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Chongwo EJ, Aoko B, Kaniala M, Esala M, Magoma P, Njoroge E, Nyamanya S, Marangu J, Khamis A, Ng’asike J, Huizink AC, Abubakar A. Intersection between individual, household, environmental and system level factors in defining risk and resilience for children in Kenya's ASAL: A qualitative study. PLoS One 2025; 20:e0316679. [PMID: 39823504 PMCID: PMC11741590 DOI: 10.1371/journal.pone.0316679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 12/14/2024] [Indexed: 01/19/2025] Open
Abstract
INTRODUCTION Children growing up in arid and semi-arid regions of Sub-Saharan Africa (SSA) face heightened risks, often resulting in poor developmental outcomes. In Kenya, the arid and semi-arid lands (ASAL) exhibit the lowest health and developmental indicators among children. Despite these risks, some children grow up successfully and overcome the challenges. However, there is limited comprehensive data on sources of risks and resilience in these children, particularly research that incorporates community perspectives and indigenous knowledge. Systematic documentation of factors influencing child outcomes is crucial for understanding the overall burden, informing policy and implementing targeted interventions. This study aimed at bridging this gap. METHODS The study was conducted in 10 ASAL counties in Kenya. Purposive and snowballing techniques were used to recruit 11 key informants per site with varied levels of involvement in early childhood development and primary caregivers. Using a semi-structured interview guide, 103 telephonic interviews were conducted between June and August 2022, involving 68 key informants and 35 caregivers. Thematic approach was used to analyze the data, using NVIVO software. RESULTS The mean age of the participants was 44years (SD = 11 years). The findings, viewed through the lens of Bronfenbrenner's ecological systems theory, reveal a complex interplay of contextual factors impacting children's development. These factors range from individual and biological aspects to family, community, systemic, and environmental level, including climatic challenges. Identified risk factors encompassed issues such as young caregiver's age, low literacy, mental health issues, drug abuse, domestic violence, malnutrition, poverty, lack of paternal involvement, early marriages, female genital mutilation, drought, heat stress, and insecurity. Nonetheless, sources of resilience include breastfeeding, immunization, responsive caregiving, family and community support, higher socio-economic status (SES), cultural practices, self-motivation, hard work, community role models, religious activities and quality service provision. CONCLUSION Urgent attention is needed to address the multifaceted challenges faced by children in ASAL regions. The study underscores the importance of addressing the root causes of risks while harnessing community strengths and resources to safeguard and promote the holistic development of these children.
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Affiliation(s)
- Esther Jebor Chongwo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Barack Aoko
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Martha Kaniala
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Moses Esala
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Phillis Magoma
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Susan Nyamanya
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Anil Khamis
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- University College London-Institute of Education, London, United Kingdom
| | | | - Anja C. Huizink
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Kenya Medical Research Institute/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
- Department of Psychiatry, University of Oxford, London, United Kingdom
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065504. [PMID: 38374809 DOI: 10.1542/peds.2023-065504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
The warming of our planet matters to every child. Driven by fossil fuel-generated greenhouse gas emissions, climate conditions stable since the founding of modern pediatrics in the mid-nineteenth century have shifted, and old certainties are falling away. Children's physical and mental health are threatened by climate change through its effects on temperature, precipitation, and extreme weather; ecological disruption; and community disruption. These impacts expose and amplify existing inequities and create unprecedented intergenerational injustice. Fossil fuel extraction and combustion cause harm today and reach centuries into the future, jeopardizing the health, safety, and prosperity of today's children and future generations. Appreciating the unique vulnerability of their patients, pediatricians have become leading health advocates for climate actions necessary to protect all living and future children. Policies that reduce reliance on fossil fuels and promote cleaner air, facilitate walking and bicycling, encourage more sustainable diets, increase access to nature, and develop more connected communities lead to immediate gains in child health and equity, and build a foundation for generations of children to thrive.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065505. [PMID: 38374808 DOI: 10.1542/peds.2023-065505] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Fortuna LR, Jimenez A, Porche MV. Climate Events, Displacement, and Mental Health-Uprooted. JAMA Psychiatry 2024; 81:5-6. [PMID: 37966826 DOI: 10.1001/jamapsychiatry.2023.3561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
This Viewpoint discusses the implications of climate event–related disasters and displacement as well as strategies for mitigating their mental health effects.
