Mark Tomlinson

Mark Tomlinson
Stellenbosch University | SUN · Department of Global Health

PhD

About

458
Publications
101,432
Reads
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15,900
Citations
Citations since 2017
245 Research Items
10436 Citations
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Introduction
My scholarly work focuses on factors that contribute to compromised maternal health, to understanding child and adolescent development in contexts of high adversity, to understand the impact of maternal depression on child and adolescent health and development, and how to develop community community based interventions to improve health and development across the life course. My work spans the perinatal period, early childhood, middle childhood and adolescence.
Additional affiliations
December 2007 - present
Stellenbosch University
Position
  • Professor

Publications

Publications (458)
Article
Full-text available
Involving men and boys as both users and supporters of Family Planning (FP) is now considered essential for optimising maternal and child health outcomes. Evidence on how to engage men and boys to meet FP needs is therefore important. The main objective of this review was to assess the strength of evidence in the area and uncover the effective comp...
Article
Full-text available
Recent evidence has shown support for the United Nations Development Programme (UNDP) accelerator concept, which highlights the need to identify interventions or programmatic areas that can affect multiple sustainable development goals (SDGs) at once to boost their achievement. These data have also clearly shown enhanced effects when interventions...
Article
Full-text available
Introduction CHERISH is designed to establish a long-term sustainable system for measurement of in utero and postnatal exposures and outcomes in children who are HIV-exposed uninfected (HEU) and HIV-unexposed to compare survival, hospitalisation, growth and neurodevelopment in the Western Cape, South Africa. Methods and analysis During 2022–2025,...
Article
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Young men in South Africa face the intersecting epidemics of HIV, substance use and endemic poverty. We tested the effectiveness of a behavioral intervention using soccer training to reduce the cluster of risks associated with HIV and substance use. This cluster randomized controlled trial was conducted with men aged 18–29 years old in 27 neighborh...
Article
Good mental health is a critical resource for mothers and caregivers of young children, given the central role of mental health in enabling responsive caregiving. However, fulfilling caregiving responsibilities under challenging circumstances such as extreme poverty, food insecurity, and gender inequality intensifies vulnerability to poor mental he...
Article
Measures that produce valid and reliable antenatal depressive symptom scores in low-resource country contexts are important for efforts to illuminate risk factors, outcomes, and effective interventions in these contexts. Establishing the psychometric comparability of scores across countries also facilitates analyses of similarities and differences...
Article
Full-text available
Purpose Screening tools such as the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) could potentially be used in resource-limited settings to identify adolescents who need mental health support. We examined the criterion validity of the isiXhosa versions of the PHQ-9 and GAD-7 in detecting depression and anxiet...
Article
Full-text available
The COVID-19 pandemic has substantially affected the lives of young people living in sub-Saharan Africa (SSA), leading to poorer short-term mental health outcomes. However, longitudinal data investigating changes in mental health from pre-COVID levels and their predictors are lacking. Our longitudinal sample comprised N = 233 young people (mean age...
Article
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Adolescents exposed to high levels of adversity are vulnerable to developing mental health challenges, with long-lasting adverse consequences. Promoting the psychological well-being of adolescents and protecting them from adverse experiences is crucial for their quality of life. There is a need for evidence on which combinations of protective facto...
Article
Throughout the rapid and intense changes that adolescents experience, their parents retain important influence over how they interact with the complex factors that shape their development. How parents care for their adolescent children has a deep and lasting impact on their well-being and development. Yet, parents often require support to meet thei...
Article
Full-text available
Objective ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. Method We used data ( n = 1,204) from a longitudinal birth cohort study spanning eight countries to...
Article
Full-text available
Introduction Alcohol-related harm is a rising global concern particularly in low-income and middle-income countries where alcohol use fuels the high rates of violence, road traffic accidents and is a risk factor for communicable diseases such as HIV/AIDS and tuberculosis. Existing evidence to address alcohol-related harm recommends the use of inter...
Article
Maternal and child health programmes often use Community Health Workers (CHWs) to help address poor access to health care, particularly in low‐ and middle‐income countries (LMIC). Supervision has long been recognised as a critical ingredient of successful CHW programmes, yet it is often reported as either of poor quality or absent. There is little...
Article
Full-text available
Background This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). Methods A total of 118...
Article
Adolescents are a crucial generation, with the potential to bring future social and economic success for themselves and their countries. More than 90% of adolescents living with HIV reside in sub-Saharan Africa, where their mental health is set against a background of poverty, familial stress, service gaps, and an HIV epidemic that is now intertwin...
Article
Full-text available
Background Improved technology and advances in clinical testing have resulted in increased detection rates of congenital anomalies during pregnancy, resulting in more parents being confronted with the possibility of terminating a pregnancy for this reason. There is a large body of research on the psychological experience and impact of terminating a...
Article
Full-text available
Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health res...
Article
Full-text available
Intimate partner violence (IPV) is a common traumatic stressor for women worldwide, especially for women living in low-and-middle-income countries. One of the most common correlates of IPV victimization is alcohol use, but the dynamics of IPV and drinking among women are not well understood. Although some research suggests that women drink in the a...
Article
Full-text available
