In this new chapter, different theories and models of cognitive development in children in the educational stage of Early Childhood Education are developed. Authors such as Piaget, Sternberg, Catell, Gardner, Smith or Guilford, approach from different points of view the cognitive development of students in the early childhood education stage as well as the importance of creative development and critical thinking as a subsection of intelligence and of vital importance for effective problem solving. Throughout the following pages, different activities or strategies that teachers can work with their students in schools to promote critical thinking in their students will be provided.
The purpose of this chapter is to highlight importance of training Early Childhood Development (ECD) practitioners to ensure safety of learners in ECD centres, known as ECE in other countries. Several government departments have established policies to ensure effective implementation of health and safety practices in ECD centres. The problem with ECD policy implementation seems to be minimal training and support of practitioners and caregivers focusing on health and safety issues in ECD centres. Policy cannot always mandate what matters to outcomes at ECD centres because individual practices ought to be central to local responses. ECD policies in South Africa provide guidelines that direct the day-to-day practices of ECD practitioners. However, health and safety of young children appears to be in the hands of untrained practitioners and caregivers. Furthermore, ECD policy implementation reveals an uncertain relationship between policies and program implementation.
AimTo document the clinical features and management of infants presenting with fever after their first meningococcal B vaccination and develop guidance for clinicians.MethodsA prospective case series over 12 months was conducted in a tertiary paediatric hospital. Infants ≤3 months of age with fever who had received their first set of immunisations within the preceding 72 h were included.ResultsA total of 92 infants met the inclusion criteria, accounting for 0.78% of the local vaccinated population. The most commonly described associated features were poor feeding, sleepiness and irritability; 66 patients (72%) were admitted to hospital. Median C‐reactive protein (CRP) was 12 mg/L, and median white cell count (WCC) was 16 × 109/L. Fifteen patients (16%) had a lumbar puncture and were commenced on antibiotics. There was one confirmed bacterial infection in an infant who had presented with fever starting 54 h after immunisation. All other microbiology samples were negative. There were no cases of missed serious bacterial infection (SBI) in those patients who were observed or discharged.ConclusionsThe routine investigation of infants presenting with post‐immunisation fever is not warranted if the infant appears otherwise well on examination. Where other common associated features are present or there is clinical concern, a period of observation is a prudent course of action. Paracetamol should be given peri‐immunisation as per the national guidance. We suggest selective use of investigations, especially inflammatory markers, which are unlikely to discriminate between SBI and post‐immunisation response. We advocate extra caution in infants presenting with fever more than 48 h after immunisation.
ABSTRACTBackground: The delivery of reproductive and child health services is of utmost importance and prime concern in India particularly states like Andhra Pradesh with limited resources, poor infrastructure and huge demand on healthcare system. The SARS-CoV-2 pandemic had presented a challenge even for developed healthcare systems around the world. Objectives: The main aim of this research is to find out Impact of SARS-CoV-2 pandemic on the Reproductive and Child Health Programme of Andhra Pradesh in India over the 3 months after Lock down imposition countrywide in March 2020. Settings & Design: Different indicators group of RCH programme (immunisation, maternal & child health, family planning) for state of Andhra Pradesh were collected and compared from previous year. Materials & Methodology: Secondary data from HMIS of Ministry of Health & Family Welfare Government of India for 2019 & 2020 were taken for analysing and understanding impact of pandemic on RCH programme over 3 months after lock down viz. April/May/June 2020. The data obtained is analysed by using Microsoft Office software. Result: The analysis of secondary data obtained from HMIS of Ministry of Health & Family Welfare website for RCH programme of the state of Andhra Pradesh shows that the lock down period & initial early phase of SARS-CoV-2 pandemic have a negative impact over the delivery of health services as well as the indicators are also affected negatively. Besides the pandemic the state is also having lack of resources, manpower, poor infrastructure as well as positive deviance at community level. These are the barriers in fact beside the epidemic. It seems that there is lack of proper plan to deal with such pandemic situation. Conclusion: The State of Andhra Pradesh has taken various steps and strategy but it seems to be insufficient to give the desired results. The barriers of healthcare system and delivery of services should be rectified added with a proper dynamic plan to carry on usual health delivery services even in pandemics. The state of Andhra Pradesh needs to develop an exclusive plan such as separate RCH cadre to tackle such situations. Keywords- Health, Decrease, Pandemic, Services/service
Timely childhood immunisation remains a critical public health priority in Bayelsa State, where gaps in vaccination schedules and caregiver-related factors continue to influence full and age-appropriate immunisation coverage among children. This study investigated the timely childhood immunisation coverage and its determinants among 3456 caregivers of children 0-59 months in Bayelsa State, focusing on caregivers’ knowledge, attitudes, and socio-demographic factors. A cross-sectional descriptive design was used to assess timely childhood immunisation coverage and its determinants among caregivers in Bayelsa State/ Caregivers were selected through multistage sampling across eight local government areas of Bayelsa State. Data were collected using structured interviewer-administered questionnaires, and descriptive statistics (mean criterion = 3.0) were used to assess caregivers’ awareness and attitudes toward timely childhood immunisation, while multiple linear regression at a 95% confidence interval examined the influence of key factors and the relationship between caregivers’ knowledge, attitudes, and timely immunisation coverage in Bayelsa State. Results were presented in figures, tables, frequencies and percentages. The findings indicated that the majority of the caregivers are between 26 and 45, with a mean age of 37.7. There is moderate immunisation timeliness, with approximately 1693 (49%) of children receiving vaccines exactly as scheduled and 2730 (79%) completing all doses by 12 months. Caregivers’ good awareness and positive attitudes were significantly associated with timely immunisation, supported by robust chi-square and logistic regression analyses. Key barriers impacting timeliness included distance to health facilities, transportation costs, and lack of family support, while reminders and caregiver education facilitated timely uptake. In conclusion, the study underscores the need for integrated interventions combining caregiver education, community support, health system strengthening, and logistical access improvements. These insights contribute critical knowledge to enhance child health strategies and improve vaccination outcomes in Bayelsa State and similar settings.
