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• Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

  Posted:07 Jun 2013 11:43:49 GMT

  Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions.

  The authors of this article in the 2013 Lancet Series on Maternal and Child Nutrition reviewed evidence of nutritional effects of programmes in four sectors - agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment.

  The article finds that:

  • evidence of the nutritional effect of agricultural programmes is inconclusive - except for vitamin A from biofortification of orange sweet potatoes - largely because of poor quality evaluations
  • social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits
  • combined early child development and nutrition interventions show promising additive or synergistic effects on child development - and in some cases nutrition - and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale
  • maternal depression is an important determinant of suboptimum caregiving and health-seeking behaviours and is associated with poor nutrition and child development outcomes
  • parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested.

  Many of the programmes reviewed byt he authors were not originally designed to improve nutrition yet have great potential to do so. The authors argue that ways to enhance programme nutrition-sensitivity include:

  • improve targeting
  • use conditions to stimulate participation
  • strengthen nutrition goals and actions
  • optimise women's nutrition, time, physical and mental health, and empowerment.

  Nutrition-sensitive programmes can help scale up nutrition-specific interventions and create a stimulating environment in which young children can grow and develop to their full potential.

  Please note: This paper is accessible upon free registration to The Lancet.

  

• Adolescent girls and migration in the developing world

  Posted:16 May 2013 13:04:37 GMT

  Migration is transforming our world: by the end of this decade, most developing countries will have more people living in cities than in rural areas. Most migrants are in their early to mid-20s. Substantial numbers of adolescent girls are also on the move. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. But more evidence is needed on how to maximise migration’s benefits and minimise its risks for adolescent girls.
  
  This policy brief provides a summary of key findings and recommendations from the the Population Council report, Girls on the Move: Adolescent Girls & Migration in the Developing World, from their Girls Count series. By providing a road map for policy makers and programme planners, the report focuses on the need to increase the visibility of migrant girls, reduce their vulnerability, and realise their full potential.

  Main recommendations include:

  • prepare and equip girls before they migrate - with knowledge of their rights, life skills, IDs, and other portable assets

  • reduce the risk of trafficking and exploitation by connecting girls with safe places to stay and trusted individuals and by building support networks

  • ensure health and education services are sensitive to age, sex, and migration status

  • prepare girls for success

  • design girl-only approaches to reach domestic workers, child brides, and sexually exploited girls

  • develop qualitative and longitudinal studies to shed light on migrant girls’ experiences

  • maximise the benefits of migration by increasing adolescent girls’ visibility in policy and advocacy

   

   

  

• World Report on Child Labour: Economic vulnerability, social protection and the fight against child labour

  Posted:03 May 2013 09:02:17 GMT

  What can be done to ensure more – and faster – progress in tackling child labour? This report argues that child labour is driven in part by household vulnerabilities associated with poverty, risk and shocks, and that social security is critical to mitigating these vulnerabilities. Following on from this, the overall aims of the report are, first, to highlight the relevance of social security as part of a broader strategy for eliminating child labour; and, second, to help advance understanding of the specific ways in which social security systems can support efforts against child labour.

• Programming for nutrition outcomes

  Posted:25 Apr 2013 13:14:40 GMT

  Chronic undernutrition affects nearly 200 million children in low and middle income countries, with vitamin and mineral deficiencies affecting many more, and there is strong evidence that undernutrition is associated with up to 35% of all child deaths globally. This training module has been designed to explore the complicated problem of undernutrition, highlight its multi-sectoral causes and identify potential programmatic solutions.
  
  There are seventeen sessions in the module. The first four sessions cover topics to assist a working knowledge of nutrition in development.  The remaining fourteen sessions focus on nutrition as it relates to the health, humanitarian, livelihoods and social development sectors. Each session should take approximately 3 hours to complete including reading time. A brief quiz at the end of each session aims to test understanding of the material covered.
  
  Core sessions:
  

  • Session 1: The Scale of the Problem
    
  • Session 2: Causes and Consequences of Undernutrition
  • Session 3: Methods of Nutritional Assessment
  • Session 4: International Landscape for Nutrition Programming

  
  Optional Sessions:
  
  

  • Session 5: Basic Epidemiology: Evaluating Quality of Evidence
  • Session 6: Introduction to Emergencies: Nutritional Assessment and Early Warning Systems
  • Session 7: Food Based Strategies for Enhanced Nutritional Status: Dietary Diversification and Biofortification
  • Session 8: Maternal Nutrition
  • Session 9: Infant and Young Child Feeding
  • Session 10: Infant and Young Child Feeding in Emergencies
  • Session 11: Social Protection for Nutritional Outcomes
  • Session 12: Agriculture and Nutrition
  • Session 13: Climate Change and Nutrition
  • Session 14: Nutrition and Infection
  • Session 15: Nutrition and Health in Emergencies
  • Session 16: Gender Equality and Nutrition
  • Session 17: Nutrition and Education

  
  Each session should take approximately 3 hours to complete including reading time. A brief quiz at the end of each session aims to test understanding of the material covered.

• Prioritising nutrition in order to achieve the MDGs in India

  Posted:09 Apr 2013 13:52:50 GMT

  Malnutrition causes long-term damage to children’s development, with huge social and economic costs. It affects not only children’s physical development but also their cognitive development, so reducing future productivity and leading ultimately to economic loss for the nation as a whole. India has recorded strong economic growth in recent years but has shown little progress in tackling malnutrition. It is evident that economic growth alone will not solve the malnutrition problem and sustaining growth will require human capital development. Young Lives research suggests that there has been very little improvement over the last decade in children’s nutritional status and demonstrates the impact of malnutrition on children’s later development. Strengthening services and social protection schemes such as Integrated Child Development Services, the Public Distribution System and the Midday Meal Scheme are important elements of securing better nutrition for children and will support progress towards the Millennium Development Goals.
  
  Analysis of Young Lives data offers a number of challenges to prevailing assumptions about orphans
  and vulnerability.
  

