\n\u003cli\u003eBarker G, Pawlak R (2011) Men, families, gender equality and care work. Men in families and family policy changing the world.\u003cem\u003e \u003c/em\u003eUnited Nations. \u003c/li\u003e\n\u003cli\u003eBentley KS, Fox RA (1991) Mothers and fathers of young children: Comparison of parenting styles. Psychol Rep 69(1):320-322. https://doi.org/10.2466/pr0.1991.69.1.320 \u003c/li\u003e\n\u003cli\u003eBornstein MH (2012) Cultural approaches to parenting. Parent Sci Pract 12(2-3):212\u0026ndash;221. https://doi.org/10.1080/15295192.2012.683359\u003c/li\u003e\n\u003cli\u003eBornstein MH, Cheah CSL (2006) The place of \u0026quot;culture and parenting\u0026quot; in the ecological contextual perspective on developmental science. In K. H. Rubin \u0026amp; O. B. Chung (Eds.), Parenting beliefs, behaviors, and parent-child relations: A cross-cultural perspective. Psychology Press, England, p 3\u0026ndash;33\u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77-101. https://doi.org/10.1191/1478088706qp063oa \u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V (2023) Toward good practice in thematic analysis: Avoiding common problems and be (com) ing a knowing researcher. Int J Transgend Health 24(1):1-6. https://doi.org/10.1080/26895269.2022.2129597 \u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V, Weate P (2016) Using thematic analysis in sport and exercise research. In B. Smith \u0026amp; A. C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise. Routledge, England, p 191-205.\u003c/li\u003e\n\u003cli\u003eCabrera N J, Aldoney D, Tamis-LeMonda C S (2012) Latino fathers. In N. J. Cabrera \u0026amp; C. S. Tamis-LeMonda (Eds.), Handbook of father involvement: Multidisciplinary perspectives, Second edition. Routledge, England. https://doi.org/10.4324/9780203101414 \u003c/li\u003e\n\u003cli\u003eCabrera NJ, Volling BL, Barr R (2018) Fathers are parents, too! Widening the lens on parenting for children\u0026rsquo;s development. Child Dev Perspect 12(3):152\u0026ndash;157. https://doi.org/10.1111/cdep.12275\u003c/li\u003e\n\u003cli\u003eCampos B, Ullman JB, Aguilera A, Dunkel Schetter C (2014) Familism and psychological health: the intervening role of closeness and social support. Cult Divers Ethn Minor Psychol 20(2):191\u0026ndash;201. https://doi.org/10.1037/a0034094\u003c/li\u003e\n\u003cli\u003eCox MJ, Paley B (1997) Families as systems. Annu Rev Psychol 48:243\u0026ndash;267. https://doi.org/10.1146/annurev.psych.48.1.243 \u003c/li\u003e\n\u003cli\u003eCox MJ, Paley B (2003) Understanding families as systems. Curr Dir Psychol Sci 12(5): 193-196. https://doi.org/10.1111/1467-8721.01259 \u003c/li\u003e\n\u003cli\u003eAuthor (2023) Designing an app for parents and caregivers to promote cognitive and socioemotional development and well-being among children aged 0 to 5 years in diverse cultural settings: scientific framework. JMIR Pediatr Parent 6(1):e38921. https://doi.org/10.2196/38921 \u003c/li\u003e\n\u003cli\u003eDiniz E, Brand\u0026atilde;o T, Monteiro L, Ver\u0026iacute;ssimo M (2021) Father involvement during early childhood: A systematic review of the literatureJ Fam Theory Rev 13(1):77-99. https://doi.org/10.1111/fare.12858 \u003c/li\u003e\n\u003cli\u003eDiniz E, Brand\u0026atilde;o T, Ver\u0026iacute;ssimo M (2023) Father involvement during early childhood: A systematic review of qualitative studies. Fam Relat 72:2710-2730. https://doi.org/10.1111/fare.12858 \u003c/li\u003e\n\u003cli\u003eEmde RN (1988) The effect of relationships on relationships: A developmental approach to clinical intervention. In R. A. Hinde and J. Stevenson-Hinde (Eds.), Relationships within families: Mutual influences. Clarendon Press, England, p 354-364.