Evaluations of Interventions with Child Domestic Workers: A Rapid Systematic Review.

Little is known about interventions to support the education, skills training, and health of female child domestic workers (CDWs). This rapid systematic literature review followed PRISMA guidelines (PROSPERO registration: CRD42019148702) and summarises peer-reviewed and grey literature on health, education, and economic interventions for CDWs and interventions targeting employers. We searched six electronic databases and purposively searched grey literature. We included observational studies, which included an intervention, quasi-experimental, and experimental studies. Two reviewers independently screened articles. Data were extracted on intervention description, inputs, activities, type of evaluation, outcomes, effect size or impact where applicable, limitations, and ethical considerations. All studies were quality appraised. We identified eight papers from five studies. Six papers reported on health-related outcomes, two on education-related outcomes, and three on economic outcomes. No evaluations of employer-related interventions were identified. Only one intervention specifically targeted CDWs. Others included CDWs in their sample but did not disaggregate data for CDWs. Findings suggest that the evaluated interventions had a limited impact on CDW's health, education, and economic outcomes. While it appears feasible to reach CDWs with outreach interventions, further work is needed to improve the consistency of their effectiveness and their ability to improve CDWs' current and future prospects.

Suitability of Measurement Tools for Assessing the Prevalence of Child Domestic Work: A Rapid Systematic Review.

Child domestic work (CDW) is a hidden form of child labour. Globally, there were an estimated 17.2 million CDWs aged 5-17 in 2012, but there has been little critical analysis of methods and survey instruments used to capture prevalence of CDW. This rapid systematic review identified and critically reviewed the measurement tools used to estimate CDWs in Low- and Middle-Income Countries, following PRISMA guidelines (PROSPERO registration: CRD42019148702). Fourteen studies were included. In nationally representative surveys, CDW prevalence ranged from 17% among 13-24-year-old females in Haiti to 2% of children aged 10-17 in Brazil. Two good quality studies and one good quality measurement tool were identified. CDW prevalence was assessed using occupation-based methods (n = 9/14), household roster (n = 7) and industry methods (n = 4). Six studies combined approaches. Four studies included task-based questions; one study used this method to formally calculate prevalence. The task-based study estimated 30,000 more CDWs compared to other methods. CDWs are probably being undercounted, based on current standard measurement approaches. We recommend use of more sensitive, task-based methods for inclusion in household surveys. The cognitive and pilot testing of newly developed task-based questions is essential to ensure comprehension. In analyses, researchers should consider CDWs who may be disguised as distant or non-relatives.

Child Domestic Work, Violence, and Health Outcomes: A Rapid Systematic Review.

This rapid systematic review describes violence and health outcomes among child domestic workers (CDWs) taken from 17 studies conducted in low- and middle-income countries. Our analysis estimated the median reported rates of violence in CDWs aged 5-17-year-olds to be 56.2% (emotional; range: 13-92%), 18.9% (physical; range: 1.7-71.4%), and 2.2% (sexual; range: 0-62%). Both boys and girls reported emotional abuse and sexual violence with emotional abuse being the most common. In Ethiopia and India, violence was associated with severe physical injuries and sexual insecurity among a third to half of CDWs. CDWs in India and Togo reported lower levels of psycho-social well-being than controls. In India, physical punishment was correlated with poor psycho-social well-being of CDWs [OR: 3.6; 95% CI: 3.2-4; p < 0.0001]. Across the studies, between 7% and 68% of CDWs reported work-related illness and injuries, and one third to half had received no medical treatment. On average, children worked between 9 and 15 h per day with no rest days. Findings highlight that many CDWs are exposed to abuse and other health hazards but that conditions vary substantially by context. Because of the often-hidden nature of child domestic work, future initiatives will need to be specifically designed to reach children in private households. Young workers will also benefit from strategies to change social norms around the value and vulnerability of children in domestic work and the long-term implications of harm during childhood.

Acupressure for frail older people in community dwellings-a randomised controlled trial.

Background: 'Frailty' is being increasing recognised as a geriatric syndrome of growing importance in the medical field. Acupressure is a non-pharmacological, non-invasive Traditional Chinese Medicine (TCM) treatment, which may serve to improve the quality of life (QOL) or prevent the progressive advancement of frailty in the aged population. Objective: to investigate the effects of a 12-week, TCM-principle guided acupressure intervention on the QOL of the frail older people living in the community. Methods: this is a randomised controlled trial with waitlist control design. Treatment group received 15 min of acupressure treatment, four times a week from both TCM practitioners and trained caregivers for 12 consecutive weeks. The waitlist control group served as a care-as-usual comparison to the treatment group for the 1st 12 weeks and then received the same treatment. Intention-to-treat principle was followed and mixed-effects models were used for data analysis. Results: the mean age of the participants was 76.12 ± 7.08, with a mean Tilburg frailty index score of 7.13 ± 1.76. Significant between-group differences were found in the change of physical domain score of WHOQOL-BREF (P = 0.001); change of Pittsburgh Sleep Quality Index (P < 0.001) and pain intensity (P = 0.006) with the treatment group demonstrating greater improvement. Within-group effect size analysis also indicated that the acupressure protocol has significant impact on these areas. Conclusions: the study's outcomes indicated that the acupressure protocol, when applied continuously for 12 weeks, 3-4 times a week, could improve the general QOL of frail older people living in community dwellings.

Tian jiu therapy for the treatment of asthma in adult patients: a meta-analysis.

OBJECTIVES: To review and evaluate the efficacy and safety of tian jiu therapy on san fu tian for adults with asthma. METHODS: A literature search through August 31, 2013, was done to identify comparative studies evaluating effective rate, pulmonary function, immune response, recurrence rate, quality of life, and adverse events. The Cochrane Library, PubMed, EMBASE, and Chinese National Knowledge Infrastructure were searched; only randomized controlled trials with treatment groups using tian jiu therapy were included. Cochrane Collaboration's risk of bias tool and Review Manager software, version 5.2, were used for the data synthesis. RESULTS: Six studies involving 657 patients were identified. tian jiu therapy was more effective than the control intervention (odds ratio [OR], 3.51; 95% confidence interval [CI], 2.05-6.00; p<0.00001; I(2)=18%). The treatment group had a bigger decrease in IgE level (standard mean difference [SMD], -1.40; 95% CI, -2.18 to -0.63; p=0.0004; I(2)=85%) and Eosinophil (Eos) level (SMD, -4.26; 95% CI, -6.28 to -2.23; p<0.00001; I(2)=91%) compared with the control group. Included studies had a high risk of bias. Few adverse effects were reported in the included studies, and no serious adverse responses occurred. Adverse effects did not result in any dropouts. CONCLUSIONS: All studies indicated that tian jiu therapy has a positive effect on adults with asthma and that it is relatively safe because of its noninvasive nature. However, the limitations of the research design of the existing studies resulted in high risk of bias. More randomized controlled trials of better methodologic quality are needed to further confirm efficacy and safety of this therapy.