Report of the Inter Ministerial Group on ICDS Restructuring, September, 2011, it was said by the Member of Planning Commission Ms. Sayeda Hameed that Adopting a life cycle approach to early childhood care and development, Anganwadi would be transformed as vibrant, child friendly ECD centres which will ultimately be owned by the women in the community. The important difference in how things will be done differently after the restructuring is decentralisation, with flexibility in implementation, for ICDS to respond effectively to the needs of local communities-especially women and young children. Decentralisation centres on the leadership of Panchayati Raj Institutions and Urban Local Bodies, with effective devolution of powers. Women Panchayat members have strong potential to be prime movers of socialchange for young children. Panchayat are also the natural platform for ensuring convergence with other flagship programmes such as the National Rural Health Mission, Sarva Shiksha Abhiyan, Total Sanitation Campaign, National Drinking Water Programme and the Mahatma Gandhi National Rural Employment Guarantee Scheme. Increased mobilisation, ownership and support of women’s groups, mothers’ committees, volunteers and communities are integral to this paradigm shift in the implementation framework. Strengthened partnerships with civil society and voluntary agencies have also been envisaged’. Though ICDS initiated as a community based programme, gradually the social component of it, i.e. the community participation was reduced. And that eventually affected the schemes implementation.
An interview questionnaire is administered to parents when the child is 2–3 months and 15–18 months of age. Data collected in the interview questionnaire includes information on country of birth, length of residence in Sweden, length of education, employment status, type of income. In addition, parents answer questions on their self-rated health and health-related quality of life using the EQ-5D instrument , their social network and social support; their perception of being a parent, using a modified version of the Parental Self Efficacy instru- ment [21–23]. Parents also rate their child’s health; sleep and feeding issues. The second interview also asks about participation in public playschool and other activities. Other comments are also invited from interviewees at the end of the interview, and during the course of the interview as described above. Most of the interview questionnaires are administered in a standardized manner by the evaluator, which reduces interviewer bias. Many interviews are done with language interpreters.
Climate change will affect future health outcomes directly through extreme weather events such as heat waves, cold spells, and flooding impacting on the built infrastructure and social and institutional systems of health care provision, and indirectly due to induced changes in the volume and structure of demand for health care . Heat waves and cold spells can put systems of health care under pressure because of the mortality and morbidity increase for cardiovascular and respiratory diseases and associated increases in hospitali- sations . Floods in turn result in increased accidents and emergency visits. Climatic extremes can increase ambulance call out rates by 25–35%, which is compar- able to increases related to major flu epidemics . They also increase mental health problems and demand for services addressing them, and influence the length of time that support addressing them is needed . Direct impacts of extreme weather on health care systems include heat stress on inpatients and adverse health outcomes associated with heat stress discussed above, potential care and service disruptions because of power outages, delays in emergency responses and reduced ac- cess to health care because of the impacts of flooding and extreme weather on transport infrastructure and services, and reduced staffing and capacity for the same reasons in health care provision .
Social shifts are related with transitions in different domains of people living. Numerous nations have experienced great shifts throughout latest decades with consequences involving economic realignment, shifts in social value arrangements, the dispersed of media technology, and shifts in educational arrangements or inhabitants structures. Specified impacts of proximal social occurrences for instance German reintegration or fast societal shift for instance in China possibly determine the lifestyles of children, adolescents and adults via altering family dynamics, shifts in the experience to benefits and disadvantages for positive psychosocial advancement or weaker social command in neighbourhoods. Furthermore, trust in organizations, school, and family probably decrease. On one individual stage, dynamic adjustment to rearranged growth spheres and recent questions begins important (Weichold and Barber, 2009). Li and Xiao (2017) reported opinion polarization in a group is a pivotal occurrence in aggregate conduct that has begins growing regular after times of social transformation. Haferkamp and Smelser (1992) noted this is important to remark that the methods socialchange has been reported have diversified significantly in the history of thinking.
Neurodevelopmental disorder (NDD) is a term used to describe neurological and psychiatric disorders with onset in early childhood. NDD includes learning and language disorders, motor coordination disorders, intellectual disabilities, autism spectrum disorder (ASD), attention-de ﬁ cit/hyperactivity disorder (ADHD), tic dis- orders, and oppositional de ﬁ ant disorder (ODD). Comorbidities are common and include sleeping disorders, feeding problems, and various sensory processing pro- blems. A change of symptom/developmental pro ﬁ le may occur during the child- hood period 1 which is emphasized in the concept of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) coined by Gillberg. 1,2 All NDDs are included under the ESSENCE umbrella. At least one in ten of all children has a diagnosable NDD.
