Integrated child nutrition, parenting, and health intervention in rural Liberia: A mixed-methods feasibility study.

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish.

Effect of a youth-led early childhood care and education programme on children's development and learning in rural Sindh, Pakistan (LEAPS): a stepped-wedge cluster-randomised implementation trial.

Background: In low-income and middle-income countries, an estimated 181·9 million (74·6%) preschool-aged children do not receive adequate nurturing care in health, nutrition, protection, learning, and responsive care, thus jeopardising their healthy development across the life course. Working alongside the health sector, multisectoral actions including social protection and education are necessary to achieve child health and development outcomes. Innovations are needed to expand access to high-quality early childhood care and education (ECCE) for young children and opportunities for youth development.

The development and validity of the Early Learning Tool for children 0-3-year-old in rural Pakistan.

Background: Research has demonstrated the critical role that early learning experiences play in shaping children's cognitive, social, and emotional development. Nevertheless, tools for assessing children's exposure to early learning experiences remain scarce. This paper describes the initial validation of the Early Learning (EL) tool, which captures the levels of stimulation with playthings and people available to children 0-3-year-old in low-resource, international settings.

The cost of not investing in the next 1000 days: implications for policy and practice.

Building on the evidence from the first paper in this Series highlighting the fundamental importance of healthy and nurturing environments for children's growth and development in the next 1000 days (ages 2-5 years), this paper summarises the benefits and costs of key strategies to support children's development in this age range. The next 1000 days build on the family-based and health-sector based interventions provided in the first 1000 days and require broader multisectoral programming. Interventions that have been shown to be particularly effective in this age range are the provision of early childhood care and education (ECCE), parenting interventions, and cash transfers.

The next 1000 days: building on early investments for the health and development of young children.

Following the first 1000 days of life that span from conception to two years of age, the next 1000 days of a child's life from 2-5 years of age offer a window of opportunity to promote nurturing and caring environments, establish healthy behaviours, and build on early gains to sustain or improve trajectories of healthy development. This Series paper, the first of a two-paper Series on early childhood development and the next 1000 days, focuses on the transition to the next 1000 days of the life course, describes why this developmental period matters, identifies the environments of care, risks, and protective factors that shape children's development, estimates the number of children who receive adequate nurturing care, and examines whether current interventions are meeting children's needs. Paper 2 focuses on the cost of inaction and the implications of not investing in the next 1000 days.

Perceptions of roles of community healthcare workers in early childhood in Limpopo, South Africa.

Background:  As part of the Reengineering Primary Health Care initiative, the South African National Department of Health (NDoH) has committed to expanding access to home-based care provided by community health workers. The NDOH also prioritised Community Health Workers (CHWs) in their agenda to improve child development outcomes in South Africa. However, there is limited research on CHWs' experiences and knowledge of early childhood development.

Perinatal depression and adverse child growth outcomes in low-income and middle-income countries (LMICs): A systematic review and meta-analysis.

Perinatal depression (PND), which encompasses the antepartum and postpartum depression (APD and PPD), is a neglected crisis in low-income and middle-income countries (LMICs). We aimed to systematically search and meta-analyze existing evidence to determine whether a mother's PND affects adverse growth outcomes in children in LMICs (PROSPERO protocol: CRD42021246803). We conducted searches, including nine databases (PubMed, EMBASE, Web of Science, CINAHL Plus, Global Health Database, Google Scholar, WHO Regional Databases, PsycINFO, and LILACS) from January 2000 to September 2023.

"When I hold my daughter, she quiets, no need [for]any verbal conversation": A qualitative understanding of responsive caregiving in rural, Sindh Pakistan.

Responsive caregiving is associated with secure attachment and positive child developmental outcomes. However, there is some debate on whether responsive caregiving is a universal construct. Few studies have researched responsive caregiving in diverse cultural settings, particularly in low- and middle-income countries.

Predictors of early child development for screening pregnant women most in need of support in Brazil.

Background: Home visiting programmes can support child development and reduce inequalities, but failure to identify the most vulnerable families can undermine such efforts. We examined whether there are strong predictors of poor child development that could be used to screen pregnant women in primary health care settings to target early interventions in a Brazilian population. Considering selected predictors, we assessed coverage and focus of a large-scale home visiting programme named Primeira Infância Melhor (PIM).

Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender.

Adversity within low- and middle-income countries (LMICs) poses severe threats to neurocognitive development, which can be partially mitigated by high-quality early family experiences. Specifically, maternal scaffolding and home stimulation can buffer cognitive development in LMIC, possibly by protecting underlying neural functioning. However, the association between family experiences and neural activity remains largely unexplored in LMIC contexts.

Factors associated with signs of congenital syphilis in newborns.

Objective: To analyze risk factors (maternal, obstetric and demographic) associated with congenital syphilis and the clinical characteristics of the newborns.

Method: A cross-sectional study carried out in ten public maternity hospitals in Fortaleza, Ceará, Brazil that included cases of live births reported with congenital syphilis in 2015.

Results: 469 cases were analyzed; 199 (42.

A qualitative study of maternal and paternal parenting knowledge and practices in rural Mozambique.

Background: Providing nurturing care for young children is essential for promoting early child development (ECD). However, there is limited knowledge about how mothers and fathers across diverse contexts in sub-Saharan Africa care for their children and from whom they receive guidance and support in their caregiving roles. We aimed to examine caregivers' nurturing care practices and sources of parenting knowledge in rural Mozambique.

Neonatal Physical Growth Predicts Electroencephalography Power in Rural South African Children.

Anthropometric measures at birth, indexing prenatal growth, are associated with later cognitive development. Children in low- and middle-income countries (LMIC) are at elevated risk for impaired prenatal and early postnatal growth and enduring cognitive deficits. However, the associations of neonatal physical growth with neural activity are not well-characterized in LMIC contexts, given the dearth of early childhood neuroimaging research in these settings.

