Diversity and the positive impact of culture and supporting families in context – A view from Africa

African mother with baby girl, location Mmankgodi village, Botswana. Source: Adobe Stock.


While many aspects of childbirth and child development are universal parts of the human experience worldwide, parenting practices and family beliefs and values regarding child rearing are culturally determined; thus, approaches to supporting optimal child development are best viewed within a cultural context. One of the greatest strengths of WAIMH is holding a global perspective that exposes us to wide-ranging beliefs, values, and customs to improve our understanding of cultural influences on child development and how development unfolds in the context of these varied family and community rituals and practices. As part of our WAIMH communication plan to highlight and address important topics affecting young children in today’s world, Astrid Berg has written the following beautiful illustration of the role of culture and of several African traditional practices related to babies and their care.

Dr Astrid Berg is an Emerita Professor in the Division of Child and Adolescent Psychiatry at the University of Cape Town and Professor Extraordinary at Stellenbosch University. She is a child and adolescent psychiatrist and fully qualified psychoanalyst. She was a founding member of the Western Cape Association for Infant Mental Health. She has been involved with WAIMH since 1996, attending nearly every WAIMH Congress since that time, including organizing the 13th International Conference of WAIMH in Cape Town, and she is currently in her second term as an Executive Committee Member of the WAIMH Board. Her work with several African cultural groups and cultural brokers has informed her perspective, which she shares with us here.

by Jody Todd Manly, USA (Associate Editor)


Diversity and the positive impact of culture and supporting families in context – A view from Africa

About culture

Culture is part of all human groupings. The customs, rituals and beliefs we have give meaning to what happens to us and how we live our lives.

An infant is embedded in his/her culture even before birth. Parents have fantasies about their unborn child and these fantasies are colored by the culture from which they came and in which they live. Culture thus forms a blanket, so to speak, whose weft and warp surround the baby from the very beginning.

And we, as human beings, all have this wrap-around – the western, Judeo-Christian one is as much a ‘culture’ as the First Nation cultures in Australia and the Americas, or the culture of the Amabantu groups of Southern Africa. No group is ‘culture-free’.

The developmental niche

How does culture influence the development of a child? The “developmental niche” is a helpful concept which describes the mutual adaptation between the individual and the environment. It consists of three components that are interrelated and interact with one another (Harkness & Super, 1994).

The physical setting of daily life is regarded as one of the most powerful ways that culture influences the child. For example, if the social group of which the family is a part lives in a community with a nomadic life-style, or are hunter-gatherers it would be important for that infant to become physically independent fairly soon; here children are expected to help in household chores from an early age and learn from the adults around them about how things are done.

The second influence on development described is that of the customs of child care. These are the daily routines such as feeding and bathing that are culturally prescribed sequences of behaviour that are considered ‘normal’. They may have originated because of the physical setting but may continue to be practised even if this physical setting has changed.

The psychology of the care-takers is the third feature of the developmental niche. In parts of Africa, for example, there is the belief is that children are played with and socialized by their older siblings and peers. Adults may thus not engage with them in the face-to face and verbal manner that is customary for western mothers.

Most published research on infants comes from Europe and the USA while the majority of infants live in Africa and Asia (Tomlinson, Bornstein, Marlow, & Swartz, 2014). This has contributed to the assumption that the Western way of rearing children is the norm. So if measured with a European yard stick, an African mother’s less frequent direct face-to-face contact with her baby could be regarded as disinterest or neglect, but if seen in its context, it becomes clear that the infant’s need for interaction is met by others in the environment and not necessarily by the mother alone.

Globalization and the hegemony of the western, industrialized life-style threaten indigenous approaches to infants and child care as they may be perceived as being ‘better’. In the words of Mary Ainsworth when she spoke with mothers in Uganda many years ago:

I do not believe that European methods of infant care are better than your customs just because they are European, or because they are methods used in my own country. I believe that some of our customs are probably better than yours, but I also believe that some of your customs are better than ours. (Ainsworth, 1967, p.20)

Non-western cultures are in danger of giving up on beneficial child rearing practices in favour of modern approaches that are not necessarily better. It thus behooves us to be circumspect when talking about or giving advice and developmental guidance to parents who come from diverse cultural backgrounds.

While not wanting to assume that African societies are homogenous, and that therefore the customs pertain to all the groups of people living on the Continent, there are some basic common denominators that can be identified as influencing child rearing and that should be given attention and, importantly, from which western cultures could learn.

In the following section four practices will be described that are respected in traditional African cultures, but that are in danger of being lost. The first two, Ubuntu and the meaning of babies, are part of the worldview of many if not all communities in Africa and thus part of the psychology of the caregivers; the other two practices are more directly practical and belong to the customs of child care described earlier.

Indigenous cultural practices and what we can learn from them


A recent review of attachment studies in Africa found that secure attachments rates were reported to range from 53.7 to 90.2% (Voges, J; Berg, A; Niehaus, 2019). Thus it would seem that the majority of mothers had the ability to create a safe environment for their infants, amidst adversity, unpredictability or turmoil, and were able to facilitate the healthy development of their children.