Introduction: South Africa's evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception...
Article
Full-text available
Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health res...
Article
Full-text available
Abstract Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for h...
Article
Full-text available
Background Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner’s miscarriage. While nume...
Article
Understanding the needs of your child is complicated. Understanding the varied needs of a population of children with whom you have no direct contact is the near impossible challenge policy makers, government planners and donors face when making policy or selecting interventions to fund and implement. They cannot unpack children’s individual needs...
Preprint
ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and foetal development; however, there has been almost no research examining their impact during pregnancy. We used data (n=1204) from a longitudinal birth cohort study spanning eight countries to address this gap. ADHD symptoms in the third trimes...
Article
Access to healthcare in developing countries remains a challenge. As a result, task‐shifting to community health workers (CHWs) is increasingly used to mitigate healthcare worker shortages. Although there is solid evidence of CHW program effectiveness, less is known about CHWs' experiences of becoming and then working daily as CHWs—information that...
Article
Full-text available
Objective: To investigate whether maternal common mental disorders (CMD) in the postnatal period are prospectively associated with child development at 2.5 and 3.5 years in a rural low-income African setting. Methods: This study was nested within the C-MaMiE (Child outcomes in relation to Maternal Mental health in Ethiopia) population-based coho...
Article
Objective This is a secondary analysis examining neighborhood factors predicting high rates of child resilience in South African Township neighborhoods. Methods A population cohort of South African pregnant women (98%; n = 1238), were recruited and assessed across five years with high follow-up rates (83–96%). Resilient children were identified ba...
Article
Objective Examine the association of migration with child growth, cognition, and behavior in South Africa. Methods Secondary analysis assessing effects of migration on child outcomes among a population cohort of women and children (n=1,238) recruited in Cape Town, South African townships and repeatedly assessed from birth to age eight. Logistic re...
Article
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The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical A...
Article
Background This study aimed to identify possible entry points for interventions that can act as development accelerators for children and adolescents in South Africa and Malawi. Methods This study was a secondary data analysis. Data were sourced from the Child Community Care longitudinal study which tracked child wellbeing outcomes among 989 child...
Article
Objective Reducing alcohol use during pregnancy is a pressing public health priority in Sub-Saharan Africa, but insight into the factors that influence prenatal drinking practices is lacking. This study investigated perceptions of, and motivations for, alcohol consumption during pregnancy and associated practices in a rural district of Lesotho. Me...
Article
Full-text available
Background: Evidence from high-income countries (HICs) has documented a higher rate of post-traumatic stress disorder (PTSD) in females than males. However, data are limited on sex differences in PTSD from low- and middle-income countries (LMICs), despite particularly high levels of trauma experienced by LMIC youth. Objectives: In a sample of ad...
Research
Full-text available
The COVID-19 pandemic has placed unprecedented stress on children, families, communities, health systems and societies, and intensified inequality. For some, the pandemic has meant a change in lifestyle, some inconvenience and changes in work-life balance. But for the majority of South Africans, the pandemic has been catastrophic with many families...
Article
Full-text available
Children are not small adults. This is a critical point that many pediatricians and other child health professionals get bored of saying, yet it does seem to need repeating. While children have the lowest risk from COVID-19 directly, they risk suffering the indirect impacts of policy decisions, many of which appear to have been made with next to no...
Article
Full-text available
This study evaluated the impact of a parenting intervention on children’s cognitive and socioemotional development in a group of caregivers and their 21‐to‐28‐month‐old children in a low‐income South African township. A randomized controlled trial compared an experimental group (n = 70) receiving training in dialogic book‐sharing (8 weekly group se...
Article
Full-text available
Abstract Background In South Africa, breastfeeding promotion is a national health priority. Regular perinatal home visits by community health workers (CHWs) have helped promote exclusive breastfeeding (EBF) in underresourced settings. Innovative, digital approaches including mobile video content have also shown promise, especially as access to mo...
Preprint
Full-text available
Background Improved technology and advances in clinical testing have resulted in increased detection rates of congenital anomalies during pregnancy, resulting in more parents being confronted with the possibility of terminating a pregnancy for this reason. There is a large body of research on the psychological experience and impact of terminating a...
Preprint
Full-text available
Background - Miscarriage can be a devastating event for women and men that can lead to short- and long-term mental illness. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner’s miscarriage. While numero...
Article
Full-text available
Social protection can take many forms. Both cash transfers and food security may have important contributions to child cognitive development. This study examines the potential impact of combinations of cash transfers and food security status on child cognitive development and educational outcomes. Cross-sectional data for 796 HIV-affected children...
Article
Background : Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergeneratio...
Book
Full-text available
The rst cases of a new coronavirus (SARS-CoV-2) were identi ed toward the end of 2019 in Wuhan, China. Over the following months, this virus spread to everywhere in the world. By now no country has been spared the devastation from the loss of lives from the disease (Covid-19) and the economic and social impacts of responses to mitigate the impact o...
Preprint
Children are not small adults. This is a critical point that many pediatricians and other child health professionals get bored of saying, yet it does seem to need repeating. While children have the lowest risk from COVID-19 directly, they risk suffering the indirect impacts of policy decisions, many of which appear to have been made with next to no...
