A pilot to promote early child development within health systems in Mozambique: a qualitative evaluation

Abstract Background Giving children the best start in life is critical for their future health and wellbeing. Political devolution in the UK provides a natural experiment to explore how public health systems contribute to children’s early developmental outcomes across four countries. Method A systematic literature review and input from a stakeholder group was used to develop a public health systems framework. This framework then informed analysis of public health policy approaches to early child development. Results A total of 118 studies met the inclusion criteria. All national policies championed a ‘prevention approach’ to early child development. Political factors shaped divergence, with variation in national conceptualizations of child development (‘preparing for life’ versus ‘preparing for school’) and pre-school provision (‘universal entitlement’ or ‘earned benefit’). Poverty and resourcing were identified as key system factors that influenced outcomes. Scotland and Wales have enacted distinctive legislation focusing on wider determinants. However, this is limited by the extent of devolved powers. Conclusion The systems framework clarifies policy complexity relating to early child development. The divergence of child development policies in the four countries and, particularly, the explicit recognition in Scottish and Welsh policy of wider determinants, creates scope for this topic to be a tracer area to compare UK public health systems longer term.

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Perceived Knowledge of Early Child Development Among New and Expecting Fathers

PsycEXTRA Dataset ◽

10.1037/e636842009-001 ◽

2009 ◽

Author(s):

Heather A. Keefe ◽

Sharnail D. Bazemore ◽

Kate Farr ◽

James F. Paulson

Keyword(s):

Child Development ◽

Early Child Development ◽

Perceived Knowledge ◽

Early Child

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Faculty Opinions recommendation of Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding: a prospective cohort study on children of women with epilepsy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718229710.793489382 ◽

2014 ◽

Author(s):

Selim Benbadis

Keyword(s):

Cohort Study ◽

Child Development ◽

Antiepileptic Drugs ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Early Child Development ◽

Early Child

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A holistic approach to promoting early child development: a cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh

BMJ Global Health ◽

10.1136/bmjgh-2020-004307 ◽

2021 ◽

Vol 6 (3) ◽

pp. e004307

Author(s):

Helen O Pitchik ◽

Fahmida Tofail ◽

Mahbubur Rahman ◽

Fahmida Akter ◽

Jesmin Sultana ◽

...

Keyword(s):

Mental Health ◽

Child Development ◽

Dietary Diversity ◽

Primary Caregivers ◽

Secondary Outcome ◽

Early Child Development ◽

Early Child ◽

Rural Bangladesh ◽

Cluster Randomised ◽

Adjusted Means

IntroductionIn low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.MethodsWe conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.ResultsIn July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54).ConclusionOur findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.Trial registration numberThe trial is registered in ISRCTN (ISRCTN16001234).

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Nutritional Status of Children 24–60 Months Attending Early Child Development Centres in a Semi-Rural Community in South Africa

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010261 ◽

2020 ◽

Vol 18 (1) ◽

pp. 261

Author(s):

Onwaba Makanjana ◽

Ashika Naicker

Keyword(s):

South Africa ◽

Child Development ◽

Nutritional Status ◽

Energy Intake ◽

Vegetable Consumption ◽

Childhood Development ◽

Early Child Development ◽

Serum Retinol ◽

Early Child ◽

Nutritional Status Of Children

Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. This study aimed to determine the nutritional status of children attending Early Child Development centres in South Africa. In this baseline study, we randomly selected two Early Child Development centres comprising 116 children aged 24–60 months, separated into two cohorts, of 24–47 months and 48–60 months. Dietary intake was measured through the 24 hDR and analysed using Food Finder software. The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements were taken and the WHO Anthro software was used to convert it to nutritional data indices. Blood samples were collected through dried blood spot cards in order to determine serum retinol and haemoglobin levels and they were assessed using WHO indicators. The findings showed that participants between 24 and 47 months had a high mean energy intake (4906.2 kJ and 4997.9 kJ for girls and boys, respectively). For the 48–60 months age group, energy intake was lower than the EER (5936.4 kJ and 5621.2 kJ; p = 0.038). There was low fruit and vegetable consumption (24–47 months; 63.8 g and 69.5 g (p = 0.037), 48–60 months; 68.3 g and 74.4 g (p = 0.038) and the top five foods consumed were carbohydrate rich foods for girls and boys, respectively. Stunting was noted in 7% and 20% (48–60 months) (p = 0.012) and overweight in 8% and 17% (24–47 months) and 17% and 13% (48–60 months) (p = 0.041) in girls and boys, respectively. Low serum retinol levels (<0.070 µmol/L) were found in 9.1% of boys (24–47 months), and 8% and 7.4% of girls and boys (48–60 months), respectively. Low haemoglobin levels (<11.0 g/dL) were found in 50.0% and 30.4% (24–47 months) and 8.6% and 39.3% (48–60 months) of girls and boys, respectively. Malnutrition, despite many national and provincial initiatives, still exists in Early Childhood Development centres in South Africa, calling for the application of contextualized nutrition interventions to suit resource-poor settings.

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