  • despite its high rate of economic growth, India is home to the largest number of malnourished children in any one country in the world.
  • malnutrition has long-term consequences for children. Stunting caused by malnutrition in early life is linked to many child development indicators (including literacy, self-confidence and educational aspirations).
  • Young Lives research shows that the problem of stunting has become increasingly concentrated in the poorest households.
  • high food prices can have both short- and long- term effects on children’s nutritional status. Government policies can buffer families from these shocks.
  • programmes such as the Public Distribution Scheme help ensure food security for families but need to be strengthened.

  

• Putting children at the centre of poverty debates

  Posted:09 Apr 2013 11:55:59 GMT

  This paper discusses the methodology of Young Lives - a 15-year study of childhood poverty in Ethiopia, India, Vietnam and Peru, following the lives of 3,000 children in each country.  The Young Lives programme is interested in children’s development within the context of economic constraint and disparities, and cumulative risk.
  
  Children’s well-being and life chances are, however, interdependent with those of their parents and carers and the communities in which they reside, so Young Lives also considers household and community circumstances as central to child well-being. Additionally, the impacts of poverty have to be assessed in terms of other forms of risk to children, such as environmental hazards or ill-health that are often a cause of, or exacerbated by, material lack.
  
  Young Lives conceptualises poverty as multidimensional in both its causes and its consequences. Access to resources (financial and other) is at the root of poverty, and there are a number of channels through which poverty may operate and create risks for children. The advantages of multidimensional approaches are that:
  
  

  • they help to demonstrate the interconnected nature of different aspects of deprivation
  • they analyse when income is (or is not) a good predictor of outcomes important for children; and
  • they can be used to summarise an aggregate of change over time in a more holistic and complete way than income measures alone

  

• Harmful traditional practices and child protection: contested understandings and practices of female child marriage and circumcision in Ethiopia

  Posted:05 Apr 2013 11:56:35 GMT

  Focusing on Ethiopia, this paper explores local perspectives on female child marriage and circumcision. Both practices are widespread in Ethiopia and reflect deep-rooted patriarchal and gerontocratic values regulating women’s reproduction and transactions between kin groups at marriage. Yet both have been designated as Harmful Traditional Practices (HTPs) by the Ethiopian government and are proscribed by law, with designated punishments.
  
  The paper explores the values that drive these practices and examines whether and in what ways they have been affected by efforts to eradicate them. It points to the complexity of beliefs and practices, highlighting differences associated with ethnicity, religion, generation and gender. It finds that the efforts of government and elite leaders to eradicate them are contributing to the diminution or transformation of female circumcision and female child marriage, although with marked regional variations and considerable contestation and resistance in some places. In mapping these processes of change, the paper identifies trends in premarital sex, clandestine surgeries, and other subterfuges that may demonstrate unexpected consequences and adverse reactions to laws which were intended to protect children. In doing so, it emphasises the challenges confronted by child- protection measures designed to bring about change to long-established customs.
  
  The analysis draws on interviews with 25 children and young people from five communities, as well as their peers, caregivers and community representatives, conducted in 2007, 2008 and 2011. The paper uses both statistical and ethnographic evidence to assess the prevalence of the two customs and the cultural and material logic underpinning them. It gives an overview of the external forces militating for change and presents evidence on trends of change. This is followed by analysis of the personal experiences of Young Lives children and the discourses against the practices, as well as a consideration of the resistance to change. Finally, the discussion reflects on wider issues of modernity and rising aspirations for girls.

• Perinatal nutrition and immunity to infection

  Posted:27 Mar 2013 09:02:37 GMT

  Epidemiological data provide strong evidence for a relationship between undernutrition and life-threatening infection in infants and children. However, the mechanisms that underlie this relationship are poorly understood. Through foetal life, infancy and childhood, the immune system undergoes a process of functional maturation. The adequacy of this process is dependent on environmental factors, and there is accumulating evidence of the impact of pre- and post-natal nutrition in this regard. This review outlines the impact of nutrition during foetal and infant development on the capacity to mount immune responses to infection. It provides an overview of the epidemiologic evidence for such a role and discusses the possible mechanisms involved.

• Factors affecting prevalence of malnutrition among children under three years of age in Botswana

  Posted:27 Mar 2013 09:02:33 GMT

  This study was a cross-sectional descriptive survey conducted to evaluate the level of malnutrition and the impact of some socio-economic and demographic factors of households on the nutritional status of children under 3years of age in Botswana. 400 households and mothers of children representing 23 health regions of the country participated in the study. Results show that the level of wasting, stunting and underweight was 4.4%, 38.7% and 15.6% respectively. Malnutrition was significantly higher among boys than girls. Undernutrition was less prevalent among children whose parents worked in the agricultural sector than among children whose parents involved in informal business. Children brought up by single parents suffered from underweight significantly. The study findings imply that efforts for redressing child undernutrition issues in Botswana should focus on factors associated with development outcomes.

• Determinants of appropriate child health and nutrition practices among women in rural Gambia

  Posted:27 Mar 2013 09:02:29 GMT

  This study aimed at exploring the factors determining mothers’ choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practice what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare when designing nutritional interventions

• Prevalence and Trends of Stunting Among Pre-school Children, 1990-2020

  Posted:26 Mar 2013 09:02:34 GMT

  The objective of this study was to quantify the prevalence and trends of stunting among children using the WHO growth standards. 576 nationally representative surveys were analysed. Linear mixed-effects modelling was used to estimate rates and numbers of affected children from 1990-2010. In 2010 it is estimated that 171 million children (167 million in developing countries) were stunted. Stunting has stagnated in Africa since 1990 at about 40% and little improvement is anticipated. Asia showed a dramatic decrease from 49% in 1990 to 28% in 2010, nearly halving the number of stunted children from 190 million to 100 million. It is anticipated that this trend will continue and that in 2020, Asia and Africa will have similar numbers of stunted children. Despite an overall decrease in developing countries, stunting remains a major public health problem in many of them. The data summarizes progress achieved in the last two decades and identifies regions needing effective interventions.