Although the alleviation of poverty, provision of education to the mothers, the change of value system about the child labour, the role of social workers, in mentally preparing the children as well as the parents, can’t solve the social and economic problems of these jockey children over night yet by implementing a careful short term as well as long term policy, we can solve this issue to a large extent. Moreover, it was observed that effective prevention requires family empowerment, basic education, capacity building, awareness raising and social mobilization. Rehabilitation measures should seek to offer different solutions and provide a comprehensive socio- economic package of services encompassing education, health and nutrition, social protection and shelter.
determinants frequently reported included maternal education, rural-urban disparities, family income and high dependency (Tables 1 and 2). Other determinants of health identified were maternal age at birth, birth interval, father ’ s participation in childcare, alcohol and drug use by parents, childcare practices, cultural beliefs, child malnutrition, nucleation as well as training of healthcare personnel. We observed that most of these factors rarely acted in isolation; they rather usually acted in combination. With regards to this, the determinants identified in 27 articles were clustered into multiple interacting factors. Studies reporting on these aspects were published between 1988 and 2015. Twenty of these studies analysed data from nationally-rep- resentative samples, with the remaining examining data from various regions of the country, namely Eastern (2 studies), Northern (2 studies), Ashanti (3 studies), Greater Accra (2 studies), Volta (1 study), Central (1 study) and Upper East (1 study) regions. Additionally, one study was conducted among participants in the Volta and Eastern regions while another was done in the Ashanti and Eastern regions. The rest examined government policies. An intriguing aspect of the social determinants reported is that they appeared to be important for almost every dis- ease studied. The health conditions associated with these factors included infant or child mor- tality, nutritional status of children, seeking treatment after burns, completion of
Pediatricians also have a responsibility to address the inverse care law as it applies to research. The weight of funding and interest in research is concen- trated on rare conditions and their cure, while the social determinants of health, a major cause of ill health, receive limited research funding or attention. In conducting sociomedical research, we should bear in mind that social factors exert their effects through complex pathways. The “single cause” fetishism that arises from the germ theory of disease is inadequate to explain many of the adverse health outcomes as- sociated with social inequality. Childhealth research must pay more attention to socioeconomic status and improve the measures used to study its effects.
offered; incorporating health literacy– related skills into standard kindergar- ten through 12th grade curricula; and funding effective adult literacy and English-as-a-second-language (ESL) programs for those with limited En- glish proﬁciency (LEP). Researchers, educators, and policy makers must identify which health literacy skills can be taught through the educational system and look for evidence-based strategies to implement effective cur- ricula. Efforts should address the de- velopmental continuum through pre- school curricula that reinforce health promotion activities among toddlers and their caregivers, and standardize kindergarten through 12th grade cur- ricula to teach health literacy compe- tencies across all educational disci- plines (eg, science, mathematics, reading, social studies, health, and phys- ical education). Adult-education modules that teach health literacy skills should be used in general educational develop- ment (GED) and English-as-a-second- language curricula. Health literacy activ- ities can be integrated into after-school, camp, home-visiting and community- based parenting programs.
Low birth weight (LBW) is the most important risk factor for death in infancy and early childhood, with long-term consequences on mortality and ill health into adult life. The incidence of LBW is around 15.5% glob- ally (ie, more than 20 million infants worldwide), 16.5% in LMICs and up to 27% in South-East Asia, while it is around 6% in Western Europe. Estimates of preterm births vary around an average of 11.3% of all births (up to 18% in some African countries), corresponding to approximately 13 million/year. Out of these, at least 10.9 million are born in Africa or Asia.
The actions of individual nations have repercussions for children living far beyond their borders. Just as contaminants in imported foods and medications pose hazards to children in the United States, our carbon emissions contribute to growing rates of asthma and to global climate change, endangering the health and wellbeing of children worldwide. Intentional or not, we are responsible for the consequences.
