Facilitating reflective supervision in an early child development center

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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Using narrative therapy with children experiencing developmental disabilities and their families in India: A qualitative study

Journal of Child Health Care ◽

10.1177/13674935211014739 ◽

2021 ◽

pp. 136749352110147

Author(s):

Jehanzeb Baldiwala ◽

Trishala Kanakia

Keyword(s):

Developmental Disabilities ◽

Child Development ◽

Narrative Therapy ◽

Mental Health Practitioners ◽

International Context ◽

Individual Interviews ◽

Indian Context ◽

Health Practitioners ◽

Child Development Center ◽

Development Center

Narrative therapy is a respectful and culturally relevant form of psychotherapy. Internationally, there is an increasing use of narrative therapy with diverse populations; however, there is limited documentation within the Indian context. The intention of the study was to understand experiences of children and their families during their participation in narrative therapy at Ummeed Child Development Center in Mumbai, India. Twelve participants were recruited for individual interviews: four children, who received counseling at Ummeed Child Development Center for a minimum of 6 months, and eight family members. Thematic analysis of data revealed three themes: Working In Partnership reflected the value of therapy being a collaborative process; Practices That Open Up Possibilities highlighted skills of children and their families that became visible through counseling; and Taking Control And Advocacy revealed how families experienced a sense of control over their own lives and an interest in advocating for others with similar lived experiences. The study has brought to light how narrative therapy can make possible change in lives of children and their families and wider society. In an international context, these findings serve to document narrative therapy as a beneficial modality for mental health practitioners to use with children experiencing developmental disabilities and their families.

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