scholarly journals Supporting child development to reduce child health inequalities in Belgium: a realist evaluation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Beauvarlet ◽  
M De Spiegelaere
Keyword(s):  
Child Development ◽  
Child Health ◽  
Poverty Reduction ◽  
Social Inequalities ◽  
Child Poverty ◽  
Poverty Line ◽  
Realist Evaluation ◽  
Structural Level ◽  
Parenting Support ◽  
Vulnerable Families

Abstract Background Reducing social inequalities in child health is a major challenge in Belgium. In Brussels, 40% of children are born in a household below the poverty line. The most efficient way to reduce social inequalities in health is to address them on a structural level, via public policies that improve families’ income. But it is also proven that direct support of child development can reduce the risk of poverty in adulthood. Therefore, this study focuses on fields projects working directly with families living in poverty and aims to understand how, for whom and in which circumstances their actions can have effects on child’s development. Methods We conducted a realist evaluation of 30 field projects funded as part of the fight against child poverty and offering parenting support from prenatal period to the age of 6. Firstly, focus groups with the projects’ workers were conducted to identify the underlying mechanisms in their interventions and the contexts facilitating or hindering these mechanisms to achieve the desired effects. Secondly, these Context-Mechanisms-Outcomes (CMO) configurations are validated with project beneficiaries through semi-directed interviews, using picture telling. Results Despite the diversity of the actions carried out, common and transversal mechanisms are highlighted within 6 different CMOs that allow us to understand how and for whom those 30 projects work. Certain contexts - e.g. the characteristics of families, their feeling of freedom regarding the project, the density of projects network - can activate or hinder the mechanisms. We also note that workers tend to adjust their actions to support very vulnerable families for whom certain common mechanisms aren’t working. Conclusions This study, co-constructed through the collaboration of researchers and actors, could help workers to better understand and improve the mechanisms induced by their interventions, and stakeholders to recognise which projects are best suited to certain contexts. Key messages This realist evaluation enables to understand how for whom and in which circumstances field projects actions can have effects on child’s development and therefore take part in child poverty reduction. The realist approach used in this study, through the parallel evaluation of 30 different field projects, allows to refine hypothesis from one project to another, ensuring transferability of results.

scholarly journals Priorities for the child public health response to the COVID-19 pandemic recovery in England

2020 ◽  
pp. archdischild-2020-320214
Author(s):  
Catherine Hefferon ◽  
Catherine Taylor ◽  
Davara Bennett ◽  
Catherine Falconer ◽  
Melisa Campbell ◽  
...  
Keyword(s):  
Child Health ◽  
Social Inequalities ◽  
Child Poverty ◽  
Unintended Consequences ◽  
Mitigation Strategies ◽  
Public Health Response ◽  
Health Response ◽  
Return To Schooling ◽  
Child Public Health

Child health is at risk from the unintended consequences of the COVID-19 response and will suffer further unless it is given proper consideration. The pandemic can be conceived as a systemic shock to the wider determinants of child health, with impacts on family functioning and income, access to healthcare and education. This article outlines COVID-19 impacts on children in England. Key priorities relate to the diversion of healthcare during lockdown; interruption and return to schooling; increased health risks and long-term impacts on child poverty and social inequalities. We provide an overview of mitigation strategies and policy recommendations aimed to assist both national and local professionals across child health, education, social care and related fields to inform the policy response.

scholarly journals Supporting parents by combatting social inequalities in health: a realist evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annabelle Pierron ◽  
Laurence Fond-Harmant ◽  
François Alla
Keyword(s):  
Social Inequalities ◽  
Perinatal Period ◽  
Realist Evaluation ◽  
World Health ◽  
Social Inequalities In Health ◽  
Structural Determinants ◽  
Inequalities In Health ◽  
Parenting Support ◽  
Mother And Child ◽  
Individual Strategies