• Socio-economic Predictors of Stunting in Pre-school Children - a population-based study from Johannesburg and Soweto

  Posted:26 Mar 2013 09:02:31 GMT

  This study aims to investigate a range of household-level socio-economic and social support predictors of stunting in children aged less than 30 months. Logical regression models were constructed using a conceptual framework to investigate the association between early life measures of socio-economic status and stunting, using data collected in the Birth to Twenty study.

  Stunting and child malnutrition remain policy priorities for the South African Department of Health, and this study suggests that policies that aim to increase parental education level and reduce unemployment or target additional support to families with low education or unemployed parents may reduce stunting in preschool-age children in this setting.

  

• Multisector Intervention to Accelerate Reductions in Child Stunting: An Observational Study from 9 Sub-African Countries

  Posted:26 Mar 2013 09:02:25 GMT

  This study was a prospective observational trial, conducted in 9 sub-Saharan African countries to examine changes in childhood stunting and its determinants after 3years of exposure to an integrated, multi-sector intervention and compared these changes to national trends. Baseline levels of childhood stunting was 20%. 2-year old children from villages were enrolled in the study. Outcome measured included principal determinants of undernutrition and childhood stunting. Three years after the start of the program in 2005-2006, consistent improvements were observed in household food security and diet diversity, and coverage with child care and disease control interventions improved for most outcomes. These findings provide encouraging evidence that a package of multi-sector interventions has the potential to produce reductions in childhood stunting.

• Leptin Malnutrition and Immune Response in Rural Gambian Children

  Posted:26 Mar 2013 09:02:23 GMT

  The adipocyte derived hormone, leptin has cytokine-like function and may mediate the effects of starvation on immunity. This study aims to describe the in vivo relation of leptin and immune function in children. Fasting plasma leptin concentrations, immune function, and mucosal function were measured in a cohort of 472 moderately malnourished rural Gambian children. Leptin concentrations correlated with body fat assessed by mid upper arm circumference or BMI for age z scores, and were low compared to well-nourished European norms. No detectable relations were found between leptin concentrations and any of the measures of immune or mucosal function. This result confirms that leptin acts as a peripheral signal of energy restriction, but do not support an association between fasting plasma leptin levels and immune function in children of this age.

• Children Malnutrition and Horizontal Inequalities in Sub-Saharan Africa:A Focus on Contrasting Domestic Trajectories

  Posted:25 Mar 2013 09:02:26 GMT

  The positive trend observed in recent accelerated economic growth in sub-Saharan African countries represents a huge opportunity to foster sustainable development, This paper contributes to the literature by providing a more accurate and nuanced view on the progress made with regards to child malnutrition and inequalities across sub-saharan Africa. It focuses on seven countries: Burkina Faso, Kenya, Malawi, Rwanda, Cameroon, Ghana and Nigeria. The study analyses the evolution of three anthropometric indicators such as underweight, stunting and wasting and elaborates a classification of countries based on how inequalities in child malnutrition have changed over the past two decades. Findings shows that countries that have registered the highest improvements in overall malnutrition rates are not proportionate to the pace of economic growth

• The neurological and neurocognitive function of HIV-infected children commenced on antiretroviral therapy

  Posted:25 Mar 2013 09:02:21 GMT

  This prospective study aims to describe the neurological and neurocognitive deficits in HIV-infected children and the short-term effect of highly active antiretroviral therapy (HAART) on the observed deficit. 39 children were evaluated before the start of HAART and 30 were reassessed 6month later. The subjects were evaluated with a range of cognitive tests used in everyday clinical practice. At the start of HAART, no child had cranial nerve or cerebellar dysfunction, but 33.3% had evidence of motor dysfunction. By 6months, 1 child had developed cerebellar dysfunction, but there was no statistically significant change in the frequency of motor dysfunction. mean baseline performances on cognitive testing were generally subnormal. Between 33% and 81% of the children recorded subnormal intelligence quotients on various cognitive tests. Mean performances did not change significantly after 6months of HAART.

• Exploring the Causes and Process of Becoming Child Domestic Worker

  Posted:22 Mar 2013 09:02:38 GMT

  The study aimed to explore the demographic and socioeconomic characteristics of households with and without child domestic workers (CDW), and explore the causes and process of becoming CDWs in Bangladesh. Both quantitative and qualitative approaches were used to collect data. A purposive sampling technique was applied to select the sample locations. Data were collected from six districts of Bangladesh:Mymensingh, Kishoreganj, Jamalpur, Bhola, Kurigram, Chapai Nawabganj, and a slum of Dhaka city. A total of 1,564 (rural 1,454 and urban 110) parents of with and without CDWs were interviewed. Ten in-depth interviews with CDWs were conducted. The findings reveals that small income, poor savings, marginal land, less access to NGO services, and sickness of main income earner in the family were the causes that compelled parents to allow their children in CDW. The findings also strongly observed that poverty is the root cause to engage children in domestic work.

• Divergent Maternal and Child Health Outcomes in Bangladesh: A Tale of Two Upazilas

  Posted:21 Feb 2013 09:01:10 GMT

  This paper attempts to seek answer to the question why some regions being economically better-off are performing poorly in respect of maternal and child health outcomes compared with those which are otherwise (economically) worse-off than the former. Analysing the data obtained from two purposively selected upazilas (sub-district) in Bangladesh, it also tries to explore the factors responsible for better maternal and child health outcomes. This paper found that the impact of better health service delivery system is much stronger than that of growth and the other factors on health outcomes. It also found that ensuring “accountability” of the health service providers is a key factor to provide better health service delivery.

• Prevalence Of Typhoid Fever Among The Children In A Semi Urban Area Of Bangladesh

  Posted:13 Feb 2013 09:01:28 GMT

  This study shows that 84(87.50%) patients had typhoid fever based on clinical examination and serological test results (widal test). It was observed that prevalence of enteric fever was high among the patients of school going age group (66.67%), habituated with unsafe drinking water (58.33%) and junk foods (72.92%). Statistical analysis showed that SSC level education in the parents who remain outside during the major part of the day for their livelihood had significant positive relationship with prevalence of typhoid fever. It was concluded that prevalence of typhoid fever was high among the children of school going age, who consume unsafe drinking water and food from outside source.

