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Background@#Access to nutritious food among the nutritionally at risk preschool children remains a challenge even in urban households in the Philippines. @*Objectives@#This study determined if the daily consumption of rice-soy meals for 120 days improved the anthropometric status of preschool children enrolled in selected child development centers in low-income barangay in Taguig City. Specifically, it determined if the proportion of underweight preschool children decreased at endline and if there was an increase in the weight of preschool children at endline. @*Methodology@#The study used the before and after study design. The Dietary Supplementation Program was implemented by the LGU’s day care teachers. An NGO supplied the rice-soy meal packs. The children were fed with different variants of rice-soy meal pack containing 23 essential micronutrients. Anthropometric measurements were taken before and after 120 days. Data were subjected to Mc Nemar’s test to determine changes in the children’s nutritional status. @*Results@#A total of 538 children were enrolled in the DSP. Results of Mc Nemar's test showed that there was a significant improvement in the nutritional status (weight-for-age) of underweight preschool children (p=0.0000001) while the paired t-test showed that the increase in the weight of preschool children after the 120 day-dietary supplementation program was extremely statistically significant (p<0.001). @*Conclusion@#The daily feeding improved the weight of the undernourished children but overweight children maintained their overweight status at endline. The DSP Guidelines should include feeding mechanism for overweight children. The DSP complementary components should also be assessed in improving household food security.
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AntropometriaRESUMO
Resumen: Objetivo: Determinar el estado de salud, bienestar, desarrollo infantil temprano (DIT) de los niños y niñas menores de cinco años y su asociación con la edad de la madre. Material y métodos: Utilizando la Encuesta Nacional de Niños, Niñas y Mujeres 2015, se compararon características sociodemográficas e indicadores de bienestar, DIT, nutrición, salud y protección infantil por edad de la madre. Se ajustó un modelo de regresión logística para conocer las características asociadas con el DIT adecuado. Resultados: Los hijos/as de madres adolescentes presentan menores posibilidades de DIT adecuado. El apoyo al aprendizaje incrementa casi tres veces las posibilidades de desarrollo adecuado; ser hombre e hijo o hija de madres con sintomatología depresiva reduce estas posibilidades. Conclusiones: Es importante diseñar políticas públicas basadas en condiciones modificables focalizadas en apoyo al aprendizaje, prevención y atención de sintomatología depresiva para disminuir riesgos para el desarrollo e incrementar la atención a los hijos/as de madres en condiciones de desventaja.
Abstract: Objective: To determine under-5 children's state of health, well-being, Early Childhood Development (ECD) and its association with mother age. Materials and methods: Using the National Survey of Girls, Boys and Women (ENIM, in Spanish) 2015, we compared sociodemographic characteristics and indicators of well-being, child development, nutrition, health, and child protection by age of the mother. We adjusted a logistic regression model to know the characteristics associated with an appropriate early child development. Results: The children of adolescent mothers are less likely to have an adequate ECD. Children with support for learning are about three times more likely to develop properly, while being a boy or having a mother with depressive symptomatology reduces this likelihood. Conclusions: It is important to design public policies based on modifiable conditions focused on support for learning, prevention and care of depressive symptoms to reduce development risks and increase care for the children of mothers in disadvantaged conditions.
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Resumen Objetivo: Presentar los métodos realizados para la inclusión del módulo de Desarrollo Infantil Temprano (DIT) en la Ensanut 100k. Material y métodos: Con dicho módulo y el cuestionario de menores de cinco años, se obtuvieron indicadores del estado de salud, desarrollo y bienestar de niñas/os en los primeros cinco años de vida. De noviembre a diciembre de 2017, se definió el diseño de la muestra, instrumentos y manuales, y se realizó una prueba piloto. Se capacitó y estandarizó al personal de campo. El levantamiento de información se realizó entre enero y junio de 2018. Resultados: Se estudió en el módulo DIT de la encuesta a 3 892 niños/as de 0 a 59 meses de edad. Conclusiones: La capacitación y estandarización del personal de campo, por parte de personal capacitado y estandarizado, minimiza los sesgos de información.
