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Rothenberg WA, Bornstein MH, Putnick DL, Lansford JE. Examining How National Levels of Life Expectancy, Education, and Income Influence Early Childhood Development: The Mediating Role of the Child's Nurturing Context. J Dev Behav Pediatr 2024; 45:e448-e455. [PMID: 39140969 PMCID: PMC11483199 DOI: 10.1097/dbp.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 06/04/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE Forty-three percent of children younger than 5 years in low- and middle-income countries (LMICs) are at risk of not meeting their developmental potential. This study investigated how 3 aspects of national development (national life expectancy, education, and income levels) are associated with early childhood development by influencing 5 domains of nurturing care (caregiving, the learning environment, safety and security, nutrition, and the health of the home environment). METHODS In total, 159,959 families with children aged 36 to 59 months living in 51 LMICs provided data. National development was measured using 3 indicators (national life expectancy, education, and income levels), and nurturing care was measured using 10 indicators that collectively captured the 5 nurturing care domains. Path analyses examined how nurturing care indicators mediated the effects of national development on early childhood development. RESULTS Higher national life expectancy was directly associated with more advanced childhood development. Higher national levels of education and income were indirectly associated with more advanced childhood development through aspects of nurturing care, such as reduced caregiver psychological aggression or physical violence, increased learning materials and wired appliances in the home environment, and greater caregiver education and child height-for-age. Greater caregiver cognitive caregiving practices promoted childhood development, regardless of levels of national development. CONCLUSION Intervening to promote caregiver education, appropriate discipline strategies, cognitive caregiving practices, and family access to wired appliances, learning materials, and adequate nutrition is key to promoting childhood development in nations with lower levels of national development.
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Affiliation(s)
| | - Marc H. Bornstein
- UNICEF, New York, NY
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Diane L. Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
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2
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Altobelli LC. Good Management Practice Is Correlated With Good Performance of Community-Engaged Primary Health Care Facilities in Peru. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300402. [PMID: 39084878 PMCID: PMC11349508 DOI: 10.9745/ghsp-d-23-00402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Increasing prioritization of quality primary health care (PHC) includes community engagement as a key element to improve PHC performance. We assessed the correlation of good regional management practices with PHC performance in Peru in community-comanaged PHC that is designed with multiple accountability mechanisms. METHODS We conducted a secondary analysis of a survey of Dirección Regional de Salud (regional health directorates, DIRESAs) regarding their management of public PHC services with collaborative community involvement by a Comunidad Local de Administración de Salud (Local Community for Health Administration, CLAS). CLAS-run facilities have previously shown evidence of superior performance over standard PHC services. We classified survey questions on 5 management functions of the Primary Health Care Performance Initiative: leadership, information system, financial control, transfer of management and leadership skills to health facilities, and supervision. An expert panel designated management practices as "good" or "less effective." The outcome, PHC service performance, was the percentage of CLAS comanaged facilities in each DIRESA achieving coverage and utilization goals. We correlated frequency of good management practices with PHC service performance. DIRESAs were divided into Group 1, "higher performance," and Group 2, "lower performance," to identify specific practices linked to better performance. RESULTS We identified 32 good management practices among 52 response options to 17 questions. Correlation between good management practice and good service performance was significant (r=.7266; 12 df; P<.01). An average of 91.1% and 37.6% of CLAS facilities achieved service goals in Groups 1 and 2, respectively. Of all good management practices identified, an average of 40.6% and 24.0% were used by Groups 1 and 2, respectively. Group 1 used 11 specific good practices more frequently than Group 2. CONCLUSIONS Regional management and community-comanaged PHC services designed with accountability mechanisms should be intentionally aligned, incorporating these into policies, budgets, processes, and capacities to strengthen PHC services.
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Affiliation(s)
- Laura C Altobelli
- Future Generations University, Franklin, WV, USA.
- School of Public Health and Administration, Cayetano Heredia University, Lima, Peru
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3
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Sando D, Sachin S, Moshi G, Sando MM, Yussuf M, Mwakitalima A, Fawzi W. School health and nutrition services for children and adolescents in Tanzania: A review of policies and programmes. MATERNAL & CHILD NUTRITION 2024:e13544. [PMID: 39094059 DOI: 10.1111/mcn.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 08/04/2024]
Abstract
School health and nutrition programmes are effective strategies to address the health problems among school-going children and adolescents. We examined the policy environments, successes and bottlenecks associated with school health and nutrition programmes in Tanzania. We used the 'policy triangle framework' to examine 22 national and regional school health and nutrition policies and programmes in Tanzania. We also interviewed 16 key informants to gain further insights into school health and nutrition programmes. Several school health and nutrition policies in Tanzania outline the basic elements of school-based health and nutrition services. Yet, these documents neither recognise vulnerable groups, recommend age-appropriate strategies to address children's and adolescents' varied and transient needs, nor provide a framework for implementing and tracking recommended activities. In these documents, underweight and infectious diseases, including human immunodeficiency virus/acquired immunodeficiency syndrome, are frequently identified as major concerns of young people, with little or no consideration of social determinants. Diverse strategies including school feeding, water and sanitation services, health and nutrition education and promotion of healthy behaviours are identified. In doing so, these documents adequately define the roles and responsibilities of all government actors, but young people and their guardians are not actively engaged in design and implementation. Additionally, there are several challenges to implementing these policies including budgetary constraints, limited resources, a lack of inter-sectoral coordination and insufficient capacity within targeted schools. To improve the health and nutritional status of school-going children and adolescents in Tanzania, adequate budgets, strengthened coordination and implementation efforts, the development of school-based stakeholders' capacity, as well as the involvement of all other stakeholders, including adolescents, are imperative.
