Can a combination of interventions accelerate outcomes to deliver on the Sustainable Development Goals for young children? Evidence from a longitudinal study in South Africa and Malawi.


Journal

Child: care, health and development
ISSN: 1365-2214
Titre abrégé: Child Care Health Dev
Pays: England
ID NLM: 7602632

Informations de publication

Date de publication:
05 2022
Historique:
revised: 01 12 2021
received: 04 01 2021
accepted: 05 12 2021
pubmed: 16 12 2021
medline: 8 4 2022
entrez: 15 12 2021
Statut: ppublish

Résumé

This study aimed to identify possible entry points for interventions that can act as development accelerators for children and adolescents in South Africa and Malawi. This study was a secondary data analysis. Data were sourced from the Child Community Care longitudinal study which tracked child well-being outcomes among 989 children (4-13 years) and their caregivers affected by HIV and enrolled in community-based organizations in South Africa and Malawi. We examined associations between five hypothesized accelerating services/household provisions-measured as access at baseline and follow-up and 12 child outcomes that relate to indicators within the Sustainable Development Goals (SDGs) framework. We calculated the adjusted probabilities of experiencing each SDG aligned outcome conditional on receipt of single, combined or all identified accelerators. The results show household food security is associated with positive child education and cognitive development outcomes. Cash grants were positively associated with nutrition and cognitive development outcomes. Living in a safe community was positively associated with all mental health outcomes. Experiencing a combination of two factors was associated with higher probability of positive child outcomes. However, experiencing all three accelerators was associated with better child outcomes, compared with any of the individual factors by themselves with substantial improvements noted in child education outcomes. Combined delivery of specific interventions or services may yield greater improvements in child outcomes across different developmental domains. It is recommended that multiple support avenues in combination like improving food security and safe communities, as well as social protection grants, should be provided for vulnerable children to maximize the impact.

Sections du résumé

BACKGROUND
This study aimed to identify possible entry points for interventions that can act as development accelerators for children and adolescents in South Africa and Malawi.
METHODS
This study was a secondary data analysis. Data were sourced from the Child Community Care longitudinal study which tracked child well-being outcomes among 989 children (4-13 years) and their caregivers affected by HIV and enrolled in community-based organizations in South Africa and Malawi. We examined associations between five hypothesized accelerating services/household provisions-measured as access at baseline and follow-up and 12 child outcomes that relate to indicators within the Sustainable Development Goals (SDGs) framework. We calculated the adjusted probabilities of experiencing each SDG aligned outcome conditional on receipt of single, combined or all identified accelerators.
RESULTS
The results show household food security is associated with positive child education and cognitive development outcomes. Cash grants were positively associated with nutrition and cognitive development outcomes. Living in a safe community was positively associated with all mental health outcomes. Experiencing a combination of two factors was associated with higher probability of positive child outcomes. However, experiencing all three accelerators was associated with better child outcomes, compared with any of the individual factors by themselves with substantial improvements noted in child education outcomes.
CONCLUSIONS
Combined delivery of specific interventions or services may yield greater improvements in child outcomes across different developmental domains. It is recommended that multiple support avenues in combination like improving food security and safe communities, as well as social protection grants, should be provided for vulnerable children to maximize the impact.

Identifiants

pubmed: 34907593
doi: 10.1111/cch.12948
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

474-485

Informations de copyright

© 2021 John Wiley & Sons Ltd.

Références

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Auteurs

Helen Mebrahtu (H)

Institute for Global Health, University College London, London, UK.

Sarah Skeen (S)

Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.

William E Rudgard (WE)

Department of Social Policy & Intervention, University of Oxford, Oxford, UK.

Stefani Du Toit (S)

Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.

Katharina Haag (K)

Institute for Global Health, University College London, London, UK.

Kathryn J Roberts (KJ)

Institute for Global Health, University College London, London, UK.

Sarah L Gordon (SL)

Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.

Mark Orkin (M)

Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
MRC-NRF Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.

Lucie Cluver (L)

Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.

Mark Tomlinson (M)

Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
School of Nursing and Midwifery, Queens University, Belfast, UK.

Lorraine Sherr (L)

Institute for Global Health, University College London, London, UK.

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