HIFASS-LOPIN-3 Empowerment Programs and the Wellbeing of Orphans and Vulnerable Children in Southern Senatorial District of Cross River State, Nigeria

This study examined the various empowerment programs carried out by Health Initiatives for Safety and Stability in Africa – Local OVC Partner in Nigeria – Region 3 (HIFASS-LOPIN-3) as they affect the wellbeing of orphans and vulnerable children (OVC). Three objectives were outlined to include investigating the relationship between HIFASS-LOPIN-3 educational empowerment program and OVC’s school enrolment; HIFASS-LOPIN-3 provision of health services and OVC’s accessibility to quality healthcare facilities; HIFASS-LOPIN-3 skills acquisition training/financial empowerment program and the income level of OVC/caregivers. An Ex-post facto research design was employed in this study and a sample size of three hundred and eighty (380) respondents was drawn using multi-stage, simple random, stratified and snowball sampling techniques. The reliability test of the instrument was done using the test-retest reliability method. Primary data was obtained using a questionnaire and in-depth interview schedule, while secondary data was sourced from journals, texts, newspapers, internet, unpublished papers. The hypotheses were tested using Pearson’s Product-Moment Correlation Coefficient (r) and Chi-Square statistical techniques, together with frequency/percentage analysis. The study revealed among others that HIFASS-LOPIN-3 educational empowerment has significantly improved OVC’s school enrolment; HIFASS-LOPIN-3 skills acquisition training/financial empowerment program has significantly improved the income level of OVC/caregivers, nevertheless, almost all the OVC who reported having income-generating skills experienced challenges like insufficient start-up capital, insecurity, and crippling economic policies. It was recommended that government should make provision for OVC’s subsidized medical bills and adequate provision for start-up capital/equipment or materials should be made for older OVC/caregivers who receive skills acquisition training.

Deficits in hospital care among clinically vulnerable children aged 0 to 4 years during the COVID-19 pandemic

Objective: To quantify deficits in hospital care for clinically vulnerable children during the COVID-19 pandemic. Design: Birth cohort in Hospital Episode Statistics (HES). Setting: NHS hospitals in England. Study population: All children aged <5 years with a birth recorded in hospital administrative data (January 2010 to March 2021). Main exposure: Clinical vulnerability defined by a chronic health condition, preterm birth (<37 weeks gestation) or low birthweight (<2500g). Main outcomes: Deficits in care defined by predicted rates for 2020, estimated from 2015-2019, minus observed rates per 1000 child years during the pandemic (March 2020-2021). Results: Of 3,813,465 children, 17.7% (1 in 6) were clinically vulnerable (9.5% born preterm or low birthweight, 10.3% had a chronic condition). Deficits in hospital care during the pandemic were much higher for clinically vulnerable children than peers: respectively, outpatient attendances (314 versus 73 per 1000 child years), planned admissions (55 versus 10), and unplanned admissions (105 versus 79). Clinically vulnerable children accounted for 50.1% of the deficit in outpatient attendances, 55.0% in planned admissions, and 32.8% in unplanned hospital admissions. During the pandemic, weekly rates of planned care returned to pre-pandemic levels for infants with chronic conditions but not older children. Deficits in care differed by ethnic group and level of deprivation. Virtual outpatient attendances increased from 3.2% to 24.8% during the pandemic. Conclusion: 1 in 6 clinically vulnerable children accounted for one-third to one half of the deficit in hospital care during the pandemic.

COVID-19 lockdown in Spain: Psychological impact is greatest on younger and vulnerable children

In 2020, quarantine home confinement measures were implemented in Spain to control a pandemic for the first time. The objective of this study is to assess both the psychological and social impact of that ‘lockdown’ on different age groups of children and adolescents and also the different strategies adopted by families in that situation. We collected data via an online questionnaire answered by 850 participants, parents of young people aged between 4 and 18, between 24th April and 8th May 2020. Our results show that living in a home smaller than 80 m2 is associated with an increased risk of presenting clinical symptoms of emotional or behavioural distress, with an odds ratio of 2.54 (95% CI: 1.07–6.02), p = 0.034; while increased age is a predictor of better psychological functioning during lockdown: coefficient of 0.25 (95% CI: 0.07–0.41), p = 0.004. Moreover, age is also a marker of higher scores on the scale of psychological symptoms, with a coefficient of 0.02 (95% CI: 0.01–0.04), p = .005. To conclude, younger children present poorer behavioural and emotional functioning and more symptoms of emotional distress than adolescents during lockdown. Living in a small home is a risk factor for presenting clinical symptoms. These findings should be taken into consideration when planning for future home confinement episodes and when considering preventative strategies in the realm of mental health care.

Child mortality in England during the first year of the COVID-19 pandemic

ObjectivesTo quantify the relative risk (RR) of childhood deaths across the whole of England during the first year of the COVID-19 pandemic, compared with a similar period of 2019.DesignThis work is based on data collected by the National Child Mortality Database (NCMD). Deaths from 1 April 2020 until 31 March 2021 (2020–2021) were compared with those from the same period of 2019–2020. RR and excess mortality were derived for deaths in 2020–2021 vs 2019–2020.SettingAll deaths reported to NCMD in England of children under 18 years of age, between April 2019 and March 2021.Participants6490 deaths of children, under the age of 18 years, reported to the NCMD over the study period.ResultsChildren had similar demographics in the 2 years. There were 356 (198–514) fewer deaths in 2020–2021 than in 2019–2020 (RR 0.90 (0.85 to 0.94), p<0.001). Deaths from infection (RR 0.49 (0.38 to 0.64)) and from other underlying medical conditions (RR 0.75 (0.68 to 0.82)) were lower in 2020–2021 than 2019–2020, and weak evidence (RR 0.50 (0.23 to 1.07), p=0.074) that this was also true of deaths from substance abuse.ConclusionsChildhood mortality in England during the first year of the SARS-CoV-2 pandemic was lower than expected, with over 300 fewer deaths than the preceding 12 months. The greatest reduction was in children less than 10 years old. It is important that we learn from this effect that potentially offers alternative ways to improve the outcome for the most vulnerable children in our society.

Assessing sources of resilience in orphans and vulnerable children in Amajuba District schools

The main aim of the study was to assess the sources of resilience in orphans and vulnerable children in district schools in the local communities of Amajuba. The study has drawn insight from the social ecological theory of Bronfenbrenner. Being a mixed-method research approach, its design is grounded within the post-positivism paradigm. A self-administered questionnaire and individual interviews were used to collect data from 303 orphans and vulnerable children purposively sampled from schools within the Amajuba district KwaZulu-Natal for the quantitative phase, while eight orphans and vulnerable children were interviewed for the qualitative phase. Frequency distributions and a thematic analysis were employed to analyse the data. The findings establish that apart from HIV/Aids related deaths of parents, poverty, disabilities, abandonment or neglect, and COVID-19 are found to be other causes of vulnerability among the participants. Conversely, future expectations, religion or spirituality, and an extraverted personality type were found to be the sources of resilience in the participants. The inclusion of resilience in the education/school curriculum across all levels as well as resilience booster interventions are recommended for African children.

United Nations Convention on the Rights of Child: Forced Conversion of Hindu Minor Girls in Pakistan

Pakistan has ratified the United Nations Convention on the Rights of Child expressing therein that the right to freedom of religion incorporates that nobody ought to be compelled to change his religion. Pakistan’s constitution guarantees religious freedom to all minority communities in Pakistan. Forced conversion to Islam has become another type of rough fanaticism in Pakistan. Constrained transformation is the point at which an individual who uses pressure, power, intimidation, or danger to drive someone else to acknowledge another religion. It influences almost all minority groups in Pakistan, but the biggest victims are Hindu minor girls in Sindh province. It should be forbidden to pursue a position of power to entice vulnerable Hindu minor girls to convert under duress. As the criminal justice system in Pakistan is not addressing this issue effectively, legislation is urgently needed to protect vulnerable children. This article focuses on the need to promulgate a law providing forcible conversion of Hindu minor girls as a criminal offense. A literature review method is adopted for this paper.

North Thames multi-centre service evaluation: Ethical considerations during COVID-19

Objectives During the COVID-19 pandemic, healthcare resources including staff were diverted from paediatric services to support COVID-positive adult patients. Hospital visiting restrictions and reductions in face-to-face paediatric care were also enforced. We investigated the impact of service changes during the first wave of the pandemic on children and young people (CYP), to inform recommendations for maintaining their care during future pandemics. Design A multi-centre service evaluation was performed through a survey of consultant paediatricians working within the North Thames Paediatric Network, a group of paediatric services in London. We investigated six areas: redeployment, visiting restrictions, patient safety, vulnerable children, virtual care and ethical issues. Results Survey responses were received from 47 paediatricians across six National Health Service Trusts. Children's right to health was largely believed to be compromised by the prioritisation of adults during the pandemic (81%; n = 33). Sub-optimal paediatric care due to redeployment (61%; n = 28) and the impact of visiting restrictions on CYP's mental health (79%; n = 37) were reported. Decreased hospital attendances of CYP were associated with parental fear of COVID-19 infection-risks (96%; n = 45) and government ‘stay at home’ advice (89%; n = 42). Reductions in face-to-face care were noted to have disadvantaged those with complex needs, disabilities and safeguarding concerns. Conclusion Consultant paediatricians perceived that paediatric care was compromised during the first wave of the pandemic, resulting in harm to children. This harm must be minimised in subsequent pandemics. Recommendations for future practice which were developed from our findings are provided, including maintaining face-to-face care for vulnerable children.