• Evidence about the effectiveness of child protection programmes in developing countries: GSDRC Helpdesk Research Report

  Posted:04 Feb 2013 17:40:17 GMT

  There is little evidence on the effectiveness of child protection programmes in developing countries. Furthermore, some of the available evidence does not provide information on links between specific practices on the one hand and improved outcomes and impact for children on the other hand. There are, however, some targeted insights into what works and what does not work.

  Overall, the effectiveness of child protection programmes seems to be only average and highly variable. One commonly cited finding is the importance of contextualising action: programming, programme implementation and programme assessment need to be tailored to local situations and practices in child protection. It is also important to acknowledge that child protection is political and reflects political choices by governments and donors.

  This report first identifies and describes the state of available evidence. It then presents findings on the effectiveness of child protection programmes in developing countries in five selected areas:

  • general factors affecting the effectiveness of child protection programmes;
  • different types of child protection measures;
  • specific settings and contexts;
  • specific categories of children;
  • cost effectiveness.

   

• Do Water and Sanitation Interventions Reduce Childhood Diarrhoea? New Evidence from Bangladesh

  Posted:21 Jan 2013 16:14:09 GMT

  The incidence of diarrhoea has declined over time in Bangladesh but still it persists as a major cause of infant mortality, morbidity and acute child malnutrition. Much of the public policy thinking in the past was guided by public investment in providing improved access to safe water. While this measure has paid off, the paper provides evidence that the relevance of water as a tool for fighting diarrhoea may have changed over time. Its changing role now needs to be seen in the broader context of combined access with other inputs such as improved sanitation. The paper uses the Bangladesh Demographic and Health Survey data and the propensity score matching technique to suggest that only combined access to improved water and sanitation can lead to reduced incidence of diarrhoea among children in contrast to their isolated use. Mere accesses to safe water, or for that matter, access to sanitation do not have any statistically significant impact on the incidence of childhood diarrhoea.

• Hypertension in the Children: A Review

  Posted:21 Jan 2013 15:58:38 GMT

  Hypertension in the Children is increasingly being recognized as an emerging critical healthcare problem, because of its increasing prevalence in recent years and also of its significant impact on the health and well-being of children and adolescents and tracking into adult life.1 Pediatric hypertension has unique features that differentiate it from hypertension in adults. It is widely accepted that childhood hypertension provides an increased risk for future cardiovascular morbidity and mortality. Hypertension is a known risk factor for coronary artery disease (CAD) in adults, and the presence of childhood hypertension may contribute to the early development of CAD. Reports show that early development of atherosclerosis does exist in children and young adults and may be associated with childhood hypertension.

• Children’s experiences and perceptions of poverty in Ethiopia

  Posted:20 Nov 2012 18:15:42 GMT

  Children can be more than just victims of poverty; they can be agents of its alleviation. This paper presents Ethiopian children’s and young people’s perceptions of poverty based on their own experiences.
  
  The paper indicates that the surveyed children identified what they believed to be the root causes of poverty and suggested what the government, parents and children should do to reduce it.
  
  Findings are as follows:
  

  • children experience poverty as an environment that is damaging to their mental, physical, and emotional development
  • children’s poverty experiences suggest the multi-dimensional, contextualised and inter-generational nature of child poverty
  • children suggested that the government could play a major role in reducing poverty (e.g. through rural development), but parents should adopt family planning and children should support parents by working
  • notably, children thought that child poverty could be addressed by changing some of the societal values that contribute to its perpetuation

  
  Conclusions include:
  

  • children and young people have demonstrated their resilience, not only by providing suggestions for tackling poverty, but also by practically contributing to family incomes
  • indeed, children and young people proved to be competent enough to provide rich data from their lived experiences of poverty
  • this data can advance the knowledge about childhood poverty and help developing apt policies to reduce it
  • yet, what researchers need is to adopt better participatory methods that can help to get more data from the children
  • policymakers needs to address education, employment and social protection for the most needy in order to end persistent poverty
  • policy interventions on child poverty should rightly estimate the challenges posed by societal values that are contributing to poverty

  

• Chronic poverty amid growth: insights from long-term poverty trajectories

  Posted:20 Nov 2012 18:14:35 GMT

  In recent years there has been growing interest in researching the dynamics of poverty, including the poverty mobility of households and communities. This paper is a part of a longitudinal study that seeks to improve understanding of the causes and consequences of childhood poverty; the focus in this paper is tribal households not conforming to the general trend of upward mobility.
  
  Relying on three case studies, the paper suggests the following factors stand behind the downward movement:
  

  • location of the households
  • households at the beginning of the family life cycle
  • households with young children, meaning fewer hands to work
  • households which started off on debts rather than on endowments
  • households suffering shocks

  
  In addition, the document reviews an analysis of qualitative data about childhood poverty in four developing countries.
  
  Conclusions encompass:
  

  • the choices that poor people make can be seen as resistance to being labelled and that, by making these choices, they are also upholding the notion of agency and self-esteem
  • the specific issues facing children are often lost when using national datasets that consider only households and fail to consider inequalities within them
  • an analysis that captures the role of agency and opportunity structure in shaping poverty mobility can inform strategies that support transitions out of poverty
  • a host of social, cultural and psychological aspects of how a household negotiates institutions based on their experiences of these systems need attention
  • two sets of policies are necessary; one set to help promote escapes from poverty and a different set to control against descents into poverty
  • the need to take into account the complex processes, dynamics and multiple influences in children’s lives is clear

  
  Finally, the authors criticise the flawed neo-liberal policies which recommend withdrawal of the state and suggest that the government’s role is only to ‘enable’.

• Is school education breaking the cycle of poverty for children?: factors shaping education inequalities in Ethiopia, India, Peru and Vietnam

  Posted:20 Nov 2012 17:45:57 GMT

  Millions of poor children and families are investing scarce resources in going to school, in the hope that it will lead to a better life. This paper looks at children’s unequal trajectories from early childhood through to the time they leave school, examining how various factors are shaping their educational opportunities and achievement.
  
