This dataset was produced within the ECD-FI (Early Childhood Development Friendly Index) project (IMAPI - in Portuguese) between 2018-2020. It contains the list of all 5,570 Brazilian municipalities codes, a general performance index (IMAPI), and five indices related to each domain of the Nurturing Care Framework: Good Health, Adequate Nutrition, Responsive Caregiving, Opportunities for Early Learning, and Security and Safety. These indices were calculated based on 31 main indicators (spanning the five domains) and 13 additional indicators, based on 2016 values and following a rigorous process involving data acquisition and engineering, weighting scores, and validation by domain experts. IMAPI is intended to be used as a supportive tool for assessing the performance of each Brazilian in relation to the offering of an adequate environment for early childhood development.
Introduction: Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and demographic subgroups of women and children are being reached by health interventions. Methods: We accessed coverage databases produced by the International Centre for Equity in Health, which were based on reanalysis of Demographic and Health Surveys, Multiple Indicator Cluster Surveys and Reproductive and Health Surveys. We limited the data to 58 countries with at least two surveys since 2008. We fitted multilevel linear regressions of coverage of RMNCH, divided into four main components-reproductive health, maternal health, child immunisation and child illness treatment-to estimate the average annual percentage point change (AAPPC) in coverage for the period 2008-2017 across these countries and for subgroups defined by maternal age, education, place of residence and wealth quintiles. We also assessed change in the pace of coverage progress between the periods 2000-2008 and 2008-2017. Results: Progress in RMNCH coverage has been modest over the past decade, with statistically significant AAPPC observed only for maternal health (1.25, 95% CI 0.90 to 1.61) and reproductive health (0.83, 95% CI 0.47 to 1.19). AAPPC was not statistically significant for child immunisation and illness treatment. Progress, however, varied largely across countries, with fast or slow progressors spread throughout the low-income and middle-income groups. For reproductive and maternal health, low-income and lower middle-income countries appear to have progressed faster than upper middle-income countries. For these two components, faster progress was also observed in older women and in traditionally less well-off groups such as non-educated women, those living in rural areas or belonging to the poorest or middle wealth quintiles than among groups that are well off. The latter groups however continue to maintain substantially higher coverage levels over the former. No acceleration in RMNCH coverage was observed when the periods 2000-2008 and 2008-2017 were compared. Conclusion: At the dawn of the SDGs, progress in coverage in RMNCH remains insufficient at the national level and across equity dimensions to accelerate towards UHC by 2030. Greater attention must be paid to child immunisation to sustain the past gains and to child illness treatment to substantially raise its coverage across all groups.
Agbessi Amouzou, Safia S Jiwani, Inácio Crochemore‐Silva et al.
Immunisation is crucial to achieving the Sustainable Development Goals for maternal and child mortality reduction. As Africa marks the 50th anniversary of implementing immunisation programmes, it is imperative to review progress, address challenges and strategise for the future. Using available programme data, this article examines the progress made in achieving the immunisation milestones in the region, describes the success factors and lessons learnt and makes recommendations on how to immunise every African child in the coming years. The article concludes that despite significant improvements in childhood immunisation coverage, the region still falls short of global targets, with disparities across countries. Contributing factors include, among others, weak health systems, rapid population growth without corresponding increases in service delivery, vaccine hesitancy, inadequate sustainable financing and disruptions caused by the COVID-19 pandemic. Moving forward, efforts to attain the global immunisation coverage milestones should focus on building on the past progress, addressing the COVID-19 setbacks, leveraging new technologies and securing sustainable immunisation funding. This can be achieved by accelerating the implementation of the Immunization Agenda 2030 and the Addis Ababa Declaration on Immunization commitments. The support of all stakeholders including political leaders, public health professionals, the vaccine industry, regional organisations, academia, donors and healthcare workers is essential for this noble endeavour.
Amos Petu, Balcha Masresha, Charles Shey Wiysonge et al.
Early childhood development (ECD) is crucial for better health and well-being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem-solving and personal-social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community-based cross-sectional survey design, 627 mother-child (12-36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ-3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem-solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non-stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition.