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Affiliation(s)
- David Sando
- Managament and Development for Health (MDH), Dar es Salaam, Tanzania
| | - Shinde Sachin
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Grace Moshi
- Department of Nutrition, The United Republic of Tanzania, Ministry of Health, Dodoma, Tanzania
| | | | - Mashavu Yussuf
- African Academy for Public Health (AAPH), Dar es Salaam, Tanzania
| | - Anyitike Mwakitalima
- Department of Nutrition, The United Republic of Tanzania, Ministry of Health, Dodoma, Tanzania
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Khizar M, Ruel-Bergeron J, Zavala E, Chang K, Kang Y, de Pee S, Black RE, Christian P. Delivery platforms for reaching adolescents with nutrition interventions in low- and middle-income countries. Ann N Y Acad Sci 2024; 1538:71-84. [PMID: 39116286 DOI: 10.1111/nyas.15196] [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] [Indexed: 08/10/2024]
Abstract
Adolescents in low- and middle-income countries (LMICs) are a vulnerable population given increased nutritional needs as puberty approaches. School-based nutrition programs exist in some settings, but the comprehensive provision of nutrition services requires knowledge of the mechanisms to reach out-of-school adolescents. A comprehensive scoping review was performed using formal and informal search strategies to landscape all potential delivery platforms with nutrition services to reach adolescents. Peer-reviewed studies, institutional strategies, program evaluations, and programmatic reports in LMICs were reviewed, including gray literature. A total of 87 out of 270 identified publications and reports describing nutrition programs for adolescents were identified. Although nutrition programs targeted at adolescents were sparse, various innovative and inclusive delivery platforms were included, such as school feeding programs, school-based anemia control, and nutrition-friendly school initiatives; health facility-based, youth-friendly health and nutrition services; social safety nets targeted at adolescents; community-based approaches targeting youth development and peer education within youth centers and faith-based settings; and technology-based platforms, including digital health services and mass media communication sensitization and mobilization efforts. Existing delivery mechanisms and platforms in health and other sectors that target adolescents offer great potential to extend nutrition interventions to this vulnerable yet hard-to-reach population.
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Affiliation(s)
- Mahum Khizar
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Eleonor Zavala
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Karen Chang
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yunhee Kang
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Saskia de Pee
- Nutrition Division, United Nations World Food Programme, Rome, Italy
| | - Robert E Black
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Parul Christian
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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McConkey R, Allen S, Mlambo C, Kambarami P, Martin K. Creating Family-Centred Support for Children with Developmental Disabilities in Africa: Examples of Local Community Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:925. [PMID: 39063501 PMCID: PMC11277198 DOI: 10.3390/ijerph21070925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/22/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Preschoolers with disabilities and their family caregivers are overlooked by many public health initiatives, especially in low-income countries. Yet they can benefit from early intervention to promote their development soon after birth and to provide a better quality of life for their families. In this paper, we describe how a community-based approach has been implemented with minimal funding in two areas in Zimbabwe: a township in Harare and in rural areas of Manicaland Province. Our aim in sharing this information-allied with references to research studies recently undertaken in Africa-is that it will enable similar support to be replicated in other communities by local personnel. A logic model is used to describe the situation in which the two projects work, the various inputs they have provided to their community, and the different forms of support they have offered to the children and their caregivers. The project outputs are listed in terms of the number of beneficiaries helped and the activities undertaken. The outcomes achieved for the children, families, and communities are reported. The sustainability and extensions of community-based projects to address unmet needs are discussed. The main conclusion is that disadvantaged communities can be energised to address the needs of their most marginalised residents.
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Affiliation(s)
- Roy McConkey
- Institute of Nursing and Health Research, Ulster University, Belfast BT15 1ED, UK
| | - Sally Allen
- Templer Foundation, 6900 N. Haggerty Road, Canton, MI 48187, USA; (S.A.); (C.M.)
| | - Chipo Mlambo
- Templer Foundation, 6900 N. Haggerty Road, Canton, MI 48187, USA; (S.A.); (C.M.)
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Banati P, Ross DA, Weobong B, Kapiga S, Weiss HA, Baltag V, Nzvere F, Glozah F, Nsanya MK, Greco G, Ferrand R, Doyle AM. Adolescent health and well-being check-up programme in three African cities (Y-Check): protocol for a multimethod, prospective, hybrid implementation-effectiveness study. BMJ Open 2024; 14:e077533. [PMID: 38908843 PMCID: PMC11331354 DOI: 10.1136/bmjopen-2023-077533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 05/15/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND During adolescence, behaviours are initiated that will have substantial impacts on the individual's short-term and long-term health and well-being. However, adolescents rarely have regular contact with health services, and available services are not always appropriate for their needs. We co-developed with adolescents a health and well-being check-up programme (Y-Check). This paper describes the methods to evaluate the feasibility, acceptability, short-term effects and cost-effectiveness of Y-Check in three African cities. METHOD This is a multi-country prospective intervention study, with a mixed-method process evaluation. The intervention involves screening, on-the-spot care and referral of adolescents through health and well-being check-up visits. In each city, 2000 adolescents will be recruited in schools or community venues. Adolescents will be followed-up at 4 months. The study will assess the effects of Y-Check on knowledge and behaviours, as well as clinical outcomes and costs. Process and economic evaluations will investigate acceptability, feasibility, uptake, fidelity and cost effectiveness. ETHICS AND DISSEMINATION Approval has been received from the WHO (WHO/ERC Protocol ID Number ERC.0003778); Ghana Health Service (Protocol ID Number GHS-ERC: 027/07/22), the United Republic of Tanzania National Institute for Medical Research (Clearance No. NIMR/HQ/R.8a/Vol.IX/4199), the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2766) and the LSHTM (Approval Numbers 26 395 and 28312). Consent and disclosure are addressed in the paper. Results will be published in three country-specific peer-reviewed journal publications, and one multicountry publication; and disseminated through videos, briefs and webinars. Data will be placed into an open access repository. Data will be deidentified and anonymised. TRIAL REGISTRATION NUMBER NCT06090006.
