RESUMO
Despite the knowledge that quality early childhood development programs, including those that target parental knowledge and behaviors, are essential for ameliorating the negative effects of early-life adversity, robust analyses of their implementation and impact in highly vulnerable settings are scarce. To address this knowledge gap, we conducted a pilot wait-list randomized controlled trial (RCT) to assess the impact and the process of implementing and evaluating the Mother-Child Education Program (MOCEP) among refugee families and one low-income community in Beirut, Lebanon. This paper focuses on the analysis of MOCEP's implementation (i.e., key enablers of and barriers to the application and evaluation of the program). Our analysis suggests that, despite multiple challenges, implementation and robust evaluations of early childhood parenting programs in fragile contexts are feasible and urgently needed. This study illustrates how implementation evaluations are a key component of RCTs and crucial to identifying strategies to optimize program uptake and maximize impact.
Assuntos
Educação não Profissionalizante/normas , Relações Mãe-Filho , Avaliação de Processos em Cuidados de Saúde/normas , Avaliação de Programas e Projetos de Saúde/normas , Refugiados , Populações Vulneráveis , Adulto , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Ciência da Implementação , Líbano , Projetos Piloto , Desenvolvimento de ProgramasRESUMO
This special issue of New Directions in Child and Adolescent Development features four review articles from authoritative leaders in the field. These articles highlight how far our field has come over the past five decades, as well as how much further effort is needed to refine, adapt, and implement - in a sustainable fashion - responsive parenting and nurturing care programs of proven value across the globe.
Assuntos
Desenvolvimento Infantil , Conservação dos Recursos Naturais , Relações Pais-Filho , Poder Familiar , Nações Unidas , Violência/prevenção & controle , Criança , HumanosAssuntos
Betacoronavirus , Desenvolvimento Infantil , Infecções por Coronavirus/epidemiologia , Saúde Global , Pneumonia Viral/epidemiologia , COVID-19 , Criança , Mortalidade da Criança , Proteção da Criança , Controle de Doenças Transmissíveis , Aglomeração , Economia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Saúde Materna , Mortalidade Materna , Saúde Mental , Pandemias , Pais/psicologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Alocação de Recursos , SARS-CoV-2 , Estresse Psicológico/complicaçõesRESUMO
The Multiple Indicator Cluster Survey was used to provide information on feeding practices, caregiving, discipline and violence, and the home environment for young children across 28 countries. The findings from the series of studies in this Special Section are the first of their kind because they provide information on the most proximal context for development of the youngest children in the majority world using one of the only data sets to study these contexts across countries. Using the framework of the Convention on the Rights of the Child, in particular the Rights to Survival, Development and Protection, findings are explained with implications for international and national-level social policies. Implications are also discussed, with respect to policy makers and the larger international community, who have the obligation to uphold these rights.
Assuntos
Defesa da Criança e do Adolescente/legislação & jurisprudência , Desenvolvimento Infantil , Países em Desenvolvimento , Política Pública , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Maus-Tratos Infantis/prevenção & controle , Educação Infantil , Proteção da Criança , Pré-Escolar , Comparação Transcultural , Educação , Feminino , Previsões , Humanos , Lactente , Cooperação Internacional , Masculino , Relações Pais-Filho , Poder Familiar , Punição , Meio Social , Valores SociaisRESUMO
The Multiple Indicator Cluster Survey (MICS) is a nationally representative, internationally comparable household survey implemented to examine protective and risk factors of child development in developing countries around the world. This introduction describes the conceptual framework, nature of the MICS3, and general analytic plan of articles in this Special Section. The articles that follow describe the situations of children with successive foci on nutrition, parenting, discipline and violence, and the home environment. They address 2 common questions: How do developing and underresearched countries in the world vary with respect to these central indicators of children's development? How do key indicators of national development relate to child development in each of these substantive areas? The Special Section concludes with policy implications from the international findings.
