scholarly journals Brief Evidence-Based Interventions for Universal Child Health Services: a restricted evidence assessment of the literature

2020 ◽  
Author(s):  
James J Newham ◽  
Karen McLean ◽  
Samuel Ginja ◽  
Lisa Hurt ◽  
Carly Molloy ◽  
...  

Abstract Background: Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS. Methods: A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline. Results: Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Child SEWB Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable. Conclusions: Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of “best bet” interventions.

2020 ◽  
Author(s):  
James J Newham ◽  
Karen McLean ◽  
Samuel Ginja ◽  
Lisa Hurt ◽  
Carly Molloy ◽  
...  

Abstract Background: Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS.Methods: A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline.Results: Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Child SEWB Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable.Conclusions: Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of “best bet” interventions.


2020 ◽  
Author(s):  
James J Newham ◽  
Karen McLean ◽  
Samuel Ginja ◽  
Lisa Hurt ◽  
Carly Molloy ◽  
...  

Abstract Background: Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS. Methods: A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline. Results: Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Child SEWB Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable. Conclusions: Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of “best bet” interventions.


2018 ◽  
Vol 7 (1) ◽  
pp. 192-206
Author(s):  
Brianna L Smith ◽  
Sara Sara Zizzo ◽  
Anouk Amzel ◽  
Sarah Wiant ◽  
Molly C. Pezzulo ◽  
...  

Background/Objectives: In the last decade, many strategies have called for integration of HIV and child survival platforms to reduce missed opportunities and improve child health outcomes. Countries with generalized HIV epidemics have been encouraged to optimize each clinical encounter to bend the HIV epidemic curve. This systematic review looks at integrated child health services and summarizes evidence on their health outcomes, service uptake, acceptability, and identified enablers and barriers. Methods: Databases were systematically searched for peer-reviewed studies. Interventions of interest were HIV services integrated with: neonatal/child services for children <5 years, hospital care of children <5 years, immunizations, and nutrition services. Outcomes of interest were: health outcomes of children <5 years, integrated services uptake, acceptability, and enablers and barriers. PROSPERO ID CRD42017082444. Results: Twenty-eight articles were reviewed: 25 (89%) evaluated the integration of HIV services into child health platforms, while three articles (11%) investigated the integration of child health services into HIV platforms. Studies measured health outcomes of children (n=9); service uptake (n=18); acceptability of integrated services (n=8), and enablers and barriers to service integration (n=14). Service integration had positive effects on child health outcomes, HIV testing, and postnatal service uptake. Integrated services were generally acceptable, although confidentiality and stigma were concerns Conclusion and Global Health Implications: Each clinical “touch point” with infants and children is an opportunity to provide comprehensive health services. In the current era of flat funding levels, integration of HIV and child health services is an effective, acceptable way to achieve positive child health outcomes. Key words: Africa, HIV, PITC • Child health services • PMTCT, neonatal health • Literature review • Immunization program Copyright © 2018 Smith et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
James J. Newham ◽  
Karen McLean ◽  
Samuel Ginja ◽  
Lisa Hurt ◽  
Carly Molloy ◽  
...  

2019 ◽  
Author(s):  
Huan Zhou ◽  
Yuju Wu ◽  
Chengfang Liu ◽  
Chang Sun ◽  
Yaojiang Shi ◽  
...  

Abstract Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfer (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services and health outcomes among children in poor rural areas of western China. Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. We conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China in 2014. In each village, 21 households were selected based on their eligibility status for the CCT program. Propensity score matching analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visit, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages was significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes. Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of the rural health facilities.


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