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Affiliation(s)
| | | | | | - Saidi Kapiga
- National Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Farirai Nzvere
- London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Mussa Kelvin Nsanya
- National Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania
| | - Giulia Greco
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rashida Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Aoife Margaret Doyle
- London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
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7
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Baltag V, Banerjee A. Leveraging the Priority Indicators to Promote Comprehensive Adolescent Health Approaches. J Adolesc Health 2024; 74:S12-S14. [PMID: 38762253 DOI: 10.1016/j.jadohealth.2023.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/01/2023] [Indexed: 05/20/2024]
Affiliation(s)
- Valentina Baltag
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
| | - Anshu Banerjee
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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8
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Li C, Meng X. Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model. Front Public Health 2024; 12:1357709. [PMID: 38699429 PMCID: PMC11063264 DOI: 10.3389/fpubh.2024.1357709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
Objective This study explored the factors and influence degree of job satisfaction among medical staff in Chinese public hospitals by constructing the optimal discriminant model. Methods The participant sample is based on the service volume of 12,405 officially appointed medical staff from different departments of 16 public hospitals for three consecutive years from 2017 to 2019. All medical staff (doctors, nurses, administrative personnel) invited to participate in the survey for the current year will no longer repeat their participation. The importance of all associated factors and the optimal evaluation model has been calculated. Results The overall job satisfaction of medical staff is 25.62%. The most important factors affecting medical staff satisfaction are: Value staff opinions (Q10), Get recognition for your work (Q11), Democracy (Q9), and Performance Evaluation Satisfaction (Q5). The random forest model is the best evaluation model for medical staff satisfaction, and its prediction accuracy is higher than other similar models. Conclusion The improvement of medical staff job satisfaction is significantly related to the improvement of democracy, recognition of work, and increased employee performance. It has shown that improving these five key variables can maximize the job satisfaction and motivation of medical staff. The random forest model can maximize the accuracy and effectiveness of similar research.
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Affiliation(s)
| | - Xuehui Meng
- Department of Health Service Management, Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, China
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9
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Bain M, Park S, Zaidi A, Atif N, Rahman A, Malik A, Surkan PJ. Social Support and Spousal Relationship Quality Improves Responsiveness among Anxious Mothers. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01702-5. [PMID: 38609719 PMCID: PMC11470967 DOI: 10.1007/s10578-024-01702-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
Maternal responsiveness, a mother's ability to consistently identify infant cues and then act on them, is critical for healthy child development. A woman's social support and spousal relationship may affect responsiveness to an infant, especially among mothers with anxiety. We assessed how social support and spousal relationship quality is associated with responsiveness among anxious mothers, and if postpartum depression (PPD) moderated these associations. Cross-sectional data were collected from 2019 to 2022 in a public hospital in Pakistan from 701 women at six-weeks postpartum. Eligible women had at least mild anxiety in early- to mid- pregnancy. Linear regression analyses assessed if spousal relationship quality and social support from family and friends were associated with maternal responsiveness, measured using the Maternal Infant Responsiveness Instrument. Interaction terms were used to examine if PPD moderated these associations. Spousal relationship quality (B = 2.49, 95% CI: 1.48, 3.50) and social support (B = 1.07, 95% CI: 0.31, 1.83) were positively related to maternal responsiveness to the infant. Emotional support from a spouse was positively associated with responsiveness (B = 1.08, 95% CI: 0.12, 2.03 depressed; B = 2.96, 95% CI: 1.34, 4.58 non-depressed), and conflict with the spouse was negatively associated with responsiveness (B=-1.02, 95% CI: -1.94, -0.09 depressed; B=-2.87, 95% CI: -4.36, -1.37 non-depressed). However, social support was related to responsiveness only in non-depressed women (B = 2.61, 95% CI: 1.14, 4.07). While spousal relationships and social support enhance maternal responsiveness, for depressed women, spousal relationships were particularly critical. In considering maternal-infant interventions to improve child development outcomes, our study indicates the importance of supportive relationships that foster effective responsiveness.
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Affiliation(s)
- Miranda Bain
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Soim Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Ahmed Zaidi
- Public Mental Health Department, Health Services Academy, PM Health Complex, Islamabad, Pakistan
| | - Najia Atif
- Human Development Research Foundation, Global Institute of Human Development, Shifa Tameer-e-Millat University, Gujar Khan Campus, Near Government Rural Health Center Mandra, Rawalpindi, Pakistan
| | - Atif Rahman
- Human Development Research Foundation, Global Institute of Human Development, Shifa Tameer-e-Millat University, Gujar Khan Campus, Near Government Rural Health Center Mandra, Rawalpindi, Pakistan
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, 1-5 Dover Street, Liverpool, L69 3GL, UK
| | - Abid Malik
- Public Mental Health Department, Health Services Academy, PM Health Complex, Islamabad, Pakistan
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
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Komasawa M, Sato M, Ssekitoleko R, Waiswa P, Gitta S, Nabugoomu J, Honda S, Saito K, Aung MN. Study protocol for a type-II hybrid effectiveness-implementation trial to reach teenagers using mobile money shops to reduce unintended pregnancies in Uganda. BMJ Open 2024; 14:e084539. [PMID: 38582537 PMCID: PMC11002355 DOI: 10.1136/bmjopen-2024-084539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION Unintended teenage pregnancies have become a global public health challenge, particularly in sub-Saharan Africa. There is a notably high prevalence of unintended pregnancies among unmarried teenagers in Uganda. This study will develop an intervention programme using mobile money shops (vendors) as a platform to deliver sexual and reproductive health and rights (SRHR) services to teenagers and assess its effectiveness and scalability in Uganda. METHODS AND ANALYSES This hybrid study comprises two integral components: an intervention study to assess the effectiveness of vendor-mediated intervention and implementation research to evaluate the implementation process. 30 vendors will be recruited for both intervention and control arms in 2 municipalities in Eastern Uganda, which have a high unintended pregnancy prevalence rate among unmarried teens aged 15-19 years. A preintervention and postintervention repeated survey involving 600 participants for each arm will be conducted over 4 months. The primary outcome is the rate of condom users among teenage vendor users. The secondary outcomes include the rate of preference for receiving SRHR services at vendors and knowledge regarding SRHR. A difference-in-differences analysis will be used to determine the effectiveness of the intervention. The Bowen model will be employed to evaluate the implementation design. ETHICS AND DISSEMINATION Ethical approval was obtained from the Ethics Review Committee of Uganda Christen University and JICA Ogata Sadako Research Institute for Peace and Development in Japan. The findings will be widely disseminated. This study was registered with the University Hospital Medical Information Network in Japan (UMIN000053332) on 12 January 2024. TRIAL REGISTRATION NUMBER UMIN000053332.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Peter Waiswa
- School of Public Health, Makerere University, Kampala, Uganda
- Busoga Health Forum, Jinja, Uganda
| | - Sheba Gitta
- School of Public Health, Uganda and Busoga Health Forum, Jinja, Uganda
- Makerere University, Kampala, Uganda
| | | | - Sumihisa Honda
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
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11
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De Bortoli Cassiani SH, Moreno Dias B, Meléndez Romero BE, Rivera J. [The role of nursing professionals in the development and care of adolescent health in HondurasPapel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras]. Rev Panam Salud Publica 2024; 48:e25. [PMID: 38562958 PMCID: PMC10984222 DOI: 10.26633/rpsp.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
Objective Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with respect to adolescent health, and by studying policies on adolescent health. Methods Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson. Results During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figures in program implementation and should be taken into consideration when developing policies aimed at adolescents. Conclusions Nurses participate in various stages of the policy implementation process and can make important contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.