What are the factors that may assist parents in creating an environment conducive to secure attachment and that help parents to overcome these challenges?  One possible protective factor is the notion of Ubuntu. This is a concept that is common to most African traditional cultures. The Xhosa proverb (Umtu ngumtu ngabantu), meaning “A person is a person because of another person”  (Berg, 2012) best describes this concept. Compassion for others and a sense of community among individuals is central. The individual is seen in relation to the broader community, and personal development is marked by rituals that involve the community within which they live. It is out of this worldview that the proverb “it takes a village to raise a child” (Mooya, Sichimba, & Bakermans-Kranenburg, 2016) is born. The infant is thought of as belonging to the community and the wellbeing of the children within that community is considered a collective responsibility (Tomlinson, Cooper, & Murray, 2005). Mothers can find support from the people around them, even if these are not direct family. Infants thus grow up within a wider network of people whom they can trust and rely upon. Sadly, this collective responsibility is diminishing as urbanization increases, resulting in mothers having to raise their children without the support that tradition encourages.

The meaning of babies

Babies carry the hope for the future: they will ensure that the family thrives and grows; they will provide for the older generation, and they will be the ones who will remember the parents when they have died. The hope in them is thus economical as well as spiritual.

In Africa not only do the nuclear and extended family play a central role, but also the clan – this includes those that have deceased. This structure runs along patriarchal lines. The reverence for the ancestors is introduced to the child from very early on through various means. There is the practice of “praising the child in his clan” – this is a rhythmical incantation that names the child and the child’s forebears, one by one, going further and further back into the ancestral history.  The child is thus explicitly embedded in the clan structure through this lullaby-like chant.

In the amaXhosa tradition of the Eastern Cape in South Africa, the infant is also introduced to the ancestors through a special ceremony, called the imbeleko. This ceremony brings together the extended family, as well as the community in which the family live, and they bear witness to the ritual through which the child is introduced to the ancestors (Berg, 2012). The Western equivalent might be the christening ceremony.

In other African cultures the spiritual meaning of the infant’s life may be articulated differently. The Beng people of the Ivory Coast believe that each baby is a reincarnation of an ancestor. Thus, when a baby is unhappy for no obvious reason, it is believed that it is trying to communicate a spiritual need and for this, a diviner may be consulted (Gottlieb, 1998). Much of the behaviour of the infant as well as the older child is explained from the basis of the child being part of a much larger life cycle than the one that Western traditions are aware of. This is an example of a very particular way of viewing the child and it may well be changing over time. However, the depth of the spiritual role that is attributed to infants and young children needs to be acknowledged and respected in this community as in all other human groups.

Back carrying

The lived, spiritual link to the ancestors and the community is grounded in the physical closeness to the mothering figure. Most infants in sub-Saharan Africa are carried on their care-givers back. On a practical level it is a method of transport for infants before they are able to walk and reflects an adaptation to the physical environment where prams are not available and also not suitable to the natural terrain. Carrying the infant on her back also enables the mother to be close to her child, ensure its well-being at all times, while being able to have her hands freed to do work. Even when the child is older, the mother will continue with this custom if there is a physical reason, such as a handicap. The Xhosa saying of “the elephant does not complain about his trunk” depicts the acceptance of this task.

Back-carrying provides multiple opportunities for bonding: physical closeness, being swaddled and feeling ‘held’, being in-tune with mother’s physical rhythm and generally feeling ‘safe’ in the high position on mother’s body. It literally provides a ‘secure base’ for the infant, one that is physically felt.

From a medical point of view there are also advantages for conditions such has hip-dysplasia (Graham) which is rarely encountered in infants in Sub-Saharan Africa.  Thus indeed, it is true that: “The mother’s back is the baby’s medicine” (Wolof proverb) (Timyan J, 1988, p.15).

Unfortunately, urbanization and modern life has encroached on this traditional way of transportation. Increasingly prams and strollers are being used, which may suit the mother better, but which do take away that very special early physical intimacy that is possible in the more traditional settings.

Breast-feeding and sleeping

Being fed and sleeping are the two primary ‘tasks’ that the infant has to engage with in order to survive and thrive. This early stage of unity between the mother and baby is known as the Mdlezana phase in the isiXhosa tradition. It could be likened to the Winnicottian concept of “primary maternal preoccupation” (Berg, 2003). Much of what is accepted in the early stages of child rearing, could be understood in terms of the mother being in the Mdlezana phase. The anxiety around sleeping and feeding, so often found in clinical practice in the urbanized population, is not evident with mothers who rear their children within traditional African norms.

Customs originate because of outer realities. Sleeping arrangements thus reflect the physical setting – when the mother is working, she may have the infant sleep on her back, to be put down on the ground once asleep. At night, the safest and possibly only space there is, would be next to the mother, in her bed. In the African tradition it is natural for children to sleep with their parents until such time they can share their bed with their older siblings.

In western industrialized populations co-sleeping has been considered dangerous, as it is claimed that it could lead to sudden unexplained infant deaths. Evidence for a direct link has however of late been questioned. New research suggests that co-sleeping may in fact be adaptive from an evolutionary point of view (Barry, 2019). Sleeping arrangements and habits are part of our culture and are as such a complex phenomenon that is intimately tied not only to physical settings but also to the psychology of the caretakers.

Other customs, such as feeding, mirror the reality of the advantages of breastfeeding: that is, a readily available milk supply. It is considered a given that the child has access to the breast at all times, including the night.

In addition, there may also be attitudes and beliefs about the specialness of mother’s milk that may be considered to transmit to the child certain powers (Timyan J, 1988).  Maiello describes an infant observation in a community in South Africa which describes the physical one-ness between the mother and her young baby. Maiello describes it thus:

The transition from ‘breast’ to ‘no-breast’ remained fluid. She (the mother) was surprised when I asked how often she fed her baby and replied “Always”. This included day and night. She was equally surprised when I told her that European babies usually sleep in a cot separated from their mothers. (Maiello, 2003, p.83)

A practice that ensures the infant’s unlimited access to the breast during the first two years of life is the madzawde practice among the people of Gorongosa in Mozambique. During the madzawde period the mother is free to devote her entire attention to her child. The infant is breastfed and in close physical contact with the mother at all times, while the mother is freed from household and other family duties.  The underlying belief is that the environment is polluted and that the infant is vulnerable to this polluted environment; the baby’s health could thus be affected if exposed too early to the bigger world. This important period of close connection between mother and child ended after two years with a specific ritual.

The madzawde period was disrupted during the war in Mozambique and the intense period of drought in Gorongosa. The struggle to survive made it impossible for the madzawde period to be respected and for the associated rituals to be performed.

A study done in Gorongosa after the war ended, found that even in the absence of food insecurity, a high percentage of infants were found to be malnourished. This was attributed to the disintegration of the madzawde practice (Igreja, 2003).

The importance of cultural beliefs and customs is evident in this example which translates the notion of the “First 1000 Days” into practice. It demonstrates the wisdom that underlies many cultural child rearing practices.

The importance of acquiring cultural knowledge and understanding

Child rearing practices are not monolithic, but, are forever moving and adapting to new settings. No culture is static, but changes according to the times and places we live in.

Because of the predominance of research on infants and their parents in western countries, there is a tendency to use the western model as the norm against which different ways of child rearing are not only measured, but also judged. In fact, the opposite could be said to be true: that western cultures could learn from other cultures, such as African cultures. In fact, it may be happening already, as some African traditions are being introduced into Europe and the USA as ideal modes of caring for babies, such as co-sleeping and on-demand breast-feeding.

For the practitioner on the ground it is essential to learn about the culture of the particular family and community, and to reflect on these customs. They may have deeper meaning and they may be more appropriate in the family’s context, than what textbooks from Europe or the USA may prescribe.

In conclusion

Traditions and rituals are part of life – the way in which we perceive the world and make meaning of it depends on the cultural group into which we are born. Even the individualized western European way of living has its own ‘weft and warp of meanings’ which underlie its customs and life-style. What is regarded as ‘the truth’ in one group may not be seen as such in another. It is essential that we understand the relativity of our convictions.

It is important not only to acknowledge and respect difference, but to acquire a basic understanding of the world view of the different cultures that are the essential part of our collective humanity.



Ainsworth, M. D. 1967. Infancy in Uganda-Infant Care and the Growth of Love. Baltimore: The Johns Hopkins Press.

Barry, E. S. (2019). Infant Behavior and Development Co-sleeping as a proximal context for infant development : The importance of physical touch. Infant Behavior and Development, 57(May), 101385. https://doi.org/10.1016/j.infbeh.2019.101385

Berg, A. (2003). Beyond the Dyad: Parent-infant psychotherapy in a multicultural society – Reflections from a South African perspective. Infant Mental Health Journal, 24(3), 265–277. https://doi.org/10.1002/imhj.10055

Berg, A. (2012). Connecting with South Africa – cultural comunication and understanding. College Station.

Gottlieb, A. (1998). Do infants have religion? The spiritual lives of Beng babies. American Anthropologist, 100(1), 122–135. https://doi.org/10.1525/aa.1998.100.1.122

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Tomlinson, M., Bornstein, M. H., Marlow, M., & Swartz, L. (2014). Imbalances in the knowledge about infant mental health in rich and poor countries: too little progress in bridging the gap. Infant Mental Health Journal, 35(6), 624–629. https://doi.org/10.1002/imhj.21462

Tomlinson, M., Cooper, P., & Murray, L. (2005). The Mother-Infant Relationship and Infant Attachment in a South African Settlement. Child Development, 76(5), 1044–1054.

Voges, J; Berg, A; Niehaus, D. (2019). Revisiting the African origins of attachment research – 50 years on from Ainsworth: A descriptive review. Infant Mental Health Journal, 40, 799–816.


Astrid Berg, Cape Town, South Africa