"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".
There is increasing international interest in the links between malnutrition and disability: both are major global public health problems, both are key human rights concerns, and both are currently prominent within the global health agenda. In this review, interactions between the two fields are explored and it is argued that strengthening links would lead to important mutual benefits and synergies. At numerous points throughout the life-cycle, malnutrition can cause or contribute to an individual's physical, sensory, intellectual or mental health disability. By working more closely together, these problems can be transformed into opportunities: nutrition services and programmes for children and adults can act as entry points to address and, in some cases, avoid or mitigate disability; disability programmes can improve nutrition for the children and adults they serve. For this to happen, however, political commitment and resources are needed, as are better data.
Paediatrics and International Child Health
Volume 34, 2014 - Issue 4: Nutrition and malnutrition in low- and middle-income countries
Neurodevelopmental delay, neurodisability, and malnutrition interact to contribute a significant burden of disease in global settings. Assessments which are well integrated with plans of management or advice are most likely to improve outcomes. Assessment tools used in clinical research and programming to evaluate outcomes include developmental and cognitive tools that vary in complexity, sensitivity, and validity as well as the target age of assessment. Few tools have been used to measure socioemotional outcomes and fewer to assess the disabled child with malnutrition. There is a paucity of tools used clinically which actually provide families and professionals with advice to improve outcomes. Brain imaging, electroencephalography, audiology, and visual assessment can also be used to assess the effect of malnutrition on brain structure and function. The interaction of neurodisability and malnutrition is powerful, and both need to be considered when assessing children.
Seminars in Pediatric Neurology, Child Neurology in Africa, Volume 21, Issue 1, March 2014, Pages 50–57
Malnutrition and neurodisability are both major public health problems in Africa. This review highlights key areas where they interact. These areas of interaction include maternal malnutrition, toxin ingestion, macronutrient malnutrition and micronutrient deficiencies - all of which cause or are caused by neurodisability, The article concludes that there is an urgent need for nutrition and disability programmes to work more closely together
Seminars in Pediatric Neurology, Volume 21, Issue 1
"The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness"
PLoS ONE 7(4)
"This document is written for local and international staff running nutrition programmes in emergencies, and for local, regional and national authorities and donors involved in such programmes. The note explains WHY nutrition programmes need to include early childhood development (ECD) activities to maximize the child’s development. It provides practical suggestions as to WHAT simple steps are necessary to create integrated programmes in situations of famine or food insecurity and it gives examples of HOW such integrated programmes have been established in other situations"
"This report reviews both published and gray literature from the past 25 years that addresses intra-household roles and dynamics related to infant and young child nutrition-specifically the roles and influence of senior women, or grandmothers, and men. The report examines infant and young child nutrition and other maternal and child health interventions explicitly involving grandmothers and/or men and reports on each intervention’s effectiveness"
This resource presents a list of priority medicines for mothers and children to help countries and partners select and make available those medicines that will have the biggest impact on reducing maternal, newborn and child morbidity and mortality
"This report reviews the effectiveness of early childhood stimulation interventions in developing countries. The report aims to answer the questions: What works in terms of early stimulation for young children in developing countries? For whom and under what conditions do these programs work and why do they work. The report is divided into several sections. Firstly, a brief discussion of the importance of early stimulation for young children in developing countries is provided. Secondly, the methods used to identify and characterize studies are provided and a review of randomized or quasi-experimental trials is presented. Thirdly, a review of the evidence for who benefits most from early interventions is presented followed by a review of program characteristics that affect the success of interventions and an examination of potential mechanisms through which interventions achieve their effects. Finally, recommendations for practice and future research are provided"
IDB working paper series
This report looks at the progress some countries have been able to make towards achieving the millennium development goals relating to health by the target date of 2015, as well as factors that have limited progress in others, as well as global factors that could have an impact on health
"The objective of this WHO/UNICEF report is to focus attention on the prevention and management of diarrhoeal diseases as central to improving child survival. It examines the latest available information on the burden and distribution of childhood diarrhoea. It also analyses how well countries are doing in making available key interventions proven to reduce its toll. Most importantly, it lays out a new strategy for diarrhoea control, one that is based on interventions drawn from different sectors that have demonstrated potential to save children’s lives. It sets out a 7-point plan that includes a treatment package to reduce childhood diarrhoea deaths, as well as a prevention package to make a lasting reduction in the diarrhoea burden in the medium to long term"
This UN Report summarizes progress towards the Millennium Development Goals between 2000 and 2008, for the world as a whole and for various country groupings. It also considers factors that may affect future progress towards achieving the goals by 2015
Young child feeding in emergencies is often poorly managed and supported, yet is a crucial component of an adequate emergency response and an important intervention to save lives and prevent malnutrition. This four day workshop aimed to reach consensus on how to protect and support Infant and young child Feeding in Emergencies (IFE) in the region. The particular focus was on emergency preparedness and the early humanitarian response on IFE
This publication defines indicators that could be used to revise those outlined in the document 'Indicators for assessing breastfeeding practices', published in 1991. This document provided a set of indicators that could be used to assess infant feeding within and across countries and evaluate the progress of breastfeeding promotion efforts
This article "reviews interventions that affect maternal and child undernutrition and nutrition-related outcomes. These interventions included promotion of breastfeeding; strategies to promote complementary feeding, with or without provision of food supplements; micronutrient interventions; general supportive strategies to improve family and community nutrition; and reduction of disease burden (promotion of handwashing and strategies to reduce the burden of malaria in pregnancy). (The authors) showed that although strategies for breastfeeding promotion have a large effect on survival, their effect on stunting is small"
The Lancet, Vol 371, Issue 9610
This report reviews current knowledge of the immediate and long-term nutritional and health benefits of: delayed umbilical cord clamping; immediate and continued skin-to-skin contact between mother and infant; and immediate initiation of exclusive breastfeeding and aims to to illustrate that these three practices can be feasibly and safely implemented together for the benefit of both mother and infant
This document aims to provide concise, practical (but non-technical) guidance on how to ensure appropriate infant and young child feeding in emergencies. A number of elements are also applicable in non-emergency settings. It is intended for emergency relief staff, programme managers, national governments, United Nations agencies, NGOs and donors, and it applies to all countries. It includes six sections of practical steps, references, key contacts and definitions. Members of the IFE Core Group are: UNICEF, WHO, UNHCR, WFP, IFBAN-GIFA, CARE USA, Fondation Terre des hommes and Emergency Nutrition Network. It is also available in Arabic, Bahasa Indonesian, French, Portuguese and Spanish
This report gives the background to the Integrated child development services (ICDS) initiative, which takes a holistic approach to child nutrition, health and development and sees the first three years of life as crucial, before going on to explain the expansion in this 11th five-year plan in order to accelerate implementation for achieving the core objectives of the programme, especially to reduce the child malnutrition and help reduction in mortality rates. The plan seeks to address the challenges of issues such as the prevention and management of malnutrition, poor maternal and adolescent nutrition, gender discrimination, lack of nutrition and health education, and inadequate community participation in the programme
This year’s State of the World’s Mothers report shows which countries are succeeding, and which are failing, to save the lives of mothers and children. It examines how investments in health care and nutrition can make a difference for children, mothers, communities and society as a whole. It also points to proven, low-cost solutions that could save the majority of these young lives
This guide is written for programme managers in governments and their partners, primarily those working in maternal and child health and nutrition. It proposes a step-wise process to develop a country-specific strategy, with plans to be implemented in support of appropriate infant and young child feeding, especially in the first two years of life
Source e-bulletin on Disability and Inclusion