The childhood years are marked by the lowest rate of mortality of any period in life. Most childhood illness is acute, and much is self-limited. This is a time of growth, change, and development. From the childhealth perspective, this is a time for disease prevention, with an emphasis on immunizations, screenings, safety, anticipatory guidance, and nutri- tion instruction. By far, the leading cause of death in this period is unintentional injury. Recognition of this pattern has led to legislative initiatives and en- hanced efforts at public awareness campaigns, as well as reinforcement of safety messages by pedia- tricians as part of their well child care routine visits. Childhood also is marked by the beginnings of mental health concerns such as behavior problems and school dysfunction. Pediatricians find them- selves confronted with morbidity related to social interaction and educational needs for at least 15% to 20% of the children they care for. 11
George Black CBE is a Visiting Professor at the International Public Policy Institute (IPPI) at the University of Strathclyde. From 2003 – 2014, he was Chief Executive of Glasgow City Council and as such, the principal policy advisor to the Council on a wide range of public services, including Education, Social Work and Economic Development. During his tenure, George Black completed the Glasgow City Deal with the UK and Scottish Governments, Glasgow City Council and several other Councils in the Clyde Valley, to create £1.13billion in capital infrastructure for the city. He also co-Chaired the Commonwealth Games Executive Committee for the highly successful Glasgow Commonwealth Games 2014. Prior to his role as CEO, George was Director of Finance at Glasgow City Council and has held senior financial roles in national and international organisations.
This study employed a mixed methods approach, analysing both quantitative and qualitative data, and thereby capita- lising on the benefits of both methods. Using a matched comparison group clarified differences between the CHS documentation for children in family foster care and those not. Investigating the CHS professionals’ documentation provided valuable information, as it exposed the routines and possible attitudes of a professional group that has both the opportunity and the obligation to make a difference when children are in vulnerable positions. It might be con- sidered a limitation that only one of the authors coded the data. However, the coding process was continuously dis- cussed and negotiated between the first and the last author. A number of study subjects were lost as an up-to-date could not be found and some parents refused to consent. In addition, some health records could not be found, prob- ably because of the children moving frequently and a defi- cient archiving system. The fairly high number of records lost due to lack of consent implies a potential selection bias. These records probably represented children with worse living conditions, with more parental problems and frequent moves. If they had been included this would prob- ably have resulted in even bigger differences between the two groups. The missing health records also demonstrated the known problems in carrying out studies of vulnerable groups of children. Furthermore, this study included a
multidimensional construct that assesses the impact of health on a number of dimensions, including physical functioning, social functioning, psychological functioning, overall life satisfaction/well-being, and perceptions of health status (Naughton & Shumaker, 2003; Testa & Simonson, 1996). The construct is patient centered in that it captures the individual’s perceptions about physical health status and psychosocial functioning, as well as level of enjoyment or social satisfaction (Eiser & Morse, 2001; Palermo et al., 2008). In a study of 5- to 18-year-olds with obesity, results indicated that youth had low health-related quality of life similar to that of children diagnosed with cancer and well below the health-related quality of life for children of a healthy weight (Schwimmer et al., 2003). This finding has been supported in other studies of pediatric clinical samples (children seeking obesity-related treatment or evaluation), in which health-related quality of life impairments were found globally and also across a number of specific domains (Janicke et al., 2007; Schwimmer et al., 2003; Zeller et al., 2006). Thus, health- related quality of life is a potentially important variable to consider when examining readiness to change in pediatric patients with obesity and in their parents. If this construct parallels severity of negative consequences in substance abuse, it suggests that more impairment in health-related quality of life will be related to higher levels of readiness to change in children and parents.
health outcomes. These analyses were intended to iden- tify combinations of risk factors were particularly likely to increase risk. Several observations could be made from these analyses. First, every social disadvantage, alone or in combination, significantly increased risk over having none of these social disadvantages. Second, most of the time, adding the social disadvantages together increased risk for poor health on all 3 outcomes. Third, in general, all the 1-risk only combinations were less risky than all 2-risk combinations, which were less risky than combining all 3 risks with 1 exception: low educa- tion was an inconsistent risk factor. Sometimes, it added significantly to risk and sometimes it did not. Poverty was a particularly potent risk factor for overall health; most combinations that included poverty status had much higher ORs than those not including it. In con- trast, for both chronic condition and activity limitation, single parent proved a particularly potent disadvantage; combinations of social disadvantage that included this factor tended to be higher than those not including it. It should be noted that some combinations of social disad- vantage are statistically rare (eg, poor college-educated 2-parent families; nonpoor single parent low education) and that estimates for these combinations may be un- stable. Overall, however, it was clear that no specific combination of social disadvantage was especially re- lated to childhealth indicators.