Abstract Objective: The methods that were carried out for the inclusion of the early childhood development module in the Ensanut 100k are presented. Materials and methods: With this module and the questionnaire for children under five years-old, indicators of the state of health, development and well-being of children in the first five years of life are obtained. From November to December 2017, the sample design, instruments and manuals were defined and a test was carried out. Field staff were trained and standardized. The information was collected between January and June 2018. Results: 3 892 children from 0 to 59 months of age were studied in the DIT Module of the Survey. Conclusions: Training and standardization of field personnel, by trained and standardized personnel, minimizes information biases.
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Pré-Escolar , Humanos , Lactente , Recém-Nascido , Desenvolvimento Infantil , Inquéritos e Questionários , MéxicoRESUMO
Home Environment of a child comprises of toys, books and stimulating play materials which are critical for promoting early development. Parents, family and atmosphere at home play a key role in stimulating child’s physical, cognitive and socio-emotional developments. This assessment was done in rural settings of forest buffer zone of Bor Tiger Sanctuary in Vidarbha to have a baseline picture about availability of play materials at households that promote child development and parent’s view about these play materials.METHODSThis was a cross-sectional survey which included assessment of 894 households in 45 villages from Seloo block of Wardha district. Survey tools included pretested questionnaire and home observation checklist which was administered at home visit and during interviews of parent-child dyads. Data was collected in android based ODK app and exported to server. Data imported from server was analysed using STATA-11.RESULTSAvailability of play materials as represented by Mean Item Availability Score (MIAS) was significantly associated with family structure, wealth index and parent’s education and occupation. Though 84.2% households had materials for moving around and outdoor play, only 26.9% households had materials for promoting coordinated gross-motor movements, 41.6% households had materials meant for stacking, constructing. Only 19.8% households had materials for learning shapes and colours, 29.8% households had picture books/charts, 32.4% households had materials for drawing and writing and only 11.3% children had materials promoting counting.CONCLUSIONSObvious gap can be seen in terms of paly materials available for under 5 children in rural and urban settings. Remote rural areas in this region need a well framed parenting program to sensitise parents about Early Child Development that can be blended with the existing ICDS program
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Resumen: Objetivo: Estimar el nivel de desarrollo infantil temprano (DIT) y sus factores asociados en población mexicana de 19 a 59 meses. Material y métodos: La Encuesta Nacional de Salud Pública y Nutrición 2018-19 evaluó el DIT mediante el Índice de Desarrollo Infantil Temprano (ECDI) y el nivel de desarrollo de lenguaje. Se estimaron modelos multivariados de acuerdo con la variable de resultado, usando modelos de regresión logística o lineal. Resultados: Los niños/as de hogares con mayor nivel socioeconómico y que cuentan con libros infantiles en el hogar tienen mayores posibilidades de DIT adecuado, mientras que los/as niños/as educados con métodos de disciplina violenta tienen menores posibilidades. Además, los niños/as residentes de áreas rurales, hijos/as de madres con mayor escolaridad, sin desnutrición y con oportunidades de aprendizaje tienen un mayor puntaje de lenguaje. Conclusión: Las políticas públicas encaminadas a mejorar el desarrollo en la primera infancia deben tomar en cuenta los factores modificables asociados.
Abstract: Objective: To estimate levels of early childhood development (ECD) and associated factors in Mexican population aged 19-59 months. Materials and methods: The Ensanut 2018-19 evaluated ECD using the Early Childhood Development Index (ECDI) and level of language development. We used multivariate models, with logistic or linear regression, depending on the outcome variable. Results: Children of wealthier households and with children's books at home are more likely of having an adequate ECDI; in contrast, children who experienced violent discipline methods are less likely. Children living in rural areas, with more highly educated mothers, who were not undernourished, and with support for learning have higher language scores. Conclusion: Public policies aimed to enhance early childhood development should take into account the associated modifiable factors.
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Criança , Pré-Escolar , Feminino , Humanos , Desenvolvimento Infantil , Desenvolvimento da Linguagem , Fatores Socioeconômicos , Características da Família , Poder Familiar , Agressão , México/epidemiologia , MãesRESUMO
Background: The objective of the study was to study the association between exposure to early childhood development (ECD) interventions and responsive feeding and nutritional status among 6-35 months’ children.Methods: The present analytical cross-sectional study was conducted with 360 children from a primary health centre (PHC) area under the ECD project and 360 children from comparison PHC area. The anthropometric measurement and responsive feeding was assessed and compared among 6-35 months’ children.Results: There was significant difference in mean scores of ECD activity (p=0.001) and responsive feeding (p<0.001) in ECD area as to comparison area. In the ECD program area, the proportion of children who were malnourished (33.3%) were less as compared to control area (53.9%).Conclusions: The present study shows ECD interventions at community level delivered through frontline workers resulted in improved responsive feeding practices better nutritional outcomes for children.
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Objective@#To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China.@*Methods@#IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors.@*Results@#The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group (P=0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference-in-differences model, the increase of the qualified rate in the intervention group was 8.2% greater than that in the control group (P=0.021). The proportion of violent discipline by caregivers in the intervention group showed a decrease of 6.2% (mid-term 49.1% (478/973) vs. baseline 55.3% (554/1 001)), whereas the proportion in control group showed an increase of 4.5% (mid-term 58.4% (560/959) vs. baseline 53.9% (558/1 036)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 11.0% (P=0.001). The proportion of families with three or more children's books in the intervention group showed an increase of 12.7% (mid-term 42.7% (588/1 378) vs. baseline 30.0% (432/1 440)), whereas the proportion of the control group showed an increase of 4.2% (mid-term 25.7% (349/1 357) vs. baseline 21.5% (298/1 388)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 6.1% (P=0.007).@*Conclusions@#The IECD intervention strategy implemented in rural China effectively improved the mental health of caregivers, optimizes families' child feeding and early stimulation behaviors, while reducing violent discipline and other risk factors. IECD provides better nurturing care for the early development of children aged 0-35 months in rural China.
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Resumen: El desarrollo infantil temprano (DIT) es la base del desarrollo económico y social de los países y de su capacidad de cumplir con los Objetivos de Desarrollo Sostenible (ODS). La gestación y los primeros 3 años de vida son fundamentales para que los niños tengan un desarrollo físico, psicosocial, emocional y cognitivo adecuado para el resto de sus vidas. La crianza y el cuidado cariñoso y sensible a las necesidades de los niños durante la gestación y la primera infancia son esenciales para el desarrollo de los billones de neuronas y trillones de sinapsis necesarias. El DIT requiere de acceso a buena nutrición y servicios de salud desde la gestación, crianza sensible de acuerdo a la etapa de desarrollo del niño, protección social y del bienestar del niño, y oportunidades de estimulación y aprendizaje temprano. Para mejorar el DIT a nivel nacional se recomiendan seis acciones con fuerte participación de la sociedad civil: expandir la voluntad política y financiamiento, crear un entorno de políticas favorables basadas en evidencia, construir capacidad con coordinación intersectorial, asegurar una gobernanza justa y transparente de los programas y servicios, aumentar apoyo a la investigación multidisciplinaria y promover el desarrollo de líderes. México ha logrado avances importantes en DIT bajo el liderazgo del Sector Salud, pero enfrenta retos significativos para implementar estas recomendaciones. La reciente creación de un marco nacional intersectorial favorable al DIT con apoyo de los organismos internacionales y la participación de la sociedad civil pueden ayudar a sobreponer estos retos.
Abstract: Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development. ECD requires access to good nutrition and health services from gestation, responsive caregiving according to the child's developmental stage, social protection and child welfare, and early stimulation and learning opportunities. Six actions are recommended to improve national ECD programs: expand political will and funding; create a supportive, evidence-based policy environment; build capacity through intersectoral coordination; ensure fair and transparent governance of programs and services; increase support for multidisciplinary research; and promote the development of leaders. Mexico has made significant progress under the leadership of the Health Ministry, but still faces significant challenges. The recent creation of a national intersectoral framework to enable ECD with support of international organizations and the participation of civil society organizations can help overcome these challenges.
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Pré-Escolar , Humanos , Lactente , Recém-Nascido , Desenvolvimento Infantil/fisiologia , Desenvolvimento Sustentável/tendências , Neurônios/fisiologia , Política Pública/tendências , Mudança Social , Cognição/fisiologia , Acessibilidade aos Serviços de SaúdeRESUMO
La presente investigación tuvo la finalidad de identificar las ventajas de la asistencia técnica en los procesos de formación continua y sus efectos en el desempeño de profesionales de salud que atienden a niños y niñas menores de 3 años en el Control de Crecimiento y Desarrollo (CRED). La investigación evidenció que al incorporar la variable Asistencia Técnica (AT), los programas de formación continua son más eficientes, es decir, cuando se fortalecen capacidades en el campo de la acción profesional. El diseño del estudio fue cuantitativo, según su profundidad es explicativo de tipo cuasiexperimental, orientado a identificar la relación de causalidad o efecto de la asistencia técnica en el desempeño profesional, comparando un grupo experimental y un grupo control. Los resultados generales muestran diferencias significativas, el grupo experimental, alcanzó una media del 51.67, mientras que el grupo control solo llegó a 26.53, aplicando la prueba no paramétrica U Mann Whitney: p≤.01. Si bien la formación continua genera avances en ambos grupos, al incorporar la variable AT se evidencia un salto significativo respecto al grupo control, concluyendo que la asistencia técnica mejora el desempeño del personal de salud que atienden en el Control de CRED, fortaleciendo e incrementando sus capacidades.
The purpose of this research was to identify the advantages of technical assistance in continuous training processes and its effects on the performance of health professionals who care for children under 3 years of age in the Growth and Development Control (CRED). The research showed that by incorporating the Technical Assistance (TA) variable, continuous training programs are more efficient, that is, when capacities are strengthened in the field of professional action. The study design was quantitative, according to its depth it is explanatory of a quasi-experimental type, aimed at identifying the causal relationship or effect of technical assistance on professional performance, comparing an experimental group and a control group. The general results show significant differences, the experimental group, reaching an average of 51.67, while the control group only reached 26.53, applying the non-parametric Mann Whitney U test: p≤.01. Although continuous training generates progress in both groups, when incorporating the AT variable, a significant jump is evidenced compared to the control group, concluding that technical assistance improves the performance of the health personnel who attend to the CRED Control, strengthening and increasing their capabilities.
O objetivo desta pesquisa foi identificar as vantagens da assistência técnica nos processos de formação contínua e seus reflexos na atuação dos profissionais de saúde que cuidam de crianças menores de 3 anos no Controle de Crescimento e Desenvolvimento (CRED). A pesquisa mostrou que, ao incorporar a variável Assistência Técnica (AT), os programas de formação contínua são mais eficientes, isto é, quando se fortalecem as capacidades no campo da atuação profissional. O delineamento do estudo foi quantitativo, pois pela sua profundidade é explicativo do tipo quase experimental, visando identificar a relação causal ou efeito da assistência técnica no desempenho profissional, comparando um grupo experimental e um grupo controle. Os resultados gerais mostram diferenças significativas, o grupo experimental, atingindo a média de 51,67, enquanto o grupo controle atingiu apenas 26,53, aplicando-se o teste não paramétrico U de Mann Whitney: p≤,01. Embora o treinamento contínuo gere avanços em ambos os grupos, ao incorporar a variável TA, evidencia-se um salto significativo em relação ao grupo controle, concluindo que a assistência técnica melhora o desempenho dos profissionais de saúde que atendem ao Controle CRED, fortalecendo e aumentando sua capacidades.
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As funções parentais ultrapassam a satisfação das necessidades da criança, promovendo a constituição subjetiva, que a insere no laço social. Estas experiências da relação pais-criança formam uma imagem corporal que se articula ao aparato biológico, possibilitando ao sujeito ter um domínio particular de seu corpo. Uma criança com deficiência física pode provocar impactos na dinâmica familiar, sendo importante atentar ao que ocorre do ponto de vista deste processo de constituição. Assim, o artigo busca discutir a parentalidade e a construção da imagem corporal nos quadros de deficiência física. Verificou-se que, nestes casos, as funções materna e paterna podem ser comprometidas, sendo apresentadas particularidades desta relação, como a necessidade de reconhecer o exercício funcional nos movimentos próprios da criança. Desta forma, foi discutida a importância de abertura para a compreensão da relação pais-criança e os efeitos em seu desenvolvimento.
The parental functions surpass child's needs, promoting subjective constitution that inserts him/her into the social bond. These experiences of the parent-child relationship shape body image that articulates with the biological apparatus, enabling the subject to have a particular control of the body. A physically disabled child may provoke impacts on the family dynamics, being important to consider what occurs from the point of view of this constitutive process. Therefore, this paper aims to discuss parenting and construction of body image in situations of physical disability. It was found that, in these cases, the maternal and paternal functions can be compromised being presented specifics of this relationship, such as the need to recognize the functional exercise in the child's own movements. The relevance of openness to understand parent-child relationship and the effects on their development are discussed.