\u003c/li\u003e\n\u003cli\u003eFeldman R (2023) Father contribution to human resilience. Dev Psychopathol 35:2402-2419. https://doi.org/10.1017/S0954579423000354 \u003c/li\u003e\n\u003cli\u003eHewlett BS (2014) Culture, history, and sex: Anthropological contributions to conceptualizing father involvement. In Peters, H. E., Day, R. D., Peterson, G. W., \u0026amp; Steinmetz, S. (Ed.), Fatherhood. Routledge, England, p 59-73\u003c/li\u003e\n\u003cli\u003eHo H, Lam YW (2019) Father involvement in East Asia: Beyond the breadwinner role? In S. B. Sheldon \u0026amp; T. A. Turner-Vorbeck (Eds.), The Wiley handbook of family, school, and community relationships in education. John Wiley \u0026amp; Sons, Inc, New Jersey, p 333-356.\u003c/li\u003e\n\u003cli\u003eAuthor (in press) The manifestations of children\u0026rsquo;s play and the factors that influence it across 12 low- and middle-income countries. Humanit Soc Sci Commun.\u003c/li\u003e\n\u003cli\u003eJeong J, Franchett EE, Ramos de Oliveira CV, Rehmani K, Yousafzai AK (2021) Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLOS Med18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602\u003c/li\u003e\n\u003cli\u003eJeong J, McCoy DC, Yousafzai AK, Salhi C, Fink G (2016) Paternal stimulation and early child development in low- and middle-income countries. Pediatr 138(4):e20161357. https://doi.org/10.1542/peds.2016-1357 \u003c/li\u003e\n\u003cli\u003eKeifert DT (2021) Family culture as context for learning through inquiry. Cogn Instr 39(3):242-274. https://doi.org/10.1080/07370008.2021.1913162 \u003c/li\u003e\n\u003cli\u003eKeown LJ, et al (2018) The role of fathers in supporting children\u0026rsquo;s development. In Sanders MR, Morawska A (Eds.), Handbook of parenting and child development across the lifespan. Springer, New York, p 121-142\u003c/li\u003e\n\u003cli\u003eLamb ME (2010) How do fathers influence children\u0026apos;s development? Let me count the ways. In ME Lamb (Ed.), The role of the father in child development. John Wiley \u0026amp; Sons, Inc, New Jersey, p 1-26 \u003c/li\u003e\n\u003cli\u003eLamb ME, Tamis-LeMonda CS (2004) The role of the father: An introduction. In ME Lamb (Ed.), The role of the father in child development. John Wiley \u0026amp; Sons, Inc, New Jersey, p 1-31. \u003c/li\u003e\n\u003cli\u003eAuthor (2022) Developing a parenting app to support young children\u0026apos;s socioemotional and cognitive development in culturally diverse low- and middle-income countries: protocol for a co-design study. JMIR Res Protoc 11(10):e39225. https://doi.org/10.2196/39225\u003c/li\u003e\n\u003cli\u003eLechowicz ME, Jiang Y, Tully LA, Burn MT, Collins DAJ, Hawes DJ, Lenroot RK, Anderson V, Doyle FL, Piotrowska PJ, Frick PJ, Moul C, Kimonis ER, Dadds MR (2019) Enhancing father engagement in parenting programs: Translating research into practice recommendations. \u003cem\u003eAust Psychol 54\u003c/em\u003e(2):83\u0026ndash;89. https://doi.org/10.1111/ap.12361\u003c/li\u003e\n\u003cli\u003eLi X (2020) Fathers\u0026rsquo; involvement in Chinese societies: Increasing presence, uneven progress. Child Dev Perspect14(3):150-156. https://doi.org/10.1111/cdep.12375 \u003c/li\u003e\n\u003cli\u003eLumivero (2023) NVivo (Version 14) www.lumivero.com\u003c/li\u003e\n\u003cli\u003eMaselko J, Hagaman AK, Bates LM, Bhalotra S, Biroli P, Gallis JA, O\u0026apos;Donnell K, Sikander S, Turner EL, Rahman A (2019) Father involvement in the first year of life: Associations with maternal mental health and child development outcomes in rural Pakistan. Soc Sci Med 237:112421. https://doi.org/10.1016/j.socscimed.2019.112421\u003c/li\u003e\n\u003cli\u003eNovianti R, Suarman, Islami N (2023) Parenting in cultural perspective: A systematic review of paternal role across cultures. Journal of Ethnic and Cultural Studies 10(1):22\u0026ndash;44. https://www.jstor.org/stable/48718233 \u003c/li\u003e\n\u003cli\u003eOduola S, Wykes T, Robotham D, Craig TK (2017) What is the impact of research champions on integrating research in mental health clinical practice? A quasiexperimental study in South London, UK. BMJ Open 7(9):e016107. https://doi.org/10.1136/bmjopen-2017-016107 \u003c/li\u003e\n\u003cli\u003ePaquette D, Coyl-Shepherd DD, Newland LA (2013) Fathers and development: New areas for exploration. Early Child Dev Care 183(6):735\u0026ndash;745. https://doi.org/10.1080/03004430.2012.723438\u003c/li\u003e\n\u003cli\u003eParke RD, Cookston JT (2019) Fathers and families. In MH Bornstein (Ed\u003cem\u003e.), \u003c/em\u003e\u003cem\u003eHandbook of parenting: Being and becoming a parent\u003c/em\u003e\u003cem\u003e (3rd ed\u003c/em\u003e). Routledge/Taylor \u0026amp; Francis Group, England, p 64-136. https://doi.org/10.4324/9780429433214-3 \u003c/li\u003e\n\u003cli\u003ePinho M, Gaunt R, Gross H (2021) Caregiving dads, breadwinning mums: Pathways to the division of family roles among role-reversed and traditional parents. Marriage Fam Rev 57(4):346\u0026ndash;374. https://doi.org/10.1080/01494929.2021.1875102 \u003c/li\u003e\n\u003cli\u003eRakotomanana H, Walters CN, Komakech JJ, Hildebrand D, Gates GE, Thomas DG, Fawbush F, Stoecker BJ (2021) Fathers\u0026rsquo; involvement in child care activities: Qualitative findings from the highlands of Madagascar. PLoS ONE 16(3):e0247112. https://doi.org/10.1371/journal.pone.0247112 \u003c/li\u003e\n\u003cli\u003eRose J, Brady M, Yerkes MA, Coles L (2015) \u0026lsquo;Sometimes they just want to cry for their mum\u0026rsquo;: Couples\u0026rsquo; negotiations and rationalisations of gendered divisions in infant care. \u003cem\u003eJ Fam Stud 21\u003c/em\u003e(1): 38-56. https://doi.org/10.1080/13229400.2015.1010264 \u003c/li\u003e\n\u003cli\u003eSchoppe-Sullivan SJ, Altenburger LE, Lee MA, Bower DJ, Kamp Dush CM (2015) Who are thegGatekeepers? Predictors of maternal gatekeeping. Parent Sci Pract 15(3):166-186. https://doi.org/10.1080/15295192.2015.1053321 \u003c/li\u003e\n\u003cli\u003eSeward RR, Stanley-Stevens L (2013) Fathers, fathering, and fatherhood across cultures. In H Selin (Ed.), Parenting Across Cultures (Vol. 7). Springer Netherlands, p 459-474. https://doi.org/10.1007/978-94-007-7503-9_34 \u003c/li\u003e\n\u003cli\u003eShwalb DW, Shwalb BJ, Lamb ME (Eds.) (2013) \u003cem\u003eFathers in cultural \u003c/em\u003e\u003cem\u003econtext.\u003c/em\u003e\u003cem\u003e \u003c/em\u003eRoutledge/Taylor \u0026amp; Francis Group, England.\u003c/li\u003e\n\u003cli\u003eSteinbach A (2019) Children\u0026apos;s and parents\u0026apos; well-being in joint physical custody: A literature review. Fam Process 58(2):353\u0026ndash;369. https://doi.org/10.1111/famp.12372\u003c/li\u003e\n\u003cli\u003eTrahan MH, Schneider L, Hernandez D (2021) Mobile applications for low-income U.S. fathers: A systematic review of content, comprehensiveness and user ratings. J Technol Hum Serv 39(2):111\u0026ndash;143. https://doi.org/10.1080/15228835.2020.1828228\u003c/li\u003e\n\u003cli\u003eVakrat A, Apter-Levy Y, Feldman R (2018) Fathering moderates the effects of maternal depression on the family process. Dev Psychopathol 30(1):27\u0026ndash;38. https://doi.org/10.1017/S095457941700044X \u003c/li\u003e\n\u003cli\u003eWang J, Donithen RW, Schoppe-Sullivan SJ (2022) Fathers and family systems. In: Molloy S, Azzam P, Isacco A (Eds.) Handbook of the Psychology of Fatherhood. Springer, Cham. https://doi.org/10.1007/978-3-031-14498-1_3 \u003c/li\u003e\n\u003cli\u003eWest MA (2000) Reflexivity, revolution and innovation in work teams. In DA Johnson, ST Beyerlein (Eds.), Advances in the interdisciplinary study of work teams: Product development teams. JAI Press, Connecticut, p 1-29.