Parenting support in the context of poverty: a meta-synthesis of the qualitative evidence.

From the outset, providing support for parents has been a key feature of New Labour's policy agenda, but 'good' parenting, and child health and well-being are often undermined by the stresses associated with poverty. Moreover, there may be a gap between policy aims, and the perceptions and motivations of those intended to benefit. Drawing on a systematic review of qualitative studies of low-income parents, the present paper explores their experiences of informal and formal support networks, considering their strengths and weaknesses in the context of poverty. Traditional systematic review methods were used to locate and critically appraise 12 UK qualitative studies, which took as their focus parents' subjective experiences of caring for children in impoverished circumstances. Meta-ethnographic methods were then used to produce a qualitative meta-synthesis of findings. Exploring the similarities and differences in parents' accounts across studies identified positive and negative aspects of social support as a resource for poor parents. The review suggests that naturally occurring support systems do provide both material and emotional help to parents, but that such support has certain inherent drawbacks. It is not universally available and, in some circumstances, carries negative associations for poor families. Low-income lone mothers in particular enjoy smaller support networks, and are more reliant on mutual support than those in two-parent families. Paradoxically, it is the most socially isolated women who are least willing to seek professional help. Overall, low-income parents' experiences of formal health and social welfare agencies are mixed, and not invariably positive. In conclusion, this paper suggests that formal support services have the potential to fill gaps in informal support systems for poor families, but only if these are provided in ways which are sensitive to their needs. Therefore, parents' perspectives are essential to informing service design, development and evaluation in health and social care.