  The paper employs the results of an analysis conducted in four developing countries (Ethiopia, India, Peru and Vietnam) and introduces the following findings:
  

  • unequal school trajectories are set in motion during early childhood
  • while there is high primary school enrolment in the study countries, there are still stark inequalities in children’s progression through school
  • children’s learning outcomes are strongly shaped by household-level factors (e.g. mother tongue and levels of parental education)
  • intersecting inequalities account for large achievement gaps (e.g. being a “girl” and “disadvantaged” makes the situation much more bad)
  • inflexible schooling further excludes children who need to combine school with paid work and responsibilities at home
  • as a result, young people are practically not relying on education as a route to employment

  
  Conclusions are as follows:
  

  • in order for school education to fulfill its promise as a route out of poverty, there is a need for more equitable, better-quality schooling and training that can translate into realistic opportunities for young people
  • there is a need for decisive strategies that take into account the development of plans for reaching marginalised children, like girls and ethnic minorities
  • broader sources of exclusion, such as rural location and household poverty should be addressed
  • possibilities for more flexible and responsive schooling need to be examined (e.g. seasonal timetables and shorter day schooling)

  

• An Update of The Neglected Crisis of Undernutrition: Evidence for Action | Human Development Resource Centre

  Posted:05 Nov 2012 09:00:59 GMT

  Reviews new research on the causes, consequences and potential actions to reduce maternal and child undernutrition undertaken since the original publication in 2009. This paper is informed by targeted searches of electronic journals and online databases (ScienceDirect, PubMed, the Cochrane library, Oxford journals, The Lancet, the BMJ and Cambridge journals). A search was also conducted for data and reports from the World Bank, UNICEF, the Food and Agriculture Organization (FAO), the World Health Organization (WHO) and other relevant reports or position papers by governmental and non-governmental organisations and international bodies. Where possible the paper draws on systematic reviews, peer-reviewed journal articles, meta-analyses and Randomised Control Trials (RCTs). Some of the new and emerging areas are less well researched and rely on organisational reports pending new research.

• Social connection of street girls in the context of Dhaka City, Bangladesh

  Posted:01 Nov 2012 09:01:22 GMT

  This year 2012, the theme of IWD is “CONNECTING GIRLS, INSPIRING FUTURES”. Following this theme, this paper is going to study about a deprived but major segment of girls who are street girls and their social connection in Dhaka city, Bangladesh.In Bangladesh, much progress has been made to protect and promote adolescent girls and girl children's rights in recent times. However, girls are found in continuous victimization of violence, deprivation of basic human needs and rights worldwide. From this study, it has been revealed that majority of the street girls (37.50 percent) are flower sellers whereas, 18.80 percent are prostitutes, 6.25 percent are garments worker, 6.25 percent are beggars, 12.50 percent are shopkeepers and 6.25 percent are paper-hawkers.In reducing gender gap not only between men and women but also among women and girls’, participation must be increased at all tiers of our society.

• Surviving Pattern of Women and Children Migrants in Urban Bangladesh

  Posted:31 Oct 2012 09:01:15 GMT

  Migration is a relevant phenomenon with important implications at three different levels: local, regional and international. On the wider level, migration is tightly related with globalization and with the workflow of human resources towards the host countries; on a local level, rural to urban migration is one of the most important aspects of the economy of the state. This paper analyses the situation of Bangladesh, with a particular focus on the causes and consequences of women and children migration, who move to big cities like Rajshahi to find work and to enhance their livelihood. The paper looks at the role of work in acquiring dignity, the filial duty in a traditionally hierarchically structured society and also women and children as active-decision makers in the migration process. The paper also focuses on the characteristics of migrant people, with sex and age disaggregated data, and statistics about the different families’ situations.

• Impact of climate change on children’s health in Limpopo province, South Africa

  Posted:30 Oct 2012 09:01:01 GMT

  This paper examines the impact of climate change on children’s health in the Limpopo province of South Africa. Over 20 years of data were collected to analyse climatic conditions in the province. The study employs regression analysis to examine the relationships between climatic parameters and incidence of diseases, and to predict distribution of diseases by 2050. The results show that the most prevalent diseases were diarrhoea, followed by respiratory infection, asthma and malaria. The most tropical location, Mussina, had the highest incidence of the most prevalent disease, diarrhoea, with 59.4 per cent. The analysis shows that maximum temperature is positively correlated with years in four cities, thereby indicating local warming. Similarly rainfall decreased over time in all of the cities. Results of the regression analysis show that 37.9 per cent of disease incidence is accounted for by the combined influence of temperature and rainfall.

• Children’s action for disaster risk reduction: views from children in Asia

  Posted:27 Oct 2012 09:01:02 GMT

  This report indicates that Asian children and youth have been involved in hazard mapping, raising awareness through radio and games, as well as influencing other children, their teachers, parents and communities on how to reduce the effects of disasters. The report underscores that children should not be seen only as victims in disasters, though they are vulnerable and face particular risks to their health, protection, access to education and nutrition. The aim of the publication is to provide children and youth in Asia a platform to report on progress made towards these commitments from their own point of view. It documents the perspective of children from seven Asia countries on how disasters and climate change affects their lives and their rights. The report also supports the implementation of the Children's Charter for Disaster Risk Reduction.

• Climate extremes and child rights in South Asia: a neglected priority

  Posted:16 Oct 2012 13:01:53 GMT

  The links between climate change and disasters in South Asia, such as flooding in Pakistan or cyclones in Bangladesh, are increasingly evident. However, there is little recognition of the potentially life-long impact of climate change and related disasters on the wellbeing of the region’s children. In a region that accounts for more than one quarter of the world’s children, with 614 million children under 18, girls and boys must receive greater priority in measures to respond to disasters and in disaster risk reduction planning.
  