Article
Full-text available
Studies in high-income countries (HICs) have shown that variability in maternal-fetal attachment (MFA) predict important maternal health and child outcomes. However, the validity of MFA ratings in low- and middle-income countries (LMICs) remains unknown. Addressing this gap, we assessed measurement invariance to test the conceptual equivalence of t...
Article
Full-text available
A Correction to this paper has been published: https://doi.org/10.1007/s00737-021-01122-7
Preprint
Full-text available
Aims This paper explores the number and characterization of latent classes of adverse childhood experiences across the Evidence for Better Lives Study cohort and investigates how the various typologies link to prenatal substance use (i.e., smoking, alcohol, and illicit drugs) and poor infant outcomes (i.e., infant prematurity and low birth weight)....
Article
Introduction: Traumatic Brain Injury (TBI) has wide-ranging neuropsychological, physical, social and financial implications. The impact on caregivers of moderate to severe TBI survivors, particularly in low- and middle-income countries, is under-investigated. Aim: Identify and describe the experiences of caregivers' of moderate to severe TBI sur...
Article
Full-text available
University administrators and mental health clinicians have raised concerns about depression and anxiety among Ph.D. students, yet no study has systematically synthesized the available evidence in this area. After searching the literature for studies reporting on depression, anxiety, and/or suicidal ideation among Ph.D. students, we included 32 art...
Article
Background: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes...
Article
Background : While the negative impact of peri-natal depression is well-documented in high-income countries, the long-term effects across the life course in low and middle-income countries is less clear. Children's adjustment over the first five years is examined as a function of patterns of maternal depressed mood. Methods : Pregnant women in 24...
Article
Full-text available
Background Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. Methods This review synthesises evidence from qu...
Article
Full-text available
Background: There is growing recognition of the need for interventions that effectively involve men and boys to promote family planning behaviours. Evidence suggests that the most effective behavioural interventions in this field are founded on theoretical principles of behaviour change and gender equality. However, there are few evidence synthese...
Article
Full-text available
Background: Households with a disabled member, be they a caregiver or a child, are poorer than households not affected by disability. Poverty, caregiving as a person with a disability and being the caregiver of a child with a disability can lead to increased parenting stress. Objectives: The objective of this study was to examine whether parenting...
Article
Full-text available
Background Youth suicide prevention in high-schools and universities is a public health priority. Our aim was to propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the research focus and methodologies used in existing intervention studies. Methods Fourtee...
Article
Full-text available
Background: Rates of adolescent HIV and unintended pregnancy in southern Africa are amongst the highest in the world. Gender-transformative interventions that address underlying gender inequalities and engage both males and females have been emphasised by the World Health Organisation, amongst others, to target prevention. However, few such gender-...
Article
An emerging body of participatory media work aims to access children's subjective experiences. One such medium, children's radio, has increasingly become a significant means of motivating and mobilising vulnerable children in many environments, including hospitals, by creating a space in which they can express their lived experiences. The present s...
Article
Full-text available
Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers’ hist...
Article
An emerging body of participatory media work aims to access children’s subjective experiences. One such medium, children’s radio, has increasingly become a significant means of motivating and mobilising vulnerable children in many environments, including hospitals, by creating a space in which they can express their lived experiences. The present s...
Article
Full-text available
A comprehensive evidence-based framework is needed to guide policies and programmes that enable children and adolescents to accrue the human capital required to meet the Sustainable Development Goals (SDGs). This paper proposes a comprehensive, multisectoral, multilevel life-course conceptualisation of human capital development by building on the N...
Article
Sports-based violence prevention programmes have broad appeal, including among police, policy makers and politicians. This policy brief presents a case study of the Eyethu Soccer League, a behavioural intervention that was carefully planned, implemented and evaluated - and yet did not achieve its aims. Findings caution against 'easy wins' and sugge...
Article
Full-text available
Ending all violence against children by 2030 is a core part of Sustainable Development Goals 5 and 16. A number of promising violence reduction strategies have been identified in research studies. However, we lack an understanding of the implementation and impact of these programs in respect to their delivery at a large scale or within existing ser...
Article
Full-text available
Studies in high-income countries (HICs) have shown that variability in maternal-fetal attachment (MFA) predict important maternal health and child outcomes. However, the validity of MFA ratings in low- and middle-income countries (LMICs) remains unknown. Addressing this gap, we assessed measurement invariance to test the conceptual equivalence of t...
Article
Full-text available
Background: Community health worker (CHW) programs have been positioned as a way to meet the needs of those who experience marginalization and inequitable access to health care, and current global health narratives also emphasize their adaptable nature to meet growing health burdens in low-income settings. However, as CHW programs adopt more techni...
Preprint
Full-text available
Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and has thus been hypothesised to be partially responsible for interg...
Preprint
Full-text available
Measures that produce valid and reliable antenatal depressive symptom scores in low resource country contexts are important for research efforts to better understand risk factors, outcomes, and effective interventions in these contexts. Establishing the psychometric comparability of scores across countries also facilitates cross-country analysis of...