Abstract Background To reduce social inequities in health, the World Health Organization’s Commission on Social Determinants of Health recommends acting as soon as life begins. In this context, parenting support is promoted as a major lever. The objective of the present research was to develop an intervention theory establishing the conditions for the success of interventions, policies, and organizations supporting parenting in terms of reducing or preventing social inequalities in health for both mother and child in the perinatal period. Methods To meet these objectives, we conducted a realist evaluation based on a multiple-case study. The study evaluated two border towns in Europe. We collected data from three sources: documentary reviews, focus groups and interviews with professionals, and parental questionnaires. Results The main results concerning the fight against social inequalities in health show a true willingness on the part of those involved to carry out universal actions, coordinated between professionals and institutions, in response to the demands of parents; however, the reality on the ground shows the complexity of their implementation and the multiplicity of results. Our middle-range theory showed that to be effective in tackling social inequalities in health, actions must address structural determinants at the macro-systemic level. However, the field of realist evaluation shows that it is first and foremost the actions focused on individual behavior that are implemented. While there is a general political desire to combat social inequalities in health in early childhood, the results show that the strategies in place are potentially not the most effective. Effective support actions would respond to individual strategies; however, current approaches target parents’ behavior, aiming to empower them but without giving them the means to do so. Conclusions This research constitutes a body of knowledge gathered for reflection and action. In particular, any perinatal policy should clearly state among its objectives the intention to reduce social inequalities in health. The policy should also state that it will be evaluated according to the criteria of proportionate universalism, interprofessional coordination, and actions based on the diversity of parents’ needs.

Child Poverty and Social Inequalities in Africa

2018 ◽  
pp. 74-87
Author(s):  
Icarbord Tshabangu
Keyword(s):  
Child Development ◽  
Social Security ◽  
United Nations ◽  
World Bank ◽  
Public Services ◽  
Social Inequalities ◽  
Child Poverty ◽  
Sub Saharan Africa ◽  
Analytic Review ◽  
Sub Saharan

Africa has continually faced challenges in providing public services for its vast populations culminating in wider inequality gaps and rising levels of child poverty. Consequently, child poverty has led to dim prospects for most children. This chapter discusses child poverty and social inequalities since these aspects are critical to child development and welfare. An analytic review of World Bank and United Nations agencies data was conducted, consisting of existing surveyed data and literature on contemporary contexts in Sub-Saharan Africa. It was noted how inadequate investment levels; children's voicelessness and a lack of social security safety nets, has negatively impacted children's rights and development. Indications are that child poverty and other social inequalities continue to be experienced in most parts of the continent despite the economic rise in some of these emerging economies.

Social, Economic, and Political Determinants of Child Health

PEDIATRICS ◽  
2003 ◽  
Vol 112 (Supplement_3) ◽  
pp. 704-706 ◽  
Author(s):  
Nick Spencer
Keyword(s):  
Child Health ◽  
Social Economic ◽  
Child Poverty ◽  
The United States ◽  
Health It ◽  
Political Factors ◽  
Political Determinants ◽  
The United Kingdom ◽  
Public Health Challenges ◽  
And Child Health

The Issue. This article presents a brief overview of the effects of social, economic, and political factors on child health. It starts by highlighting child poverty in rich nations, in particular the United Kingdom and the United States, and identifies the economic and political factors underlying this phenomenon. The evidence linking socioeconomic status and child health is briefly reviewed with particular attention to birth weight and child mental health—2 of the most important public health challenges in the 21st century. The implications for pediatricians of high levels of child poverty and the effect that these have on children are discussed.

SOCIO-ECONOMIC EMPOWERMENT OF WOMEN THROUGH MICRO CREDIT: AN EMPIRICAL STUDY

2021 ◽  
pp. 58-60
Author(s):  
T. Indumathi ◽  
G. Savaraiah
Keyword(s):  
Rural Women ◽  
Poverty Reduction ◽  
Rural Poverty ◽  
Poverty Line ◽  
Economic Empowerment ◽  
Political Empowerment ◽  
The Poor ◽  
The Government ◽  
The Impact ◽  
Micro Credit

The World Bank's Andhra Pradesh Rural Poverty Reduction Project supports the self helf groups of the women members. It promotes women's social, economic, legal and political empowerment to reduce poverty among the poor and the poorest of the poor. The important object of this article is to examine the impact of micronance on the socio economic empowerment of the rural women supported by the national reputed NGO- Rashtriya Seva Samithi (RASS). 184 women members of the SHGs promoted by Rasthriya Seva Samathi (RASS) an NGO which located in Tirupati town. 184 samples are selected randomly from 15 SHGs scattered throughout the Tirupati rural mandal (Taluk) from the area of the study have been considered to conduct the present research study. The study reveals that 87.71 percent of the sample women were below the poverty line before joining the SHGs. As a result of SHG, about 40 percent of the sample women crossed the poverty line. The highest intensive value indicates that more women have participated in social agitations for the welfare of the children and the society. The second highest intensity reveals that considerable numbers of women of SHGs have participated in the government sponsored schemes. The 1st point secured 3rd rank with total intensity value of 605 which status that the micro credit has resulted in increased social status and empowerment.