  Some positive examples are emerging, including the South Asian Association for Regional Cooperation’s Framework for Care, Protection and Participation of Children in Disasters, which recognises the different needs of girls and boys of varying age groups. In addition, the ‘Step Up Campaign’ for Disasters Resilience, developed by the United Nations Office for Disaster Risk Reduction (UNISDR) prioritised children for the 2011 International Day for Disaster Reduction, and women and girls for 2012. But these initiatives have yet to influence appropriate action at the local level. To help this process and to highlight specific priority areas for policy, Plan International has studied how girls and boys in South Asia perceive and experience climate extremes and disasters. This project briefing presents the following policy implications:
  

  • South Asia’s regional and national climate change adaptation (CCA) and disaster risk management (DRM) policies, programming and funding must address inter-connected disaster and climate threats to child rights. Interventions to strengthen community resilience to climate risks must also strengthen household and community safety-nets that protect children from harm, abuse and neglect
  • Regional and national policies and programming for CCA and DRM need to conduct more detailed disaggregated analysis of risks and vulnerability to respond to differentiated needs. This includes more financial resources to better document disaster impact by age and sex, and for appropriate DRM and adaptation interventions that consider the rights of girls and boys, as well as approaches that promote gender equality.
    
  • SAARC’s Framework for Care, Protection and Participation of Children in Disasters should be adopted at national and sub-national levels, with South Asian governments institutionalising and investing in mechanisms to roll-out, monitor and evaluate its ten priorities for action
  • South Asian decision-makers must provide appropriate spaces for girls and boys to contribute to the identification of risks and the development of action plans for a climate compatible future that takes the rights and well-being of the most vulnerable children into account
  • South Asia’s national adaptation and education policies must support greater resilience of education services to ensure that children’s access to and quality of learning are not hampered by climate extremes – through safe schools and education in emergencies programming
  • South Asia’s governments must empower future generations to better understand the causes and consequences of evolving climate risks as relevant to their local context, through formal and non-formal learning. This can support the effective transfer of adaptation skills, knowledge and resources to those on the frontline of evolving risks
    

  
  
  
  
  
  
  . Key points: - Children affected by climate related disasters in South Asia report post-disaster gender-based violence, child labour, family break-ups and barriers to their development and learning - Child protection issues are rarely prioritised in policies to reduce disaster risk or adapt to climate change - Disaster risk management and climate change adaptation policies must tailor interventions to address critical aspects of child rights, particularly child protection and education.

• Finding a curriculum that works under trees: Literacy and health education for adolescent girls in rural Malawi

  Posted:18 Sep 2012 16:32:49 GMT

  Non-formal education often represents a last chance for adolescent girls who do not attend school to receive some education to improve their health before they become mothers. This paper describes the development of a literacy and health education curriculum for adolescent girls in southern Malawi who will never enter formal schooling. The curriculum was redefined in the light of participants’ feedback and providers’ observations. The health messages could effect change but would have had limited impact on girls’ health practices without the participation of the wider community. The curriculum’s innate visibility ‘under the trees’ was a key factor in facilitating villagers’ involvement and exponential learning.

• The Extent and Nature of Witchcraft-Based Violence against Children, Women, and the Elderly in Malawi

  Posted:05 Sep 2012 09:00:40 GMT

  According to the study, the belief in witchcraft is strong, widespread and permeates all sectors in Malawi. Accusations of witchcraft are common and the vulnerable are most often the victims of such accusations and subsequent violence. Elderly women are at most risk of being accused of witchcraft. The means by which witches are identified are questionable. Until now, few systematic studies have been conducted to determine the extent and nature of witchcraft-based violence. This study presents detailed data collected from 8 districts, gives recommendations and is ultimately aimed to contribute to reduction of accusations of witchcraft and promotion of human rights.

• Is School Education Breaking the Cycle of Poverty for Children: Factors Shaping Education Inequalities in Ethiopia, India, Peru and Vietnam

  Posted:31 Aug 2012 09:14:12 GMT

  School education is held up as an ‘escape route from poverty’. Millions of poor children and families are buying into this promise and often investing scarce resources in going to school, in the hope that it will lead to a better life. This paper looks at children’s unequal trajectories from early childhood through to the time they leave school, examining the factors shaping their educational opportunities and achievement. It synthesises existing Young Lives analysis based on research with two age cohorts in each of the study countries - Ethiopia, Andhra Pradesh in India, Peru and Vietnam. It looks at the large achievement gaps that exist between different groups of children. For school education to start fulfilling its promise as a route out of poverty, there is a need for more equitable, better-quality schooling and training that can translate into realistic opportunities for young people.

• Preventing mother-to-child transmission of HIV within HIV proposals funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria

  Posted:10 Aug 2012 15:51:37 GMT

  This article aims to to analyse interventions for the prevention of mother-to-child-transmission of HIV (PMTCT) included in HIV proposals approved for funding by the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund).
  
  PMTCT interventions are guided by a comprehensive strategic approach, which includes four components:
  

  • primary prevention of HIV infection among women of childbearing age
  • preventing unintended pregnancies among HIV infected women
  • preventing HIV transmission from a woman living with HIV to her infant
  • provision of appropriate treatment, care and support to mothers living with HIV and their children and families.

  The first comprehensive analysis of sexual and reproductive health components in HIV proposals funded through the Global Fund has shown that an average of 25 per cent of all HIV proposals include interventions related to PMTCT. In light of the priority by many partners including UNAIDS to scale up PMTCT services and for the elimination of paediatric HIV in newborn, the authors conducted an in-depth analysis of the four components of the global PMTCT strategy in funded HIV proposals. A particular focus was to assess whether the interventions included comprehensive PMTCT services where a balance between the different components was apparent. Individual approved HIV proposals submitted to the Global Fund were analysed for these components.

  In total, 345 original HIV proposals approved for funding from Rounds 1 to 9 were reviewed. The four components of the global PMTCT strategy do not feature equally. In particular, prevention of unintended pregnancies in HIV infected women (component 2) was the least represented, appearing in 34 per cent of the proposals. On the other hand, preventing HIV transmission from a woman living with HIV to her infant (component 3) was present in approximately 90 per cent. However, component 2 represents the only component that consistently increased throughout the Rounds, with signs of the greatest increase between Rounds 3 and 7.

  The authors conclude that it is important for countries to support comprehensive PMTCT interventions that are balanced across the four components. The Global Fund is one of the largest donors and this study shows interventions that countries could capitalise on to scale-up PMTCT efforts as well as synergise efforts in linking with other global and national initiatives in maternal, reproductive, and child health.
  