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Affiliation(s)
- Silvia Helena De Bortoli Cassiani
- Organización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Bruna Moreno Dias
- Organización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | | | - Jairo Rivera
- Universidad Andina Simón BolívarQuitoEcuadorUniversidad Andina Simón Bolívar, Quito, Ecuador.
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Chowdhury R, Upadhyay RP, Sinha B, Taneja S, Das JK, Bhandari N. Editorial: Care during pregnancy and early childhood for growth and development in low- and middle- income countries. Front Nutr 2024; 10:1361926. [PMID: 38264194 PMCID: PMC10803586 DOI: 10.3389/fnut.2023.1361926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
| | | | | | | | - Jai K. Das
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
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Pinto NP, Scholefield BR, Topjian AA. Pediatric cardiac arrest: A review of recovery and survivorship. Resuscitation 2024; 194:110075. [PMID: 38097105 DOI: 10.1016/j.resuscitation.2023.110075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Neethi P Pinto
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
| | | | - Alexis A Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
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Verguet S, Gautam P, Ali I, Husain A, Meyer S, Burbano C, Lloyd-Evans E, Coco M, Mphangwe M, Saka A, Zelalem M, Giyose BB, Li Z, Erzse A, Hofman K, Giner C, Avallone S, Kuusipalo H, Kristjansson E, Schultz L, Bundy DAP, Angrist N. Investing in school systems: conceptualising returns on investment across the health, education and social protection sectors. BMJ Glob Health 2023; 8:e012545. [PMID: 38114237 DOI: 10.1136/bmjgh-2023-012545] [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: 04/10/2023] [Accepted: 09/04/2023] [Indexed: 12/21/2023] Open
Abstract
Public policies often aim to improve welfare, economic injustice and reduce inequality, particularly in the social protection, labour, health and education sectors. While these policies frequently operate in silos, the education sphere can operate as a cross-sectoral link. Schools represent a unique locus, with globally hundreds of millions of children attending class every day. A high-profile policy example is school feeding, with over 400 million students worldwide receiving meals in schools. The benefits of harmonising interventions across sectors with a common delivery platform include economies of scale. Moreover, economic evaluation frameworks commonly used to assess policies rarely account for impact across sectors besides their primary intent. For example, school meals are often evaluated for their impact on nutrition, but they also have educational benefits, including increasing attendance and learning and incorporating smallholder farmers into corporate value chains. To address these gaps, we propose the introduction of a comprehensive value-for-money framework for investments toward school systems that acknowledges the return to a common delivery platform-schools-and the multisectoral returns (eg, education, health and nutrition, labour, social protection) emerging from the rollout of school-based programmes. Directly building on benefit-cost analysis methods, this framework could help identify interventions that yield the highest gains in human capital per budget expenditure, with direct implications for finance ministries. Given the detrimental impact of COVID-19 on schoolchildren and human capital, it is urgent to build back stronger and more sustainable welfare systems.
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Affiliation(s)
- Stéphane Verguet
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Pratibha Gautam
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Iman Ali
- Tufts University, Medford, Massachusetts, USA
| | | | | | | | | | | | | | - Albert Saka
- Ministry of Education Science and Technology, Lilongwe, Malawi
| | - Meseret Zelalem
- Maternal, Child and Adolescent Health Lead Executive Officer, Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Boitshepo Bibi Giyose
- FAO/AUDA-NEPAD (African Union Development Agency - New Partnership for Africa's Development), Johannesburg, South Africa
| | - Zhihui Li
- Tsinghua Vanke School of Public Health, Beijing, China
| | - Agnes Erzse
- SAMRC Wits Centre for Health Economics and Decision Science PRICELESS SA, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC Wits Centre for Health Economics and Decision Science PRICELESS SA, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Céline Giner
- Organization for Economic Cooperation and Development, Paris, France
| | - Sylvie Avallone
- QualiSud, Univ Montpellier, Institut Agro, CIRAD, Avignon Université, Université de La Réunion, Montpellier, France
| | - Heli Kuusipalo
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Linda Schultz
- Research Consortium for the School Meals Coalition, London School of Hygiene and Tropical Medicine, London, UK
| | - Donald A P Bundy
- Research Consortium for the School Meals Coalition, London School of Hygiene and Tropical Medicine, London, UK
| | - Noam Angrist
- University of Oxford, Oxford, Oxfordshire, UK
- Youth Impact, Gaborone, Botswana
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15
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Aggarwal S, Armstrong G. How, when and where to intervene in self-harm in youth in low- and middle-income countries: Thinking beyond healthcare systems. Int J Soc Psychiatry 2023; 69:1837-1839. [PMID: 37162034 PMCID: PMC7615317 DOI: 10.1177/00207640231174368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Low- and middle-income countries (LMICs) account for 78% of global suicides. Self-harm is the clearest antecedent of suicide. The health and social systems have struggled to provide adequate evidence based help to young people with self-harm. In addition, the negative attitudes towards those who self-harm in these settings interfere with help-seeking behaviour. AIMS AND METHOD In our submission of a comment, we discuss the reasons for thinking beyond healthcare systems in LMICs to address self-harm in youth and the possible ways to achieve it. RESULTS AND CONCLUSION We truly believe that harnessing the potential of social systems such as schools is important for addressing self-harm in LMICs. We present our arguments in favour of feasible measures that can be implemented to achieve this.