Background: Immunization is one of the cost-effective public health interventions, and can be used to prevent life-threatening childhood illnesses. This study aimed to assess disparities in child immunization coverage in Ethiopia. Method: Data from the 2012 Ethiopian Expanded Program for Immunization coverage survey was used. In this study, absolute and relative equity analysis was employed based on socioeconomic variables Result: Equity analysis was conducted in 3,748 subjects out of 3,762 child caregivers’ data. The concentration index among the poorest and richest group for BCG immunization coverage was 11%, OPV 3 was 13.3%, Pneumococcal 3 was 38.6%, Pentavalent 3 was 21.5%, Measles was 12.9%, Vitamin A supplementation was 8.9%, and full immunization was 38.6%. Conclusion: Inequalities were observed in child immunization coverage across the socioeconomic groups, with the better-off wealth status, urban residents, and children from an educated mother being more likely to be vaccinated.
Abstract Background The COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa. Methods We conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020-2022 and with 12 healthcare providers who provided public immunisation services during the pandemic. Findings During the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities; healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a “bad vaccine” mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations. Interpretation The shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions. Funding Final Mile Consulting funded this study.
Sangiwe Moyo, Anushka Ashok, Saransh Sharma et al.
Abstract Whilst it is now widely recognised that routine immunisation (RI) was disrupted by the COVID-19 pandemic in 2020 compared to previous immunisation performance, the extent of continued interruptions in 2021 and/or rebounds to previous trends remains unclear, with sporadic surveys reporting signs of immunisation system recovery at the end of 2020. We modelled country-specific RI trends using validated estimates of national coverage from the World Health Organisation and United Nation Children’s Fund for over 160 countries, to project expected diphtheria, tetanus, and pertussis-containing vaccine first-dose (DTP1), third-dose (DTP3) and measles-containing vaccine first-dose (MCV1) coverage for 2021 based on pre-pandemic trends (from 2000-2019). We estimated a 3·6% (95%CI: [2·6%; 4·6%]) decline in global DTP3 coverage in 2021 compared to 2000-2019 trends, from an expected 90·1% to a reported 86·5% across 164 reporting countries, and similar results for DTP1 (2·8% decline; 95%CI: [2·0%; 3·6%]), and for MCV1 (3·8% decline; 95%CI: [4·8%; 2·7%]). 86·5% global coverage in 2021 represents a further decrease from that reported in 2020 and 2019, and translates to a 16-year setback in RI coverage, i.e., 2005 levels. Hypothesised and early signals of rebounds to pre-pandemic coverage were not seen in most countries. The Americas, Africa, and Asia were the most impacted regions, with low- and middle-income countries the most affected income groups. The number of Zero Dose children also continued to increase in 2021. DTP1 coverage declined worldwide from an expected 93·7% to a reported 90·9% (2·8% decline; 95%CI: [2·0%; 3·6%]) which translates into an additional 3.4 million Zero Dose children on top of an expected 11.0 million (30.9% increase) at the global level. We hope this work will provide an objective baseline to inform future interventions and prioritisation aiming to facilitate rebounds in coverage to previous levels and catch-up of growing populations of under- and un-immunised children.
Abstract Background Childhood vaccinations are a vital preventive measure to reduce disease incidence and deaths among children. As a result, immunisation coverage against measles was a key indicator for monitoring the fourth Millennium Development Goal (MDG), aimed at reducing child mortality. India was among the list of countries that missed the target of this MDG. Immunisation targets continue to be included in the post-2015 Sustainable Development Goals (SDG), and are a monitoring tool for the Indian health care system. The SDGs also strongly emphasise reducing inequalities; even where immunisation coverage improves, there is a further imperative to safeguard against inequalities in immunisation outcomes. This study aims to document whether socioeconomic inequalities in immunisation coverage exist among children aged 12–59 months in India. Methods Data for this observational study came from the fourth round of the National Family Health Survey (2015–16). We used the concentration index to assess inequalities in whether children were fully, partially or never immunised. Where children were partially immunised, we also examined immunisation intensity. Decomposition analysis was applied to examine the underlying factors associated with inequality across these categories of childhood immunisation. Results We found that in India, only 37% of children are fully immunised, 56% are partially immunised, and 7% have never been immunised. There is a disproportionate concentration of immunised children in higher wealth quintiles, demonstrating a socioeconomic gradient in immunisation. The data also confirm this pattern of socioeconomic inequality across regions. Factors such as mother’s literacy, institutional delivery, place of residence, geographical location, and socioeconomic status explain the disparities in immunisation coverage. Conclusions In India, there are considerable inequalities in immunisation coverage among children. It is essential to ensure an improvement in immunisation coverage and to understand underlying factors that affect poor uptake and disparities in immunisation coverage in India in order to improve child health and survival and meet the SDGs.