  

• Malnutrition in South-Asia. Poverty, diet or lack of female empowerment?

  Posted:20 Jul 2012 09:01:27 GMT

  Despite economic growth, and a reduction in poverty, malnutrition is still rampant in South-Asia. This indicates that non-economic factors are important, and we use a nation-wide survey from Nepal to identify factors that may explain why small children are stunted. In contrast to designated studies of child nutrition we do not have information on individual food intake, but we demonstrate that analysis of large sample surveys is a good supplement to designated studies, with the main benefit being that findings are nationally representative. We find that pulses are critical for child growth, and that boys are more often malnourished, maybe because they are expected to take other food than breast milk. Furthermore we find that girls are more likely malnourished if they have many older brothers, and we find that female empowerment improves child nutrition.

• What works? Interventions for maternal and child undernutrition and survival

  Posted:19 Jul 2012 09:01:08 GMT

  The authors of this article reviewed interventions that affect maternal and child undernutrition and nutrition-related outcomes, including: 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). They found that although strategies for breastfeeding promotion have a large effect on survival, their effect on stunting is small. To eliminate stunting in the longer term, these interventions should be supplemented by improvements in the underlying determinants of undernutrition, such as poverty, poor education, disease burden, and lack of women's empowerment.

• Extending the duration of exclusive breastfeeding in El Alto, Bolivia through a community-based approach and the provision of health services

  Posted:19 Jul 2012 09:01:05 GMT

  This document reports on a project to extend the duration of exclusive breastfeeding in a community in Bolivia. In 2003-2005, the NGO COTALMA initiated a project to improve parameters associated with exclusive breastfeeding in the Bolivian town of El Alto, adjacent to La Paz. Exclusive breastfeeding has been shown to decrease childhood mortality and decrease the prevalence of many childhood illnesses. A 2002 study suggested that only 9.9% of children exclusively breastfed up to 6 months in El Alto. El Alto is notable for its sizeable indigenous population and for the presence of manzaneras de la salud, volunteer community health workers in charge of their neighborhood block. The intervention was implemented in the Corea Health Network of El Alto, a cachement containing approximately 187,000 people. Results showed higher than expected baseline breastfeeding levels, and significant improvements after the intervention.

• Progress for children: a report card on adolescents

  Posted:07 Jul 2012 09:01:09 GMT

  As children up to the age of 18, most adolescents are protected under the Convention on the Rights of the Child. Yet, their vulnerabilities and needs often remain unaddressed. This document sets out who adolescents are, where they live, what they do, what their problems are and how their needs are, or are not, being met. Specifically, it looks at: the socio-demographic profile of adolescents; education and work; adolescent mortality morbidity and health-related behaviours; adolescent sexual behaviour, childbearing and maternal health, and HIV; violence; and the way forward. The way forward suggests a six-pronged approach: adopt a life-cycle approach; view adolescence through an equity lens; make better use of data; approach adolescents intersectorally; develop services to address the specific needs of adolescents; and, recognise adolescents’ potential as agents of change.

• Needs, challenges and opportunities: adolescents and young people living with HIV in Zambia

  Posted:07 Jul 2012 09:01:06 GMT

  The aims of this qualitative study, carried out in 2010, were twofold. The first was to explore and document the psychosocial, sexual and reproductive health (SRH) needs of adolescents (10-19) living with HIV in Zambia. The second aim was to identify gaps between these needs and existing SRH and HIV-related initiatives and services currently available to young people. The data confirms that for young people, living with HIV amplifies the need for effective support and guidance, and as they move from child to adolescent to adult, there are a range of HIV-related factors impacting on their day to day lives. Respondents identified key interventions they perceive could improve the effectiveness of HIV service providers, and these are outlined in the briefing paper.

• Adolescent fertility in low- and middle-income countries: effects and solutions

  Posted:07 Jul 2012 09:01:03 GMT

  Adolescent fertility in low- and middle-income countries presents a severe impediment to development. However, there is debate about whether adolescent pregnancy is a problem in and of itself or merely symptomatic of deeper, ingrained disadvantage. This paper aggregates recent quantitative evidence on the socioeconomic consequences of and methods to reduce of teenage pregnancy in the developing world. It finds variable results for all indicator types with the partial exception of knowledge-based indicators, though it is not clear that such interventions necessarily lead to behaviour change. The authors argue that donors should adopt a rights-based approach to adolescent fertility and shift their focus from the proximate to distal causes of pregnancy, including human rights abuses, gender inequality, child marriage, and socioeconomic marginalisation.

• Adolescence: a foundation for future health

  Posted:04 Jul 2012 13:11:07 GMT

  A focus on adolescence is central to the success of many public health agendas, including those mentioned in Millennium Development Goals. This paper argues that greater attention to adolescence is needed within each of these public health domains if global health targets are to be met.
  
  The paper notes that health in adolescence is the result of interactions between early childhood development and the specific biological and social-role changes that accompany puberty. Yet it is circumvented with risk and protective factors that affect the uptake of health-related behaviours.
  
  Findings include:
  

  • the shape of adolescence is rapidly changing - the age of onset of puberty is decreasing and the age at which mature social roles are achieved is rising
  • strategies that place the adolescent years centre stage provide important opportunities to improve health, both in adolescence and later in life.

  The document points that re-orientating child-health advocacy groups to be more inclusive of adolescents would be helpful in the short-term, but more focused initiatives on adolescents are needed in the medium-term. Conclusions include:
  

  • an international agenda on adolescent health would place the developmental phase of adolescence centre stage rather than any one health issue
  • such an agenda would support investments in preventive interventions that extend beyond the health sector through alignment with education, employment, sex equality and human rights
  • good information systems are an important step towards making adolescents and their health more visible to policy makers, researchers and donors
  • greater engagement of young people will help to ensure the relevance of interventions that set out to target this diverse population
  • funding to support the development of academic centers of excellence in adolescent health is necessary to develop advocacy and policy skills within adolescent health
  • a strong focus on adolescent health within undergraduate and postgraduate health programmes is urgently needed.

