Use of Family Care Indicators and Their Relationship with Child Development in Bangladesh.

Poor stimulation in the home is one of the main factors affecting the development of children living in poverty. The family care indicators (FCIs) were developed to measure home stimulation in large populations and were derived from the Home Observations for Measurement of the Environment (HOME). The FCIs were piloted with 801 rural Bangladeshi mothers of children aged 18 months. Five subscales were created: ‘play activities’ (PA), ‘varieties of play materials’ (VP), ‘sources of play materials’, ‘household books’, and ‘magazines and newspapers’ (MN). All subscales had acceptable short-term reliability. Mental and motor development of the children was assessed on the Bayley Scales of Infant Development and their language expression and comprehension by mothers’ report. After controlling for socioeconomic variables, VP and PA independently predicted four and three of the developmental outcomes respectively, and MN predicted both the Bayley scores. The FCI is promising as a survey-based indicator of the quality of children’s home environment.

Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programmes, few of these have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < - 1SD of the National Centre for Health Statistics references) and the adequately nourished group comprised of 407 children matched for school and class (weight-for-age > - 1SD). Both groups were stratified by class and school, than randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for one year. Children in control group were given one-quarter of an orange and the same amount of attention as children in breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the school's registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast groups. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programmes including health and educational inputs as well as school meals.

A case-control study of aggressive and pro-social Jamaican school boys

The study examined the correlates of behaviour of 102 aggressive and 103 prosocial boys, selected by peer and teacher ratings, from grades 5 and 6 in 10 schools in urban Kingston and St. Andrew. The children were given in-depth questionnaires, school achievement tests (WRAT) and verbal ability tests (Peabody Picture Vocabulary Test). Their parents were also given questionnaires. Interobserver and test-retest reliabilities were established for all questionnaires and tests. Interviewers were unaware of the boys' group. The aggressive group was significantly older (mean 11.4 years) than the pro-social boys (mean 11.1 years; t-test p,0.01). The aggressive group had significantly lower scores on both the number of possessions and the housing rating (proxies for socio-economic status), they showed significantly lower scores on spelling, arithmetic, reading and verbal IQ, and considered themselves less bright than the pro-social boys. Preliminary analyses indicate that, as expected, the aggressive boys fought more and used knives in fights more compared with the pro-social boys. They reported receiving significantly more punishments at home. The aggressive group indicated that they saw significantly more family quarrels, threats between family members and family fights. All differences remained significant when socio-economic status was controlled in analyses of covariance except that the differences in the arithmetic scores was no longer significant. Many of these patterns are similar to those reported elsewhere.

Activity levels and maternal-child behavior in undernutrition: studies in Jamaica

It has been well established that children suffering from severe or moderate protein energy malnutrition in early childhood show delayed development, but the mechanisms linking undernutrition to poor development are not well understood. One holds that undernutrition causes irreversible central nervous system changes that affect function... The authors have recently reviewed, in detail, studies on activity and undernutrition n children. This work will briefly review the literature on activity levels and behavior in undernourished children and then describe two Jamaican studies that addresses aspects of the functional isolation hypothesis. Activity levels will be discussed first, then, other behaviors

Early childhood supplementation and cognitive development, during and after intervention

Studies of the effects of supplementation during childhood have been reviewed previously and a meta-analysis of the concurrent effects on development was recently conducted. This review looks at five studies in Latin America and the Caribbean, in which the effects of supplementation have been assesses during the intervention period, as well as one or more years after the interventions ended. These studies are particularly relevant when considering the long-term effects of early childhood undernutrition and the policy implications for human resource development. The studies that will be reviewed were conducted in Mexico; Guatemala; Cali, Colombia; Bogota, Colombia; and Jamaica

Health and nutritional determinants of school failure

Education is associated with wide-ranging benefits to both the individual and society. Lockheed and colleagues reviewed the literature on primary education in developing countries and found that education had a positive effect on economic growth...It has been recognised for some time that both the quality of the school and the child's home background have marked effects on school attainment levels. There is now increasing concern that poor health and nutrition might detrimentally affect children's school achievement. This publication addresses to what extent children's health and nutrition contribute to school failure. The conditions considered to be potentially important are the following: protein energy malnutrition; iron and iodine deficiency; hunger; sensory impairment due to hearing or visual deficits from any cause including vitamin A deficiency, otitis media, and onchocerciasis; and infections, particularly parasitic infections such as malaria, geohelminth infections such as diarrhea and respiratory infections may also be important. This chapter will briefly review studies that have examined associations between children's school performance or ability and their health and nutrition. Then it will describe two studies we have conducted in Jamaica, one in primary-school children and one in adolescent girls

School feeding studies in Jamaica

This chapter will describe the three experimental studies that we conducted on the effects of giving or withholding breakfast. We will first briefly describe our earliest two studies and then will provide more details of the study that we have recently completed

Early childhood stimulation programs in Jamaica

Undernutrition and frequent infections are not the only causes of poor development in children living in poverty. These children usually have little in the way of stimulation in their homes

Adolescent girls school achievement: nutrition, health and social factors

In many developing countries there is little information on the nutritional status of adolescents. In general, research in this area has been neglected and attention focused on younger children who are most vulnerable to malnutrition. However, adolescents is a period of rapid growth and nutritional deficiencies may occur. In particular with menarche, iron deficiency may be a problem among adolescent girls (Brabin & Brabin, 1992). Poor levels of school achievement are a major problem in developing countries. Many social factors may affect school achievement, including parental attitudes to education, and the educational and occupational levels of the parents (Wagner, et al 1985). School characteristics such as teacher's training and availability of textbooks are also important (Schiefelbein & Simmons, 1979; Fuller, 1987). There is increasing recognition, however, that health and nutrition may contribute to poor school performance, either through effects on attendance, or by affecting children's ability to learn through poor attention and cognitive function (Pollitt, 1990). Health and nutrition variables have been included in some studies of the determinants of school performance among primary-school children in developing countries. After controlling for socio-economic factors, height-for-age was associated with achievement in several studies (Moock & Leslie, 1986; Agarwal et al, 1987; Florencio, 1988; Clarke et al, 1991) and weight-for-height was associated with achievement in one study (Popkin & Lim-Ybanez, 1982). Anaemia and missing breakfast or feeling hungry, also, have been reported to affect school performance (Popkin & Lim-Ybanez, 1982; Florencio, 1988; Clarke et al, 1991). Most of the children in these studies were of primary-school age and there is relatively little information on the extent to which health and nutrition affect achievement in adolescents.

Geohelminth infections in school-aged children in Jamaica

There is concern that geohelminthiasis may adversely affect the growth and development of children. The relevance of this in the Caribbean in unclear since in many territories the prevalence of geohelminths is unknown. We report the results of three surveys conducted in Jamaican primary schools located in areas at high risk for geohelminthiasis. The first was conducted in 12 Kingston schools and comprised children in grades 2 to 5 (age 7 to 10 years). The second and third surveys were conducted in rural areas with children in grades 2 to 5 and grades 4 and 5, respectively. Overall, 9244 children provided stool sample for analysis. The prevalence of Trichuris trichiura ranged from 42 per cent to 47 per cent among the surveys while that for Ascaris lumbricoides ranged from 15 per cent to 37 per cent . Children in grades 2 and 3 had lower T. trichiura prevalences than those in grades 4 and 5 in the first and second surveys (p<0.05 and p<0.005, respectively). In the second survey only, children in grades 2 and 3 had a lower prevalence of A. lumbricoides than those in grades 4 and 5(p<0.005). Most infections were light with approximately 1 per cent of the sample having heavy egg densities