Introduction: The Healthy Pregnancy, Healthy Baby study (HPHB) augments a routine service (pregnancy ultrasound) with information about fetal and infant development and the importance of parent wellbeing and infant care, to assess whether it will improve child development and growth, parent-infant attachment, parental wellbeing and routine clinic attendance. This paper outlines the process of intervention development and implementation in a complex environment with multiple stakeholders. Methods: Study participants were recruited from pregnant women attending fetal ultrasound (US) at Chris Hani Baragwanath Hospital (CHBH), Soweto, South Africa. Partners were invited to attend all sessions. The HPHB intervention, a novel combination of a health and a parenting intervention that augments a routine service (US), is being tested through a randomized controlled trial with outcome assessments at 6 weeks and 6 months follow-up. The current study outlines the process of moving from intervention design to full implementation in a high-risk clinical setting. Results: Formative research informed the design and content of the intervention materials. Implementation is monitored through weekly reports and team meetings as well as formal and informal feedback received from staff and participants. Close collaborations with clinicians enhanced recruitment practices and provided clinical oversight of the trial procedures. Ongoing stakeholder engagement informed intervention procedures and strategies to address challenges that arise during implementation. Conclusion: This study emphasizes the importance of dynamic, inclusive and interactive approaches to intervention development and implementation, as well as the purposeful use of varied information from diverse sources in decision-making for effective implementation.
Wiedaad Slemming, Roisin E. Drysdale, Linda Richter
Abstract Objectives: to analyze differences between violence against children and adolescents according to characteristics of cases, probable perpetrators, occurrences and typologies and compare their temporal and spatial distributions. Methods: data were collected from the Notifiable Diseases Information System (SINAN), Maranhão, from 2009-2019. Results: 4,457 notifications of violence against children and 5,826 against adolescents were analyzed. In the 11 years investigated, violence against children was more frequent in 2015 and 2016 and in five of the 19 Maranhão Health Regions. Violence against males was more frequent in childhood and against females prevailed mostly in adolescence (p<0.001). While mothers (p<0.001), fathers (p=0.029) and caregivers (p<0.001) were most frequently accused of violence against children, friends/ acquaintances (p<0.001), spouses/boyfriends/girlfriends (p<0.001) and strangers (p<0.001) mainly assaulted adolescents. Violence motivated by sexism (p=0.006), generational conflict (p<0.001), street situation (p=0.002) and disability (p=0.035) were more frequent in adolescence. Physical (p<0.001), sexual (p<0.001) and psychological/moral (p<0.001) violence, torture (p<0.001) and self-aggression (p<0.001) were most commonly reported in adolescence and neglect/abandonment predominated was mostly reported against children (p<0.001). Conclusions: violence against children and adolescents residing in the state of Maranhão and notified in SINAN were distinct phenomena in relation to the characteristics of cases, probable authors, occurrences, and typologies.
Vitória Evelen Oliveira Silva, Marizélia Rodrigues Costa Ribeiro, Márcio Thadeu Silva Marques et al.
Background Violence against children affects over one billion children globally. International organisations promote parenting interventions as a main strategy to reduce violence against children. Parenting interventions have therefore been implemented rapidly across the globe. Yet, evidence for their longer-term effects remains unclear. We integrated global evidence to estimate effects over time of parenting interventions to reduce physical and emotional violence against children. Methods In this systematic review and meta-analysis, we searched 26 databases and trial registries (14 non-English: Spanish, Chinese, Farsi, Russian, Thai) and conducted an extensive grey literature search up to August 01, 2022. We included randomised controlled trials (RCTs) of parenting interventions based on social learning theory for parents of children aged 2–10 years, without time or context restrictions. We critically appraised studies using Cochrane's Risk of Bias Tool. Data were synthesised using robust variance estimation meta-analyses. This study is registered with PROSPERO, CRD42019141844. Findings We screened 44,411 records and included 346 RCTs. Sixty RCTs reported outcomes on physical or emotional violence. Trials were distributed across 22 countries (22% LMICs). Risk of bias was high for various domains. Outcome data ranged from 0 weeks to 2 years after the intervention, and was largely based on parent self-report. Parenting interventions reduced physical and emotional violent parenting behaviours immediately after the intervention (n = 42, k = 59; d = −0.46; 95% CI: −0.59, −0.33), at 1–6 months follow-up (n = 18, k = 31; d = −0.24; 95% CI: −0.37, −0.11) and at 7–24 months follow-up (n = 12, k = 19; d = −0.18; 95% CI: −0.34, −0.02), but effects were smaller over time. Interpretation Our findings suggest that parenting interventions can reduce physical and emotional violence against children. Effects are maintained up to 24 months follow-up, but with diminished effect sizes. With global policy interest and imminent importance, research beyond 2 years and how effects can be better sustained over time is urgently needed. Funding Student scholarship from the Economic Social Research Council, Clarendon, and Wolfson Isaiah Berlin Fund.
Sophia Backhaus, Patty H. O. Leijten, Janina Jochim et al.
Stunting refers to a condition of chronic undernutrition in which a child's height-for-age (HAZ) falls more than two standard deviations below the WHO reference median. In 2024, Enrekang Regency reported a stunting prevalence of 34.3%, the second-highest figure in South Sulawesi Province. This research set out to examine how three dimensions of maternal caregiving—exclusive breastfeeding, complementary feeding, and household sanitation—relate to stunting among toddlers within the coverage area of Puskesmas Maiwa, Enrekang Regency. A cross-sectional quantitative design was applied, drawing 93 respondents through simple random sampling, with binary logistic regression used for data analysis. Findings indicated that exclusive breastfeeding was significantly related to stunting status (p=0.002; OR=11.058), while inappropriate complementary feeding emerged as the strongest predictor (p=0.000; OR=37.414); sanitation, by contrast, showed no significant association (p=0.675). Together, the three variables accounted for 68.7% of the variance in stunting occurrence (Nagelkerke R² = 0.687). Based on these results, efforts to prevent stunting in the area should give priority to maternal education on proper breastfeeding and complementary feeding practices.
Vivi Nur Afiah Muchlis, Pratiwi Ramlan, Zulkarnaim Sulaiman et al.
Abstract Objective. To know the perception of health, education and social service professionals about the records and notifications of violence against children and adolescents, carried out in a municipality in the south of Brazil.Methods. This is an exploratory, descriptive, and qualitative approach, specifically developed in places that integrate children and adolescents victims of violence. Ten professionals participated, including three nurses, one doctor, two social workers, two psychologists, one tutor, and one educator. Data collection was performed through a semi-structured interview. The statements were submitted to discursive textual analysis.Results. The analysis showed that the act of recording and reporting violence against children and adolescents is still not a routine practice for health professionals. The registration and formal communication of the information should be considered as a priority; however, the results showed that the protection of the victim seems to overlap with the registry. The study identified important elements in strategies for coping with violence against children and adolescents: centralization of notifications in a single service; creation of a notification flow; existence of an advisory team to deal with cases of violence; and completion of compulsory notification by education and social assistance professionals.Conclusion. For the professionals, the routine attendance of situations involving violence, but not formalized through the notification form, has contributed to the underreporting and invisibility of the cases.Descriptors: nursing; domestic violence; child advocacy; mandatory reporting; registries.How to cite this article: Silva PA, Lunardi VL, Meucci RD, Algeri S, Silva MP, Franciscatto FP. (In) visibility of notifications of violence against children and adolescents registered in a municipality in southern Brazil. Invest. Educ. Enferm. 2019; 37(2):e11.ReferencesCovell, K; Becker JO, NGO Advisory Council for Follow-up to the UN Study on Violence against Children. Five years on: a global update on violence against children [Internet]. 2011 [Cited 11 Feb 2018]. Available from: http://resourcecentre.savethechildren.se/sites/default/files/documents/5085.pdf. Viola TW, Salum GA, Kluwe-Schiavon B, Sanvicente-Vieira B, Levandowsky ML, Grassi-Oliveira R. The influence of geographical and economic factors in estimates of childhood abuse and neglect using the Childhood Trauma Questionnaire: A worldwide meta-regression analysis. Child Abuse Neglect. 2016; 51(1):1-11. Brasil. Ministério da Saúde. Portaria nº 1271, de 6 de junho de 2014. Define a Lista Nacional de Notificação Compulsória de doenças, agravos e eventos de saúde pública nos serviços de saúde públicos e privados em todo o território nacional, nos termos do anexo, e dá outras providências. Diário Oficial da União, Brasília (DF), 2014 Jun 09; Seção 1:67. Egry EY, Apostolico MR, Morais TCP. Notificação da violência infantil, fluxos de atenção e processo de trabalho dos profissionais da Atenção Primária em Saúde. Cien. Saude Colet. 2018; 23(1):83-92. Cezar PK, Arpini DM, Goetz ER. Registros de Notificação Compulsória de Violência Envolvendo Crianças e Adolescentes. Psicol. Cien. Prof. 2017; 37(2): 432-45. Delziovo CR, Bolsoni CC, Coelho EBS. Quality of records on sexual violence against women in the Information System for Notifiable Diseases (Sinan) in Santa Catarina, Brazil, 2008-2013. Epidemiol. Serv. Saude. 2018; 27(1):e20171493. Nunes AJ, Sales MCV. Violence against children in Brazilian scenery. Cien. Saude Colet. 2016; 21(3):871-80. 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Priscila Arruda da Silva, Valéria Lerch Lunardi, Rodrigo Dalke Meucci et al.
Baby schema features are a specific set of physical features-including chubby cheeks, large, low-set eyes, and a large, round head-that have evolutionary adaptive value in their ability to trigger nurturant care. In this study among nulliparous women (N = 81; M age = 23.60, SD = 0.44), we examined how sensitivity to these baby schema features differs based on individual variations in nurturant care motivation and oxytocin system gene methylation. We integrated subjective ratings with measures of facial expressions and electroencephalography (EEG) in response to infant faces that were manipulated to contain more or less pronounced baby schema features. Linear mixed effects analyses demonstrated that infants with more pronounced baby schema features were rated as cuter and participants indicated greater motivation to take care of them. Furthermore, infants with more pronounced baby schema features elicited stronger smiling responses and enhanced P2 and LPP amplitudes compared to infants with less pronounced baby schema features. Importantly, individual differences significantly predicted baby schema effects. Specifically, women with low OXTR methylation and high nurturance motivation showed enhanced differentiation in automatic neurophysiological responses to infants with high and low levels of baby schema features. These findings highlight the importance of considering individual differences in continued research to further understand the complexities of sensitivity to child cues, including facial features, which will improve our understanding of the intricate neurobiological system that forms the basis of caregiving behavior.
Hannah Spencer, Franca H. Parianen Lesemann, Renate S. M. Buisman et al.
Objective: The COVID-19 pandemic Increased the risk of impairing the mother -infant bonding. The objectives of this study were to evaluate the early bond established between mother and infant and postpartum depression (PPD) in pregnancies that occurred during the pandemic period, to identify the factors that may have influenced these outcomes and to verify if there was an association between bonding and probable PPD. Methods: This is a cross-sectional study of postpartum women from a public maternity hospital in the city of S & atilde;o Paulo conducted from February to June 2021, involving 127 mother -baby dyads. The initial data were collected in the immediate postpartum period and between 21-45 days after birth, using a semi -structured questionnaire on sociodemographic characteristics, gestational and birth conditions, and baby characteristics; the Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ) were used to evaluate PPD and bonding, respectively. Results: The presence of probable PPD and unplanned pregnancies were associated with higher PBQ score and risk to impaired bonding (p = 0.001 and p = 0.004, respectively). EPDS showed a high prevalence of PPD (29.1%) and was not associated with any Studied variable. Probably, this high prevalence of probable PPD was due to the context of insecurity secondary to the pandemic. Conclusions: We observed an increase in the prevalence of probable PPD and unplanned pregnancies during the first 18 months of the pandemic, which were associated with worse scores in mother -infant bonding. The impaired bond can affect the future development of children born during this period.
Background: Childhood stunting poses serious long-term risks to cognitive development, education, and adult productivity. While research has explored stunting’s causes and effects, there is a lack of focus on maternal knowledge of nutrition-focused nurturing care for stunted children. This gap limits the ability to design effective interventions that target improved caregiving practices. Objective: This study aimed to assess maternal knowledge of nutrition-focused nurturing care and explore associated factors, including child gender, maternal age, education, income, and prior exposure to nurturing care information, among mothers of stunted children aged 6-23 months in Indonesia. Methods: A cross-sectional study was conducted with 73 mothers in Kulon Progo, Yogyakarta. Data were collected from February to March 2024 using a validated self-assessment questionnaire covering four domains: responsive caregiving, early learning opportunities, safety and security, and supportive caregiver well-being. Statistical analyses, including t-tests and one-way ANOVA, were performed. Results: Overall maternal knowledge of nurturing care was high, with a mean score of 25.15 (SD = 4.72). Factors significantly associated with higher knowledge included having male children (p = 0.017), being aged 30-34 years (p = 0.035), possessing higher education levels (p = 0.002), and prior exposure to nurturing care information (p <0.001). Family income significantly influenced knowledge in the domain of early learning opportunities (p = 0.006), though not in other areas. Conclusion: Maternal knowledge of nutrition-focused nurturing care was influenced by child gender, maternal age, education, income, and prior exposure to nurturing care information. These findings emphasize the importance of focused educational interventions in nursing practice to enhance maternal knowledge. Addressing these factors can help align nursing strategies better to support the healthy growth and development of children.
Fitri Haryanti, Sri Hartini, Akhmadi Akhmadi et al.
Violence against children (VAC) in the home, or by household members, is a human rights and social problem with long-lasting consequences for individuals and society. Global policy instruments like the INSPIRE package have proposed strategies to prevent VAC, including Implementation and enforcement of laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, and Education and life skills. This systematic review of reviews aimed to synthesize the recent evidence base (i.e., published since 2000) for each INSPIRE strategy to reduce VAC in the home or by household members. We searched four databases using controlled vocabularies and keywords and searched for additional records in prior reviews of reviews. A total of 67 studies were included in this review, including literature reviews, meta-analyses, systematic reviews, and other types of reviews. We found extensive evidence supporting the effectiveness of parent and caregiver support interventions. However, reviews on other INSPIRE strategies were scarce. We also found a vast underrepresentation of samples from low- and- middle-income countries, children with disabilities, and families affected by forced displacement and conflict. In sum, this systematic review suggests that there are several promising strategies to prevent VAC (e.g., home visiting and parent education), but further research is necessary to strengthen the current body of evidence and effectively inform the implementation and scale-up of evidence-based interventions to protect children from violence globally.
Jorge A. Cuartas, Ana Salazar, Sophia Backhaus et al.
BACKGROUND: As part of an effort to rigorously apply behavioral science to child protection efforts, a behavior change model called Nurturing Care Groups (NCGs) was tested for effectiveness in changing child abuse and corporal punishment behaviors. OBJECTIVE: The primary research question was to what degree NCGs could change child protection knowledge, attitudes, and practices among caregivers in a low-cost program with broad reach, which could feasibly be scaled. PARTICIPANTS AND SETTING: The NCG project was implemented in two distinct ecological zones in Ghana, reaching 73,959 caregivers of children under 5 across 41 communities; while 20 communities were control sites with no NCG intervention. METHODS: Stratified random sampling was used to select intervention area respondents. Cluster sampling was utilized in control areas, using the Probability Proportional to Size method. Standard measures were used to assess changes in practices of violence and abuse, stress experience and management, parenting techniques, and the household environment. Difference-in-difference linear regression was used to compare intervention and control results. RESULTS: Intervention areas demonstrated statistically-significant and substantial changes in reported knowledge, attitudes and behaviors related to physical abuse and corporal punishment. Knowledge of negative impacts of stress on parenting, as well as stress reduction techniques increased in intervention areas, as did positive discipline and parenting practices. CONCLUSIONS: The NCG model demonstrated important promising results for changing child protection behaviors in this descriptive study. Statistically-significant decreases in reported physical and psychological punishment and corresponding increases in reported positive discipline indicate that this may be an effective and low-cost intervention for child protection behavior change.