  

• Program, District and Facility-Level Planning for Implementation of the 2010 Revised WHO Guidelines | Elizabeth Glaser Pediatric AIDS Foundation

  Posted:29 Jun 2012 09:02:36 GMT

  This toolkit from the Elizabeth Glaser Pediatric AIDS Foundation is the second of three integrated toolkits to support country teams in adaptation and implementation of the revised World Health Organization (WHO) recommendations in the four linked technical areas: ARV drugs for treatment of pregnant women living with HIV and prevention of HIV infection in infants, infant and young child feeding in the context of HIV, antiretroviral therapy for HIV infection in infants and children, and antiretroviral therapy for HIV infection in adults and adolescents.

• Girl-Centered Program Design: A Toolkit to Develop, Strengthen, and Expand Adolescent Girls Programs

  Posted:27 Jun 2012 09:00:36 GMT

  Adolescent girls face poorer health outcomes than boys, are more likely to become infected with HIV, are more socially isolated, are less likely to make the transition to secondary school or to complete it, and have fewer income-generating opportunities. Logic might have it, then, that a lot of effort in these arenas is being made to reach these adolescent girls, but unfortunately, that is not the case. Typically, what is available are general youth programs that are meant to include adolescent girls, but in reality do not. Experience has shown that to reach adolescent girls, especially vulnerable adolescent girls, programs must be designed with them as the target audience. This toolkit aims to help program managers do just that.

• Misguided Kindness: Making the Right Decisions for Children in Emergencies

  Posted:26 Jun 2012 09:05:18 GMT

  How should we care for the most vulnerable children after disaster strikes? In every humanitarian crisis, concerned outsiders respond to tragedy with actions that take children away from their families and communities – often with unintended but damaging consequences. Again and again, girls and boys are ‘rescued’ out of affected areas into orphanages or adopted into new families elsewhere in the belief that they will be better cared for away from their devastated homes. Using lessons learnt in emergencies, from the genocide in Rwanda to the Asian Tsunami and the earthquake in Haiti, the report demonstrates what action is needed to keep families together during crises and to bring separated children back into a safe and nurturing family life. Above all, this report urges people to take action to make sure that their assistance is channelled towards interventions that help children in emergencies rather than potentially cause them harm.

• Forced displacement and youth employment in the aftermath of the Congo war: from making a living to making a life

  Posted:25 Jun 2012 09:06:15 GMT

  This paper looks at what it means to be young, displaced and looking for a job in a war-affected town in the Democratic Republic of Congo. Starting off as a sociological survey into the livelihoods of young displaced migrants in the city of Butembo, it subsequently integrates more critical views on the life making perspectives of these African youngsters, who appear to be affected as much by problems of daily survival as by a lack of access to decent jobs. The high entry gates these youngsters face in their quest for a decent living illustrates the explicitly political nature of Butembo’s job market in the aftermath of war, and supports the claim that stories of daily survival and political marginalization remain inherently connected. The fact that this connection is often explicitly made in these youngsters’ imagination about a better life forces us to rethink critically the relationship between armed violence, livelihoods and economic markets in the aftermath of protracted conflicts.

• Tracking progress on child and maternal nutrition

  Posted:23 Jun 2012 09:01:48 GMT

  This report draws on wider sources in order to identify key factors for the effective implementation of programmes to improve maternal nutrition, breastfeeding, complementary feeding, and vitamin and mineral intake for infants and young children. The report also provides information that demonstrates that improving child nutrition is entirely feasible. Given what is now known about the serious, long-lasting impact of undernutrition, as well as about experiences of effective and innovative programme approaches to promoting good nutrition, this report is particularly timely. Its value lies in that it argues for nutrition as a core pillar of human development and in that it documents how concrete, large-scale programming not only can reduce the burden of undernutrition and deprivation in countries but also can advance the progress of nations.

• Change and Opportunity: The Transition from Primary to Secondary School in Rural and Urban Peru

  Posted:22 Jun 2012 13:08:02 GMT

  This paper reports the expectations, concerns and experiences of Peruvian children (aged 11-13 years) from four contrasting districts during their transition from primary to secondary school. Qualitative methods were used to elicit the views of children themselves, as well as those of their parents and teachers. The study found that children do identify a series of changes related to the different organisation and pedagogical approach in secondary schools: these are seen by children both as a difficult challenge in academic and social terms, but also as an opportunity to enjoy more freedom and autonomy and to grow up and progress in their educational careers. The study also highlights the importance of peer relationships as sources of academic and emotional support in making this transition.

• Inequalities, Life Chances and Gender

  Posted:22 Jun 2012 13:07:58 GMT

  This paper is one of two preliminary first findings reports that make use of early data from the third round of the Young Lives survey in 2009 to explore the extent to which inequalities including poverty, location (rural or urban), ethnicity or caste, and gender, are changing over time and how this may affect life chances for children. The paper considers the policy implications of these first findings, including the need to protect existing social budget expenditure and ensuring services are adapted to the needs of the poorest and most marginalised children. Policies aimed at intervening in poverty cycles need to take into account how inequalities intersect to inform the expansion of services and social protection schemes and improvements in the accessibility, appropriateness and quality of education and healthcare are essential in order to provide a strong foundation for child development and learning and for children to access better-paid employment in the future.

• Understanding the Impacts of Crisis on Children in Developing Countries

  Posted:22 Jun 2012 13:07:56 GMT

  This paper makes use of early data from Round 3 of the Young Lives survey in 2009 to explore the extent and effects of economic and environmental shocks and adverse events on Young Lives children and their households. The paper considers the recent global context, demonstrating a period of economic growth in Young Lives survey countries before the economic downturn in 2008 and also considering the extent of economic and environmental shocks and other adverse events in Young Lives families in two periods (2002–6 and 2006–9). The study concludes that shocks existed before the global food price crisis and economic downturn and, though a return to economic growth may be a necessary part of reducing poverty, this on its own will not reduce the vulnerability of many families to these adverse events. Measures to mitigate the effects of shocks are important not only in reducing poverty transmission but also to ensure that all families are able to share the fruits of economic growth.

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