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This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa.

The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis.

Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working.

Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working.

Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.

Child mortality has been a problem in developing countries for many years. This article summarizes the factors that were identified as contributing to the sustainability of a community‐based growth‐monitoring program for the prevention of child mortality in Honduras. The program used community volunteers to measure children's growth from birth until they reached two years of age. Honduras received support from the USAID to implement the program. The authors conducted an evaluation of the program that included responses from 32 health care workers, 45 weight monitors, 96 participating mothers and 32 non‐participating mothers. Individual, community, environmental and institutional factors that contribute to the sustainability of the program are summarized. The implications for program replication are discussed.

Health education that integrates community participation is essential for malaria control. However, children’s participation is not generally as active as that of adults, thus turning children into recipients, as opposed to partners in malaria control. The purpose of this paper is to develop a better understanding of how children can transform from mere recipients to active partners in malaria control efforts, by exploring the implementation of a school health education program in Uganda.

A qualitative multi-case study involving six schools where the health education program was implemented was undertaken, using six focus group discussions with 72 school children and respondent interviews with 14 teachers and district health promotion staff.

Children acted as health messengers, offered peer support and engaged in environmental management to minimize mosquito breeding. The benefits of the school malaria program included increasing access to malaria information, boosting malaria knowledge, improving children’s self-esteem and their skill as health educators. However, implementation was undermined by hostility from adults, inadequate time and tight school schedules, which should be addressed in future malaria programs.

The findings suggest that children can play an important role in malaria programs. Therefore, programs should be sufficiently structured to facilitate children’s participation. Practitioners should be encouraged to be conscious of the applicability of the health promoting school approach to malaria control.

This research facilitated a more comprehensive understanding of the role children can play in malaria control, thus providing a basis for their involvement in malaria programs. It also adds to a relatively scarce area of literature on the school health-malaria control nexus.

Each ethnic group has its own peculiar cultural practices that may widen inequalities in child health and survival among ethnic groups. This study estimated ethnic disparities in mortality of under‐five‐year‐olds, controlling for individual and community level characteristics. Using multilevel multivariable regression analysis on a nationally representative sample drawn from 7,864 households in the 2003 Nigeria Demographic and Health Survey, we estimated the risks of deaths under‐five‐year‐olds for 6,029 children nested within 2,735 mothers aged 15‐49 years old, who were in turn nested within 365 communities. Results were expressed as odds ratios with 95% confidence intervals. The observed risk of under‐five death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The mother's affiliation to the Yoruba ethnic group, compared to Hausa/Fulani/Kanuri, was still significantly associated with decreased under‐five mortality (OR = 0.66, 95% CI = 0.45 ‐ 0.96) after adjustment for individual and community level factors. Under‐five mortality was significantly related to socio‐economic and demographic factors (birth order/birth interval, mother's age, and mother's education), which explained much but not all of the ethnic disparities. Findings underscore the need for measures aimed at improving female education and the socio‐economic standard of women, changing short birth spacing norms and reducing inequitable distribution of maternal and child health services.

Children in majority world countries (MWC) have high rates of unmet mental health needs, with limited access to specialist resources. Integration of child mental health in existing psychosocial care can improve provision. Through a Train-the-Trainer (ToT) cascade approach, this study aimed to provide a framework for such integration in resource-constrained communities in Karachi, Pakistan and to establish hindering and enabling factors.

Eight practitioners attended a child mental health ToT program, including training on a five-domain service transformation framework. Trainers co-designed and implemented interventions that integrated child mental health knowledge and skills on each domain. These were attended by 136 end-users (youth, parents, teachers, managers), of whom a sub-sample of 47 stakeholders, as well as the trainers, attended focus groups on their experiences. Data were analysed through a thematic codebook.

Established themes reflected common ingredients across all domains/interventions that were deemed important for child mental health care integration. These included child-centric approaches, positive parenting, community mobilization and systemic changes.

Integrated child mental health care informed by the Train-of-Trainer approach can be a useful model for resource-constrained MWC contexts. Integrated interventions should be co-produced with communities.

The purpose of this qualitative case study was to explore perceptions of the impact of program participation on parenting styles and behavioral changes using observations and