\u003c/li\u003e\n\u003cli\u003eXu Y, Zhang L, Hee P (2014) Parenting practices and shyness in Chinese children. In Selin H (Eds) Parenting Across Cultures. Science Across Cultures: The History of Non-Western Science. Springer, New York, p 13-24. https://doi.org/10.1007/978-94-007-7503-9_2 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7616434/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7616434/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFathers play an integral and multifaceted role within the family system, including in relation to childrearing. While there are context- and culture-specific influences on fathering, existing literature highlights the considerable consistency regarding the child-centred approach to fathering evident across diverse contexts. This paper builds understanding of the commonalities in fathers\u0026rsquo; roles in family systems in low- and middle-income countries (LMICs). Drawing directly on the perspectives of fathers and their family members, we highlight how the roles of fathers are shaped by factors within the family system and subsystems and the surrounding sociocultural context. Data collected during 69 co-design workshops conducted between 2021\u0026ndash;2023 with a total of 255 parents and caregivers and 83 experts across 12 LMICs were analysed using a hybrid inductive/theoretical approach to thematic analysis guided by the principles of family systems theory. Three key themes were identified related to the paternal role: the father-family system, the father-mother subsystem, and the father-child subsystem. These themes encompassed five subthemes including fathering to provide and lead, fathering in an unbalanced system, fathering as a partner, fathering to play, and fathering to teach and transmit values. Traditional social norms placed on fathers are associated with an imbalance within the mother-father subsystem in relation to caregiving knowledge and experience, and more practically time and availability. Furthermore, systemic exclusion of fathers from parenting systems and services, and the lack of male caregiver role models, may act as enduring barriers to fathering. To encourage the active participation of fathers in caregiving, this paper proposes the development of inclusive childrearing programs and policies rooted in family systems theory.\u003c/p\u003e","manuscriptTitle":"Commonalities in the paternal role within the family system across culturally diverse low- and middle-income countries","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-17 06:34:27","doi":"10.21203/rs.3.rs-7616434/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-24T11:02:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-19T10:58:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175568949850147261185042847782952298403","date":"2026-02-02T15:01:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"227714906963666178651110020427332184847","date":"2025-12-08T12:54:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122945826774057410537939752590535505165","date":"2025-12-05T14:56:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-30T20:34:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"25156392102803576369251313540156117315","date":"2025-11-07T18:04:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-05T16:26:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-05T12:21:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-29T23:18:59+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-18T23:44:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"Humanities and Social Sciences Communications","date":"2025-10-18T23:41:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"84cb437e-8e34-4cdf-97fa-80dd9b419f6e","owner":[],"postedDate":"November 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":57937758,"name":"Humanities/Cultural and media studies"},{"id":57937759,"name":"Social science/Cultural and media studies"},{"id":57937760,"name":"Biological sciences/Psychology"},{"id":57937761,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2026-03-30T10:38:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-17 06:34:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7616434","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7616434","identity":"rs-7616434","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}