Assuntos
Desenvolvimento Infantil , Países em Desenvolvimento , Criança , Educação Infantil , Pré-Escolar , Humanos , Lactente , Internacionalidade , Avaliação Nutricional , Poder Familiar , Política Pública , Pesquisa , Meio Social , Socialização , Violência/psicologiaRESUMO
Children's environments - especially relationships with caregivers - sculpt not only developing brains but also multiple bio-behavioral systems that influence long-term cognitive and socioemotional outcomes, including the ability to empathize with others and interact in prosocial and peaceful ways. This speaks to the importance of investing resources in effective and timely programs that work to enhance early childhood development (ECD) and, by extension, reach communities at-scale. Given the limited resources currently devoted to ECD services, and the devastating impact of COVID-19 on children and communities, there is a clear need to spur government leaders and policymakers to further invest in ECD and related issues including gender and racial equity. This essay offers concrete examples of scholarly paradigms and leadership efforts that focus on child development to build a peaceful, equitable, just, and sustainable world. As scholars and practitioners, we need to continue to design, implement, assess, and revise high-quality child development programs that generate much-needed evidence for policy and programmatic changes. We must also invest in global partnerships to foster the next generation of scholars, practitioners, and advocates dedicated to advance our understanding of the bio-behavioral systems that underlie love, sociality, and peace across generations. Especially where supported by structural interventions, ECD programs can help create more peaceful, just, and socially equitable societies.
RESUMO
BACKGROUND: Advocates for children's rights have recommended the elimination of all forms of violent discipline given its detrimental effects on children's development. Yet, little is known about the global prevalence of various forms of discipline, including physical and psychological aggression, as well as alternative forms of non-violent discipline, especially in low- and middle-income countries (LMICs). OBJECTIVE: This study aims to obtain national, regional, and global prevalence estimates of the percentage and number of 2- to- 4-y-olds in LMICs exposed to these disciplinary practices by their caregivers. PARTICIPANTS AND SETTING: We use data collected between 2010 and 2016 from 107,063 2- to- 4-y-old children living in 49 LMICs as part of the Multiple Indicator Cluster Survey (MICS). METHODS: Using the best-fitting model based on cross-validation techniques, we performed predictive modeling to generate country-level prevalence estimates for 131 LMICs in 2013, as well as 95% confidence intervals around these estimates. RESULTS: We estimate that 296.2 million 2- to- 4-y-olds (95% CI 256.9, 300.9) were exposed to non-violent discipline in 2013, which corresponds to 83.9% of the population. Furthermore, 220.4 million (95% CI 138.1, 283.7) and 230.7 million (95% CI 128.4, 300.6) children were exposed to aggressive physical and psychological discipline, respectively, which corresponds to prevalence of 62.5% and 65.4%. We also identify a high heterogeneity in the estimates across and within regions, finding a higher prevalence of both violent disciplinary methods in South Asia and Sub-Saharan Africa. CONCLUSIONS: These results suggest the need for new policies and programs to minimize violent discipline around the world.
Assuntos
Agressão/psicologia , Abuso Físico/psicologia , Punição/psicologia , Adolescente , Experiências Adversas da Infância/estatística & dados numéricos , África Subsaariana , Agressão/fisiologia , Ásia , Cuidadores , Criança , Desenvolvimento Infantil , Pré-Escolar , Países em Desenvolvimento , Feminino , Humanos , Masculino , Abuso Físico/estatística & dados numéricos , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Prevalência , Inquéritos e QuestionáriosRESUMO
Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on Responsive Caregiving and Early Learning (RCEL). Multilevel partnerships, leadership and targeted situational analysis were crucial to design and adaptation. A theory of change approach to consider pathways to impact was useful for design, but practical situational analysis tools and local data to guide these processes were lacking. Several RCEL programmes, implemented within government services, had positive impacts on ECD outcomes and created more enabling caregiving environments. Engagement of informal and private sectors provided an alternative approach for reaching children where government services were sparse. Cost-effectiveness was infrequently measured. At small-scale RCEL interventions can be successfully adapted and implemented across diverse settings through processes which are responsive to situational analysis within a partnership model. Accelerating progress will require longitudinal evaluation of ECD interventions at much larger scale, including programmes targeting children with disabilities and humanitarian settings with further exploration of cost-effectiveness, critical content and human resources.
Assuntos
Desenvolvimento Infantil , Serviços de Saúde da Criança/organização & administração , Criança , Pré-Escolar , Países em Desenvolvimento , Política de Saúde , Humanos , Lactente , Recém-Nascido , Relações InterinstitucionaisAssuntos
Desenvolvimento Infantil , Criança , Serviços de Saúde da Criança , Proteção da Criança , Pré-Escolar , Humanos , Lactente , Recém-NascidoRESUMO
While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs.