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Park C, Alley S, Reinke W, Yarlagadda S, Hansen J. Child maltreatment in children with medical complexity and disability. Semin Pediatr Neurol 2024; 50:101134. [PMID: 38964809 DOI: 10.1016/j.spen.2024.101134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 07/06/2024]
Abstract
Child maltreatment is common and pediatric healthcare providers are becoming increasingly aware of risk factors and signs of abuse.1-4 Children with disabilities and those with special medical needs are recognized as a population at increased risk of child maltreatment. Understanding this risk and recognizing that not all disabilities confer the same risks can provide deeper insight for pediatric providers regarding the supports these children and their families need to prevent maltreatment.
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Affiliation(s)
- Clair Park
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Samantha Alley
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Whitney Reinke
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Shravya Yarlagadda
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Jennifer Hansen
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
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Rahman MM, Alam MI, Mansur M. Functional difficulty among young children in Bangladesh: An analysis of nationally representative data. PLoS One 2024; 19:e0300403. [PMID: 38512905 PMCID: PMC10956765 DOI: 10.1371/journal.pone.0300403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Functional difficulty in children is a crucial public health problem still undervalued in developing countries. This study explored the socio-demographic factors and anthropometry associated with children's functional difficulty in Bangladesh. Data for 2-4-year-old children, obtained from Multiple Indicator Cluster Survey 2019, were used in this study. The mixed-effects logistic regression model was used to analyse the data. Children whose mothers had functional difficulty were found to be 2.75 times more likely to have functional difficulty than children whose mothers had no functional difficulty (95% CI 1.63-4.63). Male children were more likely to experience functional difficulty than female children (OR = 1.48). Furthermore, stunting was found to be significantly associated with functional difficulty (OR = 1.50). The study also revealed that division and mother's education, specifically, children with mothers having higher secondary + education, had significant association with the outcome variable. The findings provided a vital overview of child disability in a developing country.
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Affiliation(s)
- Maisha Maliha Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - M Iftakhar Alam
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Mohaimen Mansur
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
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Ekman AT, Sengeh PA, Webber N, Jalloh MB, Hollander AC, Newby H, Cappa C, Orsini N, Alfvén T, Frielingsdorf H. Prevalence of children under five with disabilities in Sierra Leone in 2017: Insights from a population-based multiple indicator cluster survey. Disabil Health J 2023; 16:101481. [PMID: 37316393 DOI: 10.1016/j.dhjo.2023.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/16/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Children with disabilities have been low on the agenda of child health, including in Sierra Leone, and there are still many gaps in our knowledge and understanding of the issue. OBJECTIVE To estimate the prevalence of children with disabilities in Sierra Leone using functional difficulty as a proxy and to understand the factors associated with disabilities among children two to four years living in Sierra Leone. METHODS We used cross-sectional data from the Sierra Leone 2017 Multiple Indicator Cluster Survey. Disability was defined using a functional difficulty definition with additional thresholds used to define children with severe functional difficulty and multiple disabilities. Logistic regression models estimated odds ratios (ORs) of childhood disability and how they were associated with socioeconomic factors and living conditions. RESULTS Prevalence of children with disabilities was 6.6% (95% confidence interval (CI) 5.8-7.6%) and there was a high risk of comorbidity between different functional difficulties. Children with disabilities were less likely to be girls (adjusted odds ratio (AOR) 0.8 (CI 0.7-1.0) and older (AOR 0.3 (CI 0.2-0.4)), but more prone to be stunted (AOR 1.4 (CI 1.1-1.7)) and have younger caregivers (AOR 1.3 (CI 0.7-2.3)). CONCLUSION The prevalence of disabilities in young Sierra Leonean children was comparable to other countries in West and Central Africa when using the same measure of disability. Preventive as well as early detection and intervention efforts are recommended to be integrated with other programs, e.g vaccinations, nutrition, and poverty reducing programs.
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Affiliation(s)
- Anna-Theresia Ekman
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Paul A Sengeh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Nance Webber
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Mohammad Bailor Jalloh
- FOCUS 1000, 7E Conteh Drive, Off Old Railway Line, Tengbeh Town, Freetown, Sierra Leone.
| | - Anna-Clara Hollander
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Global Public Health Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | | | - Claudia Cappa
- Data & Analytics Section, UNICEF, New York City, USA.