BACKGROUND: The benefits of childhood vaccines are critically dependent on vaccination coverage. We used a vaccine registry (as gold standard) in Kenya to quantify errors in routine coverage methods (surveys and administrative reports), to estimate the magnitude of survivor bias, contrast coverage with timeliness and use both measures to estimate population immunity. METHODS: Vaccination records of children in the Kilifi Health and Demographic Surveillance System (KHDSS), Kenya were combined with births, deaths, migration and residence data from 2010 to 17. Using inverse survival curves, we estimated up-to-date and age-appropriate vaccination coverage, calculated mean vaccination coverage in infancy as the area under the inverse survival curves, and estimated the proportion of fully immunised children (FIC). Results were compared with published coverage estimates. Risk factors for vaccination were assessed using Cox regression models. RESULTS: We analysed data for 49,090 infants and 48,025 children aged 12-23 months in 6 birth cohorts and 6 cross-sectional surveys respectively, and found 2nd year of life surveys overestimated coverage by 2% compared to birth cohorts. Compared to mean coverage in infants, static coverage at 12 months was exaggerated by 7-8% for third doses of oral polio, pentavalent (Penta3) and pneumococcal conjugate vaccines, and by 24% for the measles vaccine. Surveys and administrative coverage also underestimated the proportion of the fully immunised child by 10-14%. For BCG, Penta3 and measles, timeliness was 23-44% higher in children born in a health facility but 20-37% lower in those who first attended during vaccine stock outs. CONCLUSIONS: Standard coverage surveys in 12-23 month old children overestimate protection by ignoring timeliness, and survivor and recall biases. Where delayed vaccination is common, up-to-date coverage will give biased estimates of population immunity. Surveys and administrative methods also underestimate FIC prevalence. Better measurement of coverage and more sophisticated analyses are required to control vaccine preventable diseases.
Ifedayo Adetifa, Boniface Karia, Alex Mutuku et al.
This paper investigates the relationships between caregivers' parenting knowledge and early childhood development, based on a survey conducted in 1715 rural households in 100 villages located in an undeveloped rural area of western China. The results find that, first, caregivers' parenting knowledge is positively and significantly associated with children's development outcomes, including cognitive, language, motor, and social-emotional development; second, caregivers' parental investments significantly mediate the link between parenting knowledge and early childhood development; third, in contrast with other parental investments, play materials (in terms of variety and quantity) and play activities in the households are the strongest mediators. Our findings might be informative for policy makers to design policies targeted to foster human capital formation in rural China.
Childhood Development refers to the physical, cognitive, linguistic, and socio-emotionaldevelopment of a child from the prenatal stage up to age eight. This development happens in a variety ofsettings (homes, schools, health facilities, community-based centers) and involves a wide range ofactivities from child care to nutrition to parent education. Providers of services can include public,private, and non-governmental agencies. Early Childhood Development encompasses a number ofdistinct sub-stages, each of which presents particular needs Pregnancy and pre-natal prenatal care,attended births, registration, postnatal care 0 to 3 parent education, early stimulation and nutritioninterventions, home-based care, crèches 3 to 6 parent education, preschool 6 to 8 transition to formaleducation, improved early primary school From a development point of view, children who come fromthe most vulnerable and disadvantaged backgrounds need good-quality services and care the most,including children with special needs for early childhood development. To ensure a nation‘s childrendevelop well, adequate investment in early childhood development is essential.
Immunisation has been a proven and one of the mostcost-effective child survival interventions in the world.1Every country has its own immunisation programmeto provide selected vaccines to the targeted group ofpopulation, generally focusing on infants and children,and pregnant women, who are at a high risk of diseasespreventable by vaccines. There are at least 27 causativeagents against which vaccines are available and manymore agents are targeted for development of vaccines.2The number of antigens used in the immunisationprogrammes varies from country to country. However,there are a few selected antigens which are given againstdiphtheria, pertussis, tetanus, poliomyelitis, measles andhepatitis B which are part of immunisation programmesin most of the countries in the world. The first vaccine,against small pox, was discovered in 1798, and fromthe early 18th century, the British health administrationintroduced vaccination against small pox in the Indiansub-continent.3 The first doses of smallpox vaccinelymph in India arrived in May 1802.4 The most strikingsuccess of these efforts has been the eradication ofsmallpox disease from the world.5 EPI is implemented in192 countries of the world. But data shows that despitebeing a proven cost-effective preventive public healthintervention, the benefits of immunisation is not reachingmany children who are at risk of the diseases preventableby these vaccines. Majority of the children who do notreceive these vaccines live in the developing countries. Itis important to understand the underlying factors whichcauses non-immunisation of children and specifically, inBangladesh, in this review article.
The 2018 special issue of Annals of the New York Academy of Sciences on implementation research and practice for early childhood development brings together emerging evidence on implementing effective nurturing care programs, addressing issues of quality and scale. Translating evidence to practice requires addressing the barriers perceived by policy makers, which have been highlighted in the published literature. Here, I describe how UNICEF and other global partners are addressing these barriers.
The Community of Practice is a space to share knowledge and promote dialogue between different stakeholders. This Community of Practice will build upon the knowledge and networks created during the implementation of the diverse portfolio of projects of the ECD Financing partnership, the recently created ECD Hub, the large knowledge created by other organizations, and the community of innovators that has been growing across the region in recent years. More than 50 civil society organizations have joined this Community to support and promote the ECD agenda in the region.