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Affiliation(s)
- Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
- now with Department of Psychiatry and Neuroscience, University of California, Riverside
| | - Aida Jimenez
- Department of Psychology, University of Puerto Rico, Río Piedras, Puerto Rico
| | - Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
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Li Y, Sun J, Lei R, Zheng J, Tian X, Xue B, Luo B. The Interactive Effects between Drought and Air Pollutants on Children's Upper Respiratory Tract Infection: A Time-Series Analysis in Gansu, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1959. [PMID: 36767324 PMCID: PMC9915313 DOI: 10.3390/ijerph20031959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
As a destructive and economic disaster in the world, drought shows an increasing trend under the continuous global climate change and adverse health effects have been reported. The interactive effects between drought and air pollutants, which may also be harmful to respiratory systems, remain to be discussed. We built the generalized additive model (GAM) and distributed lag nonlinear model (DLNM) to estimate the effects of drought and air pollutants on daily upper respiratory infections (URTI) outpatient visits among children under 6 in three cities of Gansu province. The Standardized Precipitation Index (SPI) based on monthly precipitation (SPI-1) was used as an indicator of drought. A non-stratified model was established to explore the interaction effect of SPI-1 and air pollutants. We illustrated the number of daily pediatric URTI outpatient visits increased with the decrease in SPI-1. The interactive effects between air pollutants and the number of daily pediatric URTIs were significant. According to the non-stratified model, we revealed highly polluted and drought environments had the most significant impact on URTI in children. The occurrence of drought and air pollutants increased URTI in children and exhibited a significant interactive effect.
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Affiliation(s)
- Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Jianyun Sun
- Gansu Provincial Centre for Diseases Prevention and Control, Lanzhou 730000, China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Jie Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, China
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Ngare IO, Gikonyo SW, Gathuku GN, Ogutu EA. Review: Climate change resilience disconnect in rural communities in coastal Kenya. A rhetoric communication discord proliferated by COVID-19 pandemic. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.943181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The world has been hit by consequential pandemics in the past two millennia. The COVID-19 pandemic has taken center stage, paralyzing vulnerable communities in the global south impacted by unprecedented climate vagaries. The focus of this study is COVID-19 and climate resilience communication rhetoric. In this context, we embed this study in response to the resilience of rural livelihoods to the COVID-19 crisis and climate resilience education communication rhetoric. We posit our review based on the following questions: Has COVID-19 worsened the climate resilience pathway for rural communities in coastal Kenya? Is the COVID-19 pandemic a proxy for climate resilience in rural livelihoods? How does COVID-19 communication rhetoric undermine climate resilience for vulnerable coastal communities in Kenya? Through a resilient theoretical paradigm, we enclose our view based on the existing literature along with climate resilience and COVID-19 proliferation. In light of the current state of COVID-19, the focus has shifted to the pandemic that will cover climate resilience. From the review, climate resilience pathway has been impacted by corona virus with noted funding response variations, in addition, even with the corona virus pandemic, climate resilience communication should be on-going rather than sporadic. Increasing the discursive process about climate change challenges is critical among Kenyan coastal communities. We recommend inclusion of climate resilience communication in existing policy frameworks as a salient solution to notable information discourse bottlenecks.
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Buser JM, Taha AA. Global Child Health Is Local Child Health. J Pediatr Health Care 2022; 36:401-403. [PMID: 35597737 PMCID: PMC9115624 DOI: 10.1016/j.pedhc.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Julie Marie Buser
- Julie Marie Buser, Senior Research Area Specialist, Center for International Reproductive Health Training, C.S. Mott Children's Hospital, Pediatric Hematology/Oncology/BMT Clinic, University of Michigan, Ann Arbor, MI.
| | - Asma A Taha
- Asma A. Taha, Program Director, School of Nursing, Oregon Health & Science University, Portland, OR
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Lawrance EL, Thompson R, Newberry Le Vay J, Page L, Jennings N. The Impact of Climate Change on Mental Health and Emotional Wellbeing: A Narrative Review of Current Evidence, and its Implications. Int Rev Psychiatry 2022; 34:443-498. [PMID: 36165756 DOI: 10.1080/09540261.2022.2128725] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.
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Affiliation(s)
- Emma L Lawrance
- Institute of Global Health Innovation, Imperial College London, UK.,Mental Health Innovations, UK.,Grantham Institute of Climate and the Environment, Imperial College London, UK
| | | | | | - Lisa Page
- Brighton & Sussex Medical School, UK
| | - Neil Jennings
- Grantham Institute of Climate and the Environment, Imperial College London, UK
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