Quality of life and associated factors for community health workers in the context of the COVID-19 pandemic in northeastern Brazil.

In this study, we evaluated the quality of life (QoL) and associated factors of community health workers (CHWs) in different urban settings as a contributor to the preparedness of Brazilian primary care for future sanitary emergencies. The sample included 1935 CHWs from 4 state capitals and 4 inland municipalities in northeastern Brazil. Information was collected on QoL (WHOQOL-BREF), work routines, sociodemographics, direct and indirect exposure to violence, general self-efficacy, social support (MSPSS), mental health (SRQ-20) and coronavirus anxiety.

The effects of a large-scale home visiting programme for child development on use of health services in Brazil.

Partnership between early childhood development interventions and primary health care services can help catalyse health care uptake by socially vulnerable families. This study aimed to assess the real-life effects of a large-scale home visiting programme [Primeira Infância Melhor (PIM)] in Brazil on the use of preventive (prenatal visits, well child visits, dentist visits and vaccination) and recovery (emergency room visits and hospitalization) health services. A quasi-experiment nested in a population-based birth cohort study was conducted.

A meta-analytic review of the implementation characteristics in parenting interventions to promote early child development.

This review summarizes the implementation characteristics of parenting interventions to promote early child development (ECD) outcomes from birth to 3 years. We included 134 articles representing 123 parenting trials (PROSPERO record CRD42022285998). Studies were conducted across high-income (62%) and low-and-middle-income (38%) countries.

Effect of a Center-Based Early Childhood Care and Education Program on Child Nutritional Status: A Secondary Analysis of a Stepped-Wedge Cluster Randomized Controlled Trial in Rural Sindh, Pakistan.

Background: High-quality early childhood care and education (ECCE) programs can positively impact children's development. However, as an unintended consequence, ECCE attendance may also affect children's nutritional status.

Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan.

Effects of engaging fathers and bundling parenting and nutrition interventions on early child development and maternal and paternal parenting in Mara, Tanzania: a factorial cluster-randomized controlled trial.

Background: Multicomponent interventions are needed to address the various co-occurring risks that compromise early child nutrition and development. We compared the independent and combined effects of engaging fathers and bundling parenting components into a nutrition intervention on early child development (ECD) and parenting outcomes.

Methods: We conducted a 2×2 factorial cluster-randomized controlled trial across 80 villages in Mara Region, Tanzania, also known as EFFECTS (Engaging Fathers for Effective Child Nutrition and Development in Tanzania; ClinicalTrials.

Effects of a Parenting and Nutrition Intervention on Siblings: A Cluster-RCT.

Objectives: The majority of the evidence about the effectiveness of early parenting and nutrition interventions pertains to 1 targeted index child in a given household. We evaluated whether nontargeted sibling children benefited from a bundled parenting and nutrition intervention.

Methods: We designed a sub-study within a broader cluster-randomized trial that evaluated the effects of engaging both mothers and fathers and bundling parenting and nutrition interventions in Mara, Tanzania.

Informal settlements and the care of children 0-3 years of age: a qualitative study.

Background: There is a rapid increase in urbanization with a high percentage of people living in poverty in urban informal settlements. These families, including single parents, are requiring accessible and affordable childcare. In Mlolongo, an informal settlement in Machakos County in Nairobi metropolitan area, Kenya, childcare centres, referred to as 'babycares' are increasing in number.

Community health workers perspective on the COVID-19 impact on primary health care in Northeastern Brazil.

This article evaluates the COVID-19 pandemic impacts on the Family Health Strategy (FHS) team's work routines across a range of northeast Brazilian cities as perceived by community health workers (CHW). Data on COVID-19, CHW activities, and FHS teams were collected in 2021 by a structured questionnaire. A total of 1,935 CHWs from four state capitals (Fortaleza - Ceará State, João Pessoa - Paraíba State, Recife - Pernambuco State, Teresina - Piauí State) and four hinterland cities (Crato, Juazeiro do Norte, Barbalha, Sobral - Ceará State) participated in the study.

Mental health of community health workers in the COVID-19 context.

This study aimed to analyze the factors related to the mental health of Community Health Workers (ACS) in the COVID-19 context. A total of 1,935 ACS from four Northeastern capitals and four cities in the inland region of Ceará participated. The following data were collected: sociodemographic; professional; SRQ-20; WHOQOL-Bref, exposure to violence, General Self-Efficacy Scale (EAEG), Multidimensional Scale of Perceived Social Support (MSPSS), COVID-19-related information, and the coronavirus anxiety scale (EAC).

Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone Survey.

This paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted in the midst of a global pandemic, between December 2021 and February 2022, we present the first nationally representative estimates of child development for children under 3 years of age and school readiness for children 3-6 years of age, using internationally validated instruments. The paper examines how risk factors that were exacerbated due to the COVID-19 pandemic, such as parental distress, lack of psychosocial stimulation, food insecurity, low maternal education, no enrollment in early childhood education, and living in a rural area, are associated with children's outcomes.

When social identities intersect: understanding inequities in growth outcomes by religion- caste and religion-tribe as intersecting strata of social hierarchy for Muslim and Hindu children in India.

Background: Minority social status determined by religion, caste and tribal group affiliations, are usually treated as independent dimensions of inequities in India. This masks relative privileges and disadvantages at the intersections of religion-caste and religion-tribal group affiliations, and their associations with population health disparities.

Methods: Our analysis was motivated by applications of the intersectionality framework in public health, which underlines how different systems of social stratification mutually inform relative access to material resources and social privilege, that are associated with distributions of population health.