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
| | - Helena Frielingsdorf
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
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Thi AM, Zimmerman C, Ranganathan M. Hazardous Child Labour, Psychosocial Functioning, and School Dropouts among Children in Bangladesh: A Cross-Sectional Analysis of UNICEF's Multiple Indicator Cluster Surveys (MICS). CHILDREN (BASEL, SWITZERLAND) 2023; 10:1021. [PMID: 37371253 DOI: 10.3390/children10061021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Child labour is a common financial coping strategy in poor households, especially in low-and middle-income countries with many children working under hazardous conditions. Little is known about the linkages between hazardous work conditions and psycho-social and educational outcomes. We analysed the Bangladesh Multiple Indicator Cluster Survey (BMICS) round 6 to assess the association between the exposure variables, including child labour, hazardous child labour (HZCL) and hazardous work, and outcome variables, including psychosocial functioning difficulty and school dropout, in children aged 5 to 17 years. We conducted bivariable and multivariable analyses to examine the association. In the adjusted analyses, children engaged in HZCL had increased odds of psychosocial functioning difficulty (aOR: 1.41; 95% CI: 1.16-1.72) and school dropout (aOR: 5.65; 95% CI: 4.83-6.61) among 5-14-year-olds compared to children who did not engage in child labour and hazardous work. Other independent factors associated with psychosocial functioning difficulty and school dropout included being male, living in a deprived neighbourhood, being exposed to violent punishment, the caregiver's attitude towards physical punishment, the mother's functional difficulty and lower maternal education. The linkages between hazardous work and psychosocial functioning difficulty appear more prominent among children not in school. Further, the evidence on the relationship between hazardous work and school dropout is stronger among children with psychosocial functioning difficulty. Policies and programmes that target the most hazardous forms of work are likely to have the greatest benefits for children's mental health, social well-being and educational attainment.
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Affiliation(s)
- Aye Myat Thi
- Innovations for Poverty Action, Yangon 11111, Myanmar
| | - Cathy Zimmerman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Meghna Ranganathan
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
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Bhatia A, Davey C, Bright T, Rotenberg S, Eldred E, Cappa C, Kuper H, Devries K. Inequities in birth registration, violent discipline, and child labour by disability status and sex: Evidence from the Multiple Indicator Cluster Surveys in 24 countries. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001827. [PMID: 37224158 DOI: 10.1371/journal.pgph.0001827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/24/2023] [Indexed: 05/26/2023]
Abstract
Nearly 240 million children are estimated to have a disability globally. We describe inequities by disability status and sex in birth registration, child labour, and violent discipline outcomes. Data come from Round 6 of the Multiple Indicator Cluster Survey programme and includes 323,436 children, aged 2-17 years in 24 countries. We estimated non-registration of birth, child labour, and violent discipline, stratified by sex and disability in each country. We estimated age-adjusted prevalence ratios and prevalence differences, accounting for survey design, to calculate inequities by disability. There was large variation across countries in the percentage of children with disabilities (range: 4% to 28%), in non-registration (range: 0% to73%), child labour (range: 2% to 40%), and violent discipline (range: 48% to 95%). We found relative inequities by disability in birth registration in two countries among girls and one country among boys, and in birth certification in two countries among girls and among boys. Child labour was higher among girls with disabilities in two countries and among boys in three countries. We found larger and more prevalent inequities by disability in hazardous labour in six countries among girls (aPR range: 1.23 to 1.95) and in seven countries among boys (aPR range: 1.24 to 1.80). Inequities in the prevalence of violent discipline by disability were significant in four countries among girls (aPR range: 1.02 to 1.18) and among boys (aPRs: 1.02 to 1.15) and we found inequities in severe punishment nine countries among girls (aPR range: 1.12 to 2.27) and in 13 countries among boys (aPRs: 1.13 to 1.95). Context specific research is needed to understand the large variations in inequities by disability status and sex within and across countries. Monitoring inequities in child rights by disability status and sex is important to achieve the SDGs and ensure child protection programs reduce inequities.
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Affiliation(s)
- Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Calum Davey
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tess Bright
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom
| | - Emily Eldred
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Claudia Cappa
- Data and Analytics Section, UNICEF, New York, NY, United States of America
| | - Hannah Kuper
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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