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Affiliation(s)
- Shilpa Aggarwal
- Public Health Foundation of India, New Delhi, India
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Mellbourne, VIC, Australia
- Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Greg Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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16
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Sabet F, Prost A, Rahmanian S, Al Qudah H, Cardoso MN, Carlin JB, Sawyer SM, Patton GC. The forgotten girls: the state of evidence for health interventions for pregnant adolescents and their newborns in low-income and middle-income countries. Lancet 2023; 402:1580-1596. [PMID: 37837988 DOI: 10.1016/s0140-6736(23)01682-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 03/06/2023] [Accepted: 08/09/2023] [Indexed: 10/16/2023]
Abstract
Every year, an estimated 21 million girls aged 15-19 years become pregnant in low-income and middle-income countries (LMICs). Policy responses have focused on reducing the adolescent birth rate whereas efforts to support pregnant adolescents have developed more slowly. We did a systematic review of interventions addressing any health-related outcome for pregnant adolescents and their newborn babies in LMICs and mapped its results to a framework describing high-quality health systems for pregnant adolescents. Although we identified some promising interventions, such as micronutrient supplementation, conditional cash transfers, and well facilitated group care, most studies were at high risk of bias and there were substantial gaps in evidence. These included major gaps in delivery, abortion, and postnatal care, and mental health, violence, and substance misuse-related outcomes. We recommend that the fields of adolescent, maternal, and sexual and reproductive health collaborate to develop more adolescent-inclusive maternal health care and research, and specific interventions for pregnant adolescents. We outline steps to develop high-quality, evidence-based care for the millions of pregnant adolescents and their newborns who currently do not receive this.
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Affiliation(s)
- Farnaz Sabet
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - Audrey Prost
- Institute for Global Health, University College London, London, UK
| | | | - Heba Al Qudah
- Department of Diagnostic Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mauro Nogueira Cardoso
- Coletivo da Saude, Research Group in Public Health, Pontifical Catholic University of Minas Gerais, Minas Gerais, Brazil
| | - John B Carlin
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - George C Patton
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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17
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Bhutta ZA, Bhavnani S, Betancourt TS, Tomlinson M, Patel V. Adverse childhood experiences and lifelong health. Nat Med 2023; 29:1639-1648. [PMID: 37464047 DOI: 10.1038/s41591-023-02426-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023]
Abstract
With the advent of the sustainable development goals, the field of global child health has shifted its focus from reducing mortality to improving health, nutrition and development outcomes - often measured as human capital. A growing knowledge of the biology of development and neuroscience has highlighted the importance of adverse environmental exposures, collectively termed adverse childhood experiences (ACEs) on health outcomes. ACEs are associated with short-term, medium-term and long-term negative consequences for health and development and their effects may be multiplicative, especially during critical periods of sensitivity and developmental plasticity. Some of these effects are compounded by emerging global threats such as climate change, conflict and population displacement. In this Review, we discuss the key mechanisms linking ACEs to health outcomes and consider promising strategies to prevent and mitigate their effects, highlighting evidence from programs in low-income and middle-income countries. Finally, we emphasize the need for early recognition of ACEs and delivery of packages of interventions spanning key sectors such as health, education, women's empowerment and social protection.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
- Institute for Global Health & Development, The Aga Khan University, South Central Asia, East Africa, United Kingdom, and Karachi, Pakistan.
| | | | | | - Mark Tomlinson
- Institute for Life Course Health Research, Stellenbosch University, Cape Town, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Vikram Patel
- Department of Global Health and Population, Harvard Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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18
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Grantham-McGregor SM, Walker SP. Early Childhood Interventions: Issues to Consider in Getting to Scale. Pediatrics 2023; 151:191221. [PMID: 37125888 DOI: 10.1542/peds.2023-060221p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 05/02/2023] Open
Affiliation(s)
| | - Susan P Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
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19
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N’dure Baboudóttir F, Jandi Z, Indjai B, Einarsdóttir J, Gunnlaugsson G. "Just Standing Still": A Qualitative Study on Adolescents' Experiences of School Closures Due to Emerging COVID-19 in Bissau, Guinea-Bissau. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5265. [PMID: 37047881 PMCID: PMC10094378 DOI: 10.3390/ijerph20075265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic affected the lives of children in a myriad of ways across the world. It exposed and aggravated existing inequalities between children within countries and across continents and hampered education. In Guinea-Bissau, school closure was one of the first restrictions implemented to confront the emerging pandemic. The aim was to describe and analyse the experiences of adolescents of school closures in the capital Bissau, their concerns about their future and manifestations of inequality. Data were collected by semi-structured, open-ended interviews with 30 adolescents aged 15-17 years three months into the pandemic during an enforced state of emergency. A thematic analysis identified five themes: appreciation of education, feeling left behind, being stuck in confinement, suggestions for support, and a disrupted future. The results highlight global rather than local inequalities in the demographic, manifested by a lack of targeted educational support for public and private school students; they knew about such efforts elsewhere. The school-attending participants suggested ways to mitigate disruptions in their education, while those out of school aiming to return saw their possibilities fading away. They appreciated education for personal and national benefits, and participants worried about the long-term effects of the pandemic. The study highlighted education loss for all and disrupted future expectations.
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Affiliation(s)
- Fatou N’dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Zeca Jandi
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Bucar Indjai
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
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20
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Machailo RM, Koen D, Matsipane M. Towards an Understanding of Successes of the Psychiatric Nurses in Caring for Children with Mental Health Problems: An Appreciative Inquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1725. [PMID: 36767093 PMCID: PMC9914087 DOI: 10.3390/ijerph20031725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/30/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Psychiatric nurses have a specialized body of knowledge and skills in providing care to persons with mental health challenges. The literature provides scanty evidence on child psychiatric nursing practices. This paper explored the successes of psychiatric nurses in caring for children with mental health problems using appreciative inquiry (AI). DESIGN A qualitative exploratory and descriptive design was used to allow for new ideas that can fundamentally reshape the practice of child psychiatric nursing. Purposive sampling was used to select psychiatric nurses caring for children with mental health problems. Focus groups were used to generate data. FINDINGS The results indicate both positive and negative prospects for psychiatric nursing practice. The positive possibilities included commitment, passion and dedication of staff to the children. The negative aspects that need urgent attention include lack of specific, integrated child mental health within the mental health care services, shortage of resources and not-fit-for purpose infrastructure. CONCLUSION Appreciative inquiry verified the commitment of psychiatric nurses in caring for children with mental health problems and the potential for dedicated child psychiatric institutions in realizing the needs of such children. The needs of children with mental health problems must be addressed through positive care in the health system.
