Facilitators and Barriers to Sustained Engagement in Parenting Programs: A Systematic Review

Background Parenting programs are a key public health strategy to prevent child maltreatment in low- and middle-income countries (LMICs). However, their effectiveness is often limited by low levels of sustained parental engagement. This systematic review synthesizes evidence on facilitators and barriers to sustained engagement in parenting programs in LMICs. Method This systematic review synthesized evidence from 88 studies identified through searches of PsycINFO, PubMed, Scopus, and Web of Science. Peer-reviewed studies were included if they examined parental engagement in structured parenting programs in LMICs. Thematic analysis was used to synthesize findings, organized within a multilevel ecological framework. Results Sustained engagement was facilitated by parents’ perceived benefits, practical and culturally grounded content, flexible delivery modalities, supportive implementation environments, and responsive facilitator practices. Barriers operated across multiple levels, including low motivation, family resistance and limited support, rigid or culturally incongruent designs, gendered caregiving norms, material deprivation, and constrained access to services. Disengagement was driven more by structural inequities than by individual motivation, with mothers bearing disproportionate caregiving burdens and fathers being marginalized by gendered program designs and inflexible scheduling. Conclusion Sustained parental engagement in LMIC parenting programs depends on structural conditions and intervention design. The findings advocate for gender-sensitive engagement strategies that address material constraints and realistic problems, challenge gendered caregiving norms, and integrate parenting programs within broader social protection and public policy systems.