scholarly journals The Impact of Integrated Management for Salt Tolerant Forage Production on Small Farmers Poverty Egypt Case Study (Sahl El-Tina)

2016 ◽  
Vol 4 (10) ◽  
pp. 825
Author(s):  
Sherine Fathy Mansour ◽  
Dalia Elsaid Abozaid
Keyword(s):  
Poverty Reduction ◽  
Integrated Management ◽  
Poverty Line ◽  
Policy Instrument ◽  
Small Farmers ◽  
Forage Production ◽  
Capita Expenditure ◽  
Farming Household ◽  
Per Capita ◽  
The Impact

This study examines the impact of New Integrated Management Package (IMP) adoption on income and poverty among fodder farming household in Sahl El-Tina. The IMP such as Rate, time, and methods of nitrogen fertilization and other fertilization, Leaching requirements for some crops, Intercropping system, Use of suitable crop genotype/variety, Use of modern irrigation systems or modified systems to save water, date, rate and method of planting. The study aims mainly to improve the lives of small farmers through the level of dissemination and application of cultivation techniques forage crops tolerant to salinity through develop and disseminate technologies packages of forage production. And reducing their probability of falling below the poverty line. Therefore suggest that intensification of the investment on IMP dissemination is a reasonable policy instrument to raise incomes and reduce poverty among fodder farming household. It used instrumental variables (IV)-based estimator to estimate the Local Average Treatment Effect (LATE) of adoption of IMP on income and poverty reduction, using cross-sectional data of 200 farmers from Shal El-Tina. The findings reveal a robust positive and significant impact of IMP adoption on farm household income and welfare measured by per capita expenditure and poverty reduction. Specifically, the empirical results suggest that adoption of IMP raises household per capita expenditure and income by an average of 529.27$ and 1371$ in Shal El-Tina per cropping season respectively, thereby reducing their probability of falling below the poverty line. Therefore suggest that intensification of the investment on IMP dissemination is a reasonable policy instrument to raise incomes and reduce poverty among fodder farming household, although complementary measures are also needed. The incidence of poverty was higher among non-IMP adopters (55.2%) than IMP adopters (49.5%). In addition, both the depth and severity of poverty were also higher (20.85% and 15.42%) among non-adopters than the adopters (18.48% and 9.88%). All three poverty measures indicate that poverty was more prevalent and severe among non-adopters compared to adopters.

scholarly journals Poverty Eradication in Nigeria: A Focus on National Poverty Eradication Programme in Abia State, 2001- 2013

2018 ◽  
Vol 14 (5) ◽  
pp. 105
Author(s):  
Greene Ifeanyi Eleagu
Keyword(s):  
Poverty Reduction ◽  
Youth Unemployment ◽  
Poverty Line ◽  
Poverty Eradication ◽  
Eradication Programme ◽  
Financial Flows ◽  
Long Time ◽  
Broad Objective ◽  
The Impact ◽  
Huge Challenge

Poverty has been a huge challenge to Nigeria for a long time as majority of Nigerians live below poverty line. Successive civilian and military governments in Nigeria agreed on the need to eradicate or alleviate this ugly situation. In an attempt to ameliorate the situation, they introduced a number of schemes and programmes. The apparent failure of the various schemes and programmes and the resultant citizen discontent led to the creation of the National Poverty Eradication Programme, NAPEP, in all the states of the federation and the Federal Capital Territory. The broad objective of the study was to empirically evaluate the impact of NAPEP towards poverty eradication in Abia state, through the provision of youth employment. The structuralfunctionalist theory was adopted with an interrogation of relevant documents on financial flows, projects and programmes. The findings suggest that youth unemployment was pervasive. Again, the poverty reduction or alleviation efforts were fraught with corruption. To correct these, the work recommended disbursing monies to beneficiaries through banks. It also suggested, among others, that future efforts should be rural-centred, instead of urban-centred.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2021 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background: Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results: Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

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