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21
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Dotse-Gborgbortsi W, Tatem AJ, Matthews Z, Alegana VA, Ofosu A, Wright JA. Quality of maternal healthcare and travel time influence birthing service utilisation in Ghanaian health facilities: a geographical analysis of routine health data. BMJ Open 2023; 13:e066792. [PMID: 36657766 PMCID: PMC9853258 DOI: 10.1136/bmjopen-2022-066792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To investigate how the quality of maternal health services and travel times to health facilities affect birthing service utilisation in Eastern Region, Ghana. DESIGN The study is a cross-sectional spatial interaction analysis of birth service utilisation patterns. Routine birth data were spatially linked to quality care, service demand and travel time data. SETTING 131 Health facilities (public, private and faith-based) in 33 districts in Eastern Region, Ghana. PARTICIPANTS Women who gave birth in health facilities in the Eastern Region, Ghana in 2017. OUTCOME MEASURES The count of women giving birth, the quality of birthing care services and the geographic coverage of birthing care services. RESULTS As travel time from women's place of residence to the health facility increased up to two2 hours, the utilisation rate markedly decreased. Higher quality of maternal health services haves a larger, positive effect on utilisation rates than service proximity. The quality of maternal health services was higher in hospitals than in primary care facilities. Most women (88.6%) travelling via mechanised transport were within two2 hours of any birthing service. The majority (56.2%) of women were beyond the two2 -hour threshold of critical comprehensive emergency obstetric and newborn care (CEmONC) services. Few CEmONC services were in urban centres, disadvantaging rural populations. CONCLUSIONS To increase birthing service utilisation in Ghana, higher quality health facilities should be located closer to women, particularly in rural areas. Beyond Ghana, routinely collected birth records could be used to understand the interaction of service proximity and quality.
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Affiliation(s)
| | - Andrew J Tatem
- School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Zoe Matthews
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Victor A Alegana
- Population Health Unit-Wellcome Trust Research Programme, Kenya Medical Research Institute, Nairobi, Kenya
| | - Anthony Ofosu
- Headquarters, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Jim A Wright
- School of Geography and Environmental Science, University of Southampton, Southampton, UK
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22
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Akhbari Ziegler S, de Souza Morais RL, Magalhães L, Hadders-Algra M. The potential of COPCA's coaching for families with infants with special needs in low- and middle-income countries. Front Pediatr 2023; 11:983680. [PMID: 37082703 PMCID: PMC10111824 DOI: 10.3389/fped.2023.983680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/16/2023] [Indexed: 04/22/2023] Open
Abstract
Infants at high biological risk of or with a neurodevelopmental disorder run a high risk of delayed school readiness. This is especially true for infants in low- and middle-income countries (LMICs). This perspective paper first summarizes evidence on intervention elements that are effective in promoting family well-being and child development in infants at high biological risk in high income countries. Crucial elements are family centeredness, goal orientation, a home setting, focus on activity and participation, and challenging the infant to explore the world and the own body by means of self-produced movements. The studies revealed that coaching as applied in COPCA (COPing and CAring for infants with special needs) is a pivotal element determining the success of intervention.The paper continues by describing COPCA and its coaching. Next, we report on two pilot studies addressing COPCA's implementation in Brazil. Finally, we discuss why COPCA is a promising early intervention program for infants at high biological risk of neurodisability in LMICs: COPCA is adapted to the families' strengths and needs, it empowers families and promotes child development therewith facilitating school readiness. Moreover, it may be delivered by tele-coaching therewith eliminating families' burden to travel to distant intervention clinics.
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Affiliation(s)
- Schirin Akhbari Ziegler
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
- Correspondence: Schirin Akhbari Ziegler
| | | | - Lívia Magalhães
- Department of Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Division of Developmental Neurology and University of Groningen, Faculty of Theology and Religious Studies, Groningen, Netherlands
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23
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Banati P, Banerjee A, Daelmans B, Baltag V. The Need for New Models to Measure the Impact of Prevention. J Adolesc Health 2023; 72:9-11. [PMID: 36369114 DOI: 10.1016/j.jadohealth.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Prerna Banati
- Department of Maternal, Newborn, Child & Adolescent Health & Ageing, World Health Organization, Geneva, Switzerland.
| | - Anshu Banerjee
- Department of Maternal, Newborn, Child & Adolescent Health & Ageing, World Health Organization, Geneva, Switzerland
| | - Bernadette Daelmans
- Department of Maternal, Newborn, Child & Adolescent Health & Ageing, World Health Organization, Geneva, Switzerland
| | - Valentina Baltag
- Department of Maternal, Newborn, Child & Adolescent Health & Ageing, World Health Organization, Geneva, Switzerland
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24
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Soysal Cimen H, Karaaslan BT. Expectant mothers and fathers' knowledge of nurturing care in a developing country. Front Pediatr 2022; 10:1024593. [PMID: 36483466 PMCID: PMC9722760 DOI: 10.3389/fped.2022.1024593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background The Nurturing Care Framework (NCF), which has been emphasized by the World Health Organization (WHO) in recent years and is among the United Nations Sustainable Development Goals (SDGs), expresses the conditions created to promote early childhood development (ECD). These conditions aim to provide opportunities for children in the Good Health, Adequate Nutrition, Responsive Caregiving, Security and Safety, and Opportunities for Early Learning (5 Components) by caregivers, primarily from low and middle-income countries (LMICs). The aim of this study is to examine the knowledge and awareness of expectant mothers and fathers in Turkey, about the NCF. Methods In this study, a cross-sectional, analytical research design was used. Nurturing Care (NC) knowledge and awareness levels of expectant mothers and fathers in the 2nd and 3rd trimesters of pregnancy were determined via the online form of "The Knowledge of Nurturing Care Inventory (KNCI)" prepared by the researchers. This form consists of 60 questions describing the 5 components mentioned above. The sample contains a total of 103 people, 91 (88.3%) women, and 12 (11.7%) men. Results Among the findings, the highest mean of knowledge level (13.76 ± 1.22) was found in Responsive Caregiving, and the lowest mean of knowledge level (4.35 ± 1.83) was found in Opportunities for Early Learning. The general level of knowledge on NC was found to vary statistically significantly depending on gender in favor of the women [t(101) = 3.27, p < .05], depending on educational status in favor of those with university and graduate education [F(2, 100) = 3.481, p < .05], depending on participation in pregnancy school training in favor of those who attended [t(101) = 2.349, p < .05], and depending on knowledge on how to support development in favor of those who know how to support [t(101) = 2.370, p < .05]. Conclusions As a result, expectant parents need information and support about the period when children can acquire the basic developmental milestones and about the developmental risk indicators. More research is needed to implement the NCF starting from the preconception period, especially in LMICs, so that the opportunities in early childhood (which is the time period when the brain architecture is shaped, and development is the fastest) are not missed.
