Child Rights during the COVID-19 Pandemic: Learning from Child Health-and-Rights Professionals across the World

The COVID-19 pandemic underscores the importance of a child rights-based approach to policymaking and crisis management. Anchored in the United Nations Convention on the Rights of the Child, the 3P framework-provision, protection, and participation-forms the foundation for health professionals advocating for children's rights. Expanding it with two additional domains-preparation and power-into a 5P framework has the potential to enhance child rights-based policies in times of crisis and future pandemics. The study aimed to (1) gather perspectives from child health-and-rights specialists on how children's rights were highlighted during the early phase of the pandemic in their respective settings; and (2) evaluate the usefulness of the 5P framework in assessing children's visibility and rights. A qualitative survey was distributed among child health-and-rights professionals; a total of 68 responses were analysed in Atlas.ti 9 from a multi-disciplinary group of policymakers and front-line professionals in eight world regions. As framed by the 5Ps, children's rights were generally not safeguarded in the initial pandemic response and negatively impacted children's health and wellbeing. Further, children lacked meaningful opportunities to raise their concerns to policymakers. The 5P framework holds the potential to shape an ethical child rights-based decision-making framework for future crises, both nationally and globally.

Children and young people's participation in decision-making within healthcare organisations in New Zealand: An integrative review

There is a paucity of literature on children and young people's participation in decision-making within healthcare organisations in New Zealand. This integrative review examined child self-reported peer-reviewed manuscripts and published guidelines, policy, reviews, expert opinion and legislation to explore how New Zealand children and young people participate in discussions and decision-making processes within healthcare settings and what are barriers and benefits to such participation. Four child self-reported peer-reviewed manuscripts and twelve expert opinion documents were retrieved from four electronic databases including academic, government and institutional websites. Inductive content thematic analysis generated one theme (a discourse in children and young people's participation within healthcare settings), four sub-themes, 11 categories, 93 codes and 202 findings. It is evident within this review that there is a discourse between what expert opinion are stating is required to promote children and young people's participation in discussions and decision-making processes within healthcare settings and what is occurring in practice. Despite literature reporting on how children and young people's participation and voice were essential for healthcare provision, there was sparse literature published on children and young people's participation in discussions and decision-making processes in healthcare delivery in New Zealand.

Partnering to implement the Global Initiative for Childhood Cancer in the Americas: prioritizing systems strengthening

Working with PAHO/WHO to prioritize childhood cancer in the context of systems strengthening is central to St. Jude Children's Research Hospital (SJCRH)'s role as WHO Collaborating Centre for Childhood Cancer. This manuscript focuses on how SJCRH and PAHO/WHO have partnered to apply C5 (Country Collaboration for Childhood Cancer Control) to define and implement priority actions regionally, strengthening Ministry programs for childhood cancer, while implementing the Global Initiative for Childhood Cancer since 2018. Using C5, a tool developed by SJCRH, PAHO/WHO and SJCRH co-hosted regional/national workshops engaging authorities, clinicians and other stakeholders across 10 countries to map health systems needs and prioritize strategic activities (spanning Central America, Dominican Republic, Haiti, Brazil and Uruguay). SJCRH provided English/Spanish/Portuguese C5 versions/templates for analysis/prioritization exercises, and worked with PAHO/WHO and country teams to implement C5, analyze findings, and develop outputs. In an eight-country regional workshop, countries defined priorities within national/regional initiatives and ranked their value and political will, incorporating country-specific surveys and stakeholder dialogues. Each country prioritized one strategic activity for 2022-2023, exchanged insights via storytelling, and disseminated and applied results to inform country-specific and regional action plans. National workshops analyses have been incorporated into cancer control planning activities and collaborative work regionally. Implementation success factors include engaging actors beyond the clinic, enabling flexibility, and focusing on co-design with stakeholders. Joint implementation of C5 catalyzed prioritization and accelerated strategic activities to improve policies, capacity, and quality of care for children in the Americas, supporting Ministries to integrate childhood cancer interventions as part of systems strengthening.

Tailored interviewing to uncover the perspectives of children with multiple disabilities on daily activities: A qualitative analyses of interview methods and interviewer skills

INTRODUCTION

Uncovering the perspective of children with multiple disabilities is important in health care to enable person-centred health care. For occupational therapists, uncovering the child perspective on meaningful activities is necessary to set appropriate goals for treatment. It is not always evident that children with multiple disabilities can express themselves in an interview. The interviewer should adapt his communication to the child. In literature, alternative communication is widely studied, but a clear algorithm for deciding what to use to successfully gain insight into the child perspective is missing. This study aims to identify helpful interview techniques and interviewer skills and how they can be used to effectively uncover the perspective of children.

METHODS

Videos of nine interviews with children with a mitochondrial disorder, conducted by an occupational therapist, were analysed by five researchers. The interviews were analysed to see how well the interviewee had obtained the child's perspectives followed by observation of communicative abilities of the child and the types of questions the interviewer asked. A qualitative directed content analysis of the semi-structured interviews followed.

FINDINGS

An interview pattern was observed in the children's communication leading to six successful interviews. Children communicated verbally on four different levels and also used non-verbal communication. The interviewer used five types of questions, which varied between and within the children. The content analysis resulted in two themes: parental influences and interviewer skills.

CONCLUSION

Results show the importance of matching the type of questions to the verbal communication level of the child and revealed several interviewer skills and techniques. An overview to guide tailor-made interviewing is presented. The interviewer has a major role in successful interviewing and thus in enabling the inclusion of the child perspective in research and care.

Demystifying the Op-Ed. A Novel Group Writing Workshop to Improve Upon Existing Pediatric Advocacy Training

An op-ed writing workshop utilizing a group compilation exercise increases participant self-reported comfort in writing op-eds and has led to published op-eds. An experiential op-ed writing workshop could be incorporated into advocacy curricula in pediatric residency programs.

Experiences of incarcerated mothers living with their children in a prison in Lima, Peru, 2020: a qualitative study

OBJECTIVES

This study explores the experiences of incarcerated women living with their children in the Women Chorrillos Penitentiary, Lima, Peru, 2020.

MATERIAL AND METHOD

Qualitative, exploratory study with a phenomenological design, through semi-structured interviews with inmates who lived with their minor in the prison. In total there were 13 interviews considering the theoretical saturation of categories.

RESULTS

The experiences consisted of mostly negative intrapersonal experiences, related to different individual aspects and the conditions of confinement and prison treatment. Serious deficiencies perceived in the health care of inmates and children stand out, with emphasis on mistreatment and indifference on the part of the staff. Other factors involved in the construction of these experiences were identified.

DISCUSSION

The results provide evidence of serious structural and organizational deficiencies that violate the fundamental rights of the population group studied. Government efforts to date are partial and insufficient. Sustainable policies and programs are urgently needed that prioritize quality health care and adequate prison treatment for these people with an emphasis on preventive promotional actions. There is a need for evidence-based interventions to reduce the harmful effects of childhood incarceration.

Can Asset-Based Community Development with Children and Youth Enhance the Level of Participation in Health Promotion Projects? A Qualitative Meta-Synthesis

The asset-based community development (ABCD) approach have been widely used to map local assets and to ensure participation of local communities in public health promotion strategies. Participatory practices, such as ABCD, have been applied to shift public health strategies towards addressing health inequities. In this meta-synthesis, we ask if, and how, ABCD enhance the level of participation for children, youth and schools. Three thousand eight hundred eight titles and abstracts were identified in ten databases and transferred to the online program Rayyan. Through a blinded process we excluded texts that did not meet the inclusion criteria. The twelve included texts on ABCD for children, youth and schools are of varying quality. The research on ABCD for children, youth and schools have not been cumulative. Nevertheless, the texts show that ABCD provides strategies that enhance the participation of children, youth, and schools, in health promotion projects. The projects were categorized according to Robert Hart’s classical participation ladder, and we found that the projects with the highest level of adherence to ABCD principles also had the highest level of participation. The projects with high levels of participation were supported by adult facilitators that created learning environments where children and youth developed their participatory skills.

(In)visibility of notifications of violence against children and adolescents registered in a municipality in southern Brazil

OBJECTIVES

To know the perception of health, education and social service professionals about the records and notifications of violence against children and adolescents, carried out in a municipality in the south of Brazil.

METHODS

This is an exploratory, descriptive, and qualitative approach, specifically developed in places that integrate children and adolescents victims of violence. Ten professionals participated, including three nurses, one doctor, two social workers, two psychologists, one tutor, and one educator. Data collection was performed through a semi-structured interview. The statements were submitted to discursive textual analysis.

RESULTS

The analysis showed that the act of recording and reporting violence against children and adolescents is still not a routine practice for health professionals. The registration and formal communication of the information should be considered as a priority; however, the results showed that the protection of the victim seems to overlap with the registry. The study identified important elements in strategies for coping with violence against children and adolescents: centralization of notifications in a single service; creation of a notification flow; existence of an advisory team to deal with cases of violence; and completion of compulsory notification by education and social assistance professionals.

CONCLUSIONS

For the professionals, the routine attendance of situations involving violence, but not formalized through the notification form, has contributed to the underreporting and invisibility of the cases.

Child sex trafficking and commercial sexual exploitation: health care needs of victims

Child sex trafficking and commercial sexual exploitation of children (CSEC) are major public health problems in the United States and throughout the world. Despite large numbers of American and foreign youth affected and a plethora of serious physical and mental health problems associated with CSEC, there is limited information available to pediatricians regarding the nature and scope of human trafficking and how pediatricians and other health care providers may help protect children. Knowledge of risk factors, recruitment practices, possible indicators of CSEC, and common medical and behavioral health problems experienced by victims will help pediatricians recognize potential victims and respond appropriately. As health care providers, educators, and leaders in child advocacy, pediatricians play an essential role in addressing the public health issues faced by child victims of CSEC. Their roles can include working to increase recognition of CSEC, providing direct care and anticipatory guidance related to CSEC, engaging in collaborative efforts with medical and nonmedical colleagues to provide for the complex needs of youth, and educating child-serving professionals and the public.

Pediatricians' involvement in community child health from 2004 to 2010

BACKGROUND AND OBJECTIVE

Pediatricians are encouraged to engage in community child health activities, yet practice constraints and personal factors may limit involvement. The objective was to compare community involvement in 2004 and 2010 and factors associated with participation in the past year.

METHODS

Analysis of 2 national mailed surveys of pediatricians (2004: n = 881; response rate of 58%; 2010: n = 820; response rate of 60%). Respondents reported personal characteristics (age, gender, marital status, child ≤5 years old, underrepresented in medicine), practice characteristics (type, setting, full-time status, time spent in general pediatrics), formal community pediatrics training, and community pediatrics involvement and related perspectives. We used χ2 statistics to measure associations of personal and practice characteristics, previous training, and perspectives with involvement in the past 12 months. Logistic regression assessed independent contributions.

RESULTS

Fewer pediatricians were involved in community child health in 2010 (45.1% in 2004 vs. 39.9% in 2010) with a higher percentage participating as volunteers (79.5% vs. 85.8%; both P = .03). In 2010, fewer reported formal training at any time (56.1% vs. 42.9%), although more reported training specifically in residency (22.0% vs. 28.4%; both P < .05). Factors associated with participation in 2010 included older age, not having children ≤5 years old, practice in rural settings, practice type, training, and feeling moderately/very responsible for child health. In adjusted models, older age, practice setting and type, feeling responsible, and training were associated with involvement (P < .05).

CONCLUSIONS

Formal training is associated with community child health involvement. Efforts are needed to understand how content, delivery, and timing of training influence involvement.