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Affiliation(s)
- Hafize Soysal Cimen
- Child Development Master's Program, Institute of Health Sciences, Üsküdar University, Istanbul, Turkey
| | - Bedriye Tugba Karaaslan
- Department of Child Development, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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25
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Bhutta ZA, Vaivada T, Black MM, Black RE. A healthy future for children and adolescents - Authors' reply. Lancet 2022; 400:1101-1102. [PMID: 36183725 DOI: 10.1016/s0140-6736(22)01842-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
| | - Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; RTI International, Research Triangle Park, NC, USA
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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26
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Childhood Cancer and the Family: A Pilot Proposal for Comprehensive Intervention at the Time of Diagnosis. Healthcare (Basel) 2022; 10:healthcare10091790. [PMID: 36141402 PMCID: PMC9498655 DOI: 10.3390/healthcare10091790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Childhood cancer has a great impact on children and their environment. To minimize this, countries such as Canada and the USA have protocols in the field of social work, although these are scarce in Europe and especially in Spain. This paper aims to develop a pilot protocol in Aragon (Spain) for the practice of onco-pediatric social work in one of the hardest moments: the diagnosis. For its elaboration, a previous study was carried out in three phases, which provided data on the disease and its impact on the family and children and a methodological basis for the intervention from social work, all considering the participation of the agents involved as a fundamental element. Variables have been identified that influence the impact on the family support network and its quality of life at the time of diagnosis of childhood cancer. In addition, different indicators have been explored, based on the reality of these families. Finally, a pilot proposal for a comprehensive family intervention protocol in the diagnosis of childhood cancer has been elaborated. This work is intended to be a guide for intervention and delimitation of quality standards to be considered when dealing with the diagnosis of childhood cancer.
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27
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Berti C, Elahi S, Catalano P, Bhutta ZA, Krawinkel MB, Parisi F, Agostoni C, Cetin I, Hanson M. Obesity, Pregnancy and the Social Contract with Today's Adolescents. Nutrients 2022; 14:3550. [PMID: 36079808 PMCID: PMC9459961 DOI: 10.3390/nu14173550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 12/16/2022] Open
Abstract
Adolescent health and well-being are of great concern worldwide, and adolescents encounter particular challenges, vulnerabilities and constraints. The dual challenges of adolescent parenthood and obesity are of public health relevance because of the life-altering health and socioeconomic effects on both the parents and the offspring. Prevention and treatment strategies at the individual and population levels have not been successful in the long term, suggesting that adolescent pregnancy and obesity cannot be managed by more of the same. Here, we view adolescent obese pregnancy through the lens of the social contract with youth. The disruption of this contract is faced by today's adolescents, with work, social and economic dilemmas which perpetuate socioeconomic and health inequities across generations. The lack of employment, education and social opportunities, together with obesogenic settings, increase vulnerability and exposure to lifelong health risks, affecting their offspring's life chances too. To break such vicious circles of disadvantage and achieve sustainable solutions in real-world settings, strong efforts on the part of policymakers, healthcare providers and the community must be oriented towards guaranteeing equity and healthy nutrition and environments for today's adolescents. The involvement of adolescents themselves in developing such programs is paramount, not only so that they feel a sense of agency but also to better meet their real life needs.
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Affiliation(s)
- Cristiana Berti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Unit, 20122 Milan, Italy
| | | | - Patrick Catalano
- Mother Infant Research Institute, Tufts University School of Medicine, Boston 02111, MA, USA
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi 74800, Pakistan
| | - Michael B. Krawinkel
- Institute of Nutritional Sciences—International Nutrition, Justus-Liebig-University, 35392 Giessen, Germany
| | - Francesca Parisi
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Unit, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Irene Cetin
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy
- Department of Biomedical and Clinical Sciences, School of Medicine, University of Milan, 20154 Milan, Italy
| | - Mark Hanson
- Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton SO17 1BJ, UK
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28
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Datta V, Ghosh S, Aquino LD. Progressing towards SDG 2030 goals with system changes: the India Newborn Action Plan. BMJ Open Qual 2022; 11:bmjoq-2022-001971. [PMID: 35545276 PMCID: PMC9092168 DOI: 10.1136/bmjoq-2022-001971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vikram Datta
- Director Professor, Department of Neonatology, Lady Hardinge Medical College, New Delhi, India
| | - Sumita Ghosh
- Additional Commissioner Child Health Division, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Luigi D Aquino
- Chief of Health, UNICEF India Country Office, New Delhi, India
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29
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Ghebreyesus TA, Russell C. Opportunities in crisis for optimising child health and development. Lancet 2022; 399:1761-1763. [PMID: 35489359 DOI: 10.1016/s0140-6736(22)00608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 01/13/2023]
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30
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Vaivada T, Lassi ZS, Irfan O, Salam RA, Das JK, Oh C, Carducci B, Jain RP, Als D, Sharma N, Keats EC, Patton GC, Kruk ME, Black RE, Bhutta ZA. What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years. Lancet 2022; 399:1810-1829. [PMID: 35489360 DOI: 10.1016/s0140-6736(21)02725-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
Abstract
Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5-9 years) and the transition from childhood to adolescence (10-19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.
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Affiliation(s)
- Tyler Vaivada
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Zohra S Lassi
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, SA, Australia; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Irfan
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Christina Oh
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bianca Carducci
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Reena P Jain
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daina Als
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Naeha Sharma
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Keats
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Johns Hopkins University, MD, USA
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women and Child Health and Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
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31
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Bhutta ZA, Boerma T, Black MM, Victora CG, Kruk ME, Black RE. Optimising child and adolescent health and development in the post-pandemic world. Lancet 2022; 399:1759-1761. [PMID: 35489362 DOI: 10.1016/s0140-6736(21)02789-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Institute for Global Health and Development, The Aga Khan University, Karachi 74800, Pakistan.
| | - Ties Boerma
- Countdown to 2030 for Women's, Children's and Adolescents' Health and Institute for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; RTI International, Research Triangle Park, NC, USA
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Margaret E Kruk
- Department of Global Health and Populations, Harvard University TH Chan School of Public Health, Boston, MA, USA
| | - Robert E Black
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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32
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Black RE, Liu L, Hartwig FP, Villavicencio F, Rodriguez-Martinez A, Vidaletti LP, Perin J, Black MM, Blencowe H, You D, Hug L, Masquelier B, Cousens S, Gove A, Vaivada T, Yeung D, Behrman J, Martorell R, Osmond C, Stein AD, Adair LS, Fall CHD, Horta B, Menezes AMB, Ramirez-Zea M, Richter LM, Patton GC, Bendavid E, Ezzati M, Bhutta ZA, Lawn JE, Victora CG. Health and development from preconception to 20 years of age and human capital. Lancet 2022; 399:1730-1740. [PMID: 35489357 PMCID: PMC9061873 DOI: 10.1016/s0140-6736(21)02533-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/02/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
Optimal health and development from preconception to adulthood are crucial for human flourishing and the formation of human capital. The Nurturing Care Framework, as adapted to age 20 years, conceptualises the major influences during periods of development from preconception, through pregnancy, childhood, and adolescence that affect human capital. In addition to mortality in children younger than 5 years, stillbirths and deaths in 5-19-year-olds are important to consider. The global rate of mortality in individuals younger than 20 years has declined substantially since 2000, yet in 2019 an estimated 8·6 million deaths occurred between 28 weeks of gestation and 20 years of age, with more than half of deaths, including stillbirths, occurring before 28 days of age. The 1000 days from conception to 2 years of age are especially influential for human capital. The prevalence of low birthweight is high in sub-Saharan Africa and even higher in south Asia. Growth faltering, especially from birth to 2 years, occurs in most world regions, whereas overweight increases in many regions from the preprimary school period through adolescence. Analyses of cohort data show that growth trajectories in early years of life are strong determinants of nutritional outcomes in adulthood. The accrual of knowledge and skills is affected by health, nutrition, and home resources in early childhood and by educational opportunities in older children and adolescents. Linear growth in the first 2 years of life better predicts intelligence quotients in adults than increases in height in older children and adolescents. Learning-adjusted years of schooling range from about 4 years in sub-Saharan Africa to about 11 years in high-income countries. Human capital depends on children and adolescents surviving, thriving, and learning until adulthood.
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Affiliation(s)
- Robert E Black
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Li Liu
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Fernando P Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas Brazil
| | - Francisco Villavicencio
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Centre for Demographic Studies, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Rodriguez-Martinez
- Medical Research Council Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Luis P Vidaletti
- International Center for Equity in Health, Federal University of Pelotas, Pelotas Brazil
| | - Jamie Perin
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; RTI International, Research Triangle Park, NC, USA
| | - Hannah Blencowe
- Maternal Adolescent Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Danzhen You
- Data and Analytics Section, UNICEF, New York, NY, USA
| | - Lucia Hug
- Data and Analytics Section, UNICEF, New York, NY, USA
| | - Bruno Masquelier
- Centre de Recherche en Démographie, Université Catholique de Louvain, Louvain, Belgium
| | - Simon Cousens
- Maternal Adolescent Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Amber Gove
- RTI International, Research Triangle Park, NC, USA
| | - Tyler Vaivada
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Diana Yeung
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jere Behrman
- Department of Economics, Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Linda S Adair
- Nutrition Department, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline H D Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Bernardo Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas Brazil
| | - Manuel Ramirez-Zea
- Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Linda M Richter
- Department of Science and Innovation, National Research Foundation Centre of Excellence in Human Development, University of the Witwatersrand, Parktown, South Africa
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Eran Bendavid
- Department of Medicine, Stanford University, Stanford, CA, USA
| | - Majid Ezzati
- Medical Research Council Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre for Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Joy E Lawn
- Maternal Adolescent Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas Brazil
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33
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Victora CG, Hartwig FP, Vidaletti LP, Martorell R, Osmond C, Richter LM, Stein AD, Barros AJD, Adair LS, Barros FC, Bhargava SK, Horta BL, Kroker-Lobos MF, Lee NR, Menezes AMB, Murray J, Norris SA, Sachdev HS, Stein A, Varghese JS, Bhutta ZA, Black RE. Effects of early-life poverty on health and human capital in children and adolescents: analyses of national surveys and birth cohort studies in LMICs. Lancet 2022; 399:1741-1752. [PMID: 35489358 PMCID: PMC9061872 DOI: 10.1016/s0140-6736(21)02716-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022]
Abstract
The survival and nutrition of children and, to a lesser extent, adolescents have improved substantially in the past two decades. Improvements have been linked to the delivery of effective biomedical, behavioural, and environmental interventions; however, large disparities exist between and within countries. Using data from 95 national surveys in low-income and middle-income countries (LMICs), we analyse how strongly the health, nutrition, and cognitive development of children and adolescents are related to early-life poverty. Additionally, using data from six large, long-running birth cohorts in LMICs, we show how early-life poverty can have a lasting effect on health and human capital throughout the life course. We emphasise the importance of implementing multisectoral anti-poverty policies and programmes to complement specific health and nutrition interventions delivered at an individual level, particularly at a time when COVID-19 continues to disrupt economic, health, and educational gains achieved in the recent past.
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Affiliation(s)
- Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.
| | - Fernando P Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis P Vidaletti
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Linda M Richter
- Department of Science and Innovation, National Research Foundation Centre of Excellence in Human Development, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Fernando C Barros
- Post-Graduate Program of Health in the Life Cycle, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maria F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Nanette R Lee
- USC Office of Population Studies Foundation, University of San Carlos, Cebu, Philippines
| | - Ana Maria B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Shane A Norris
- SAMRC Pathways for Health Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Alan Stein
- MRC-Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; African Health Research Institute, Durban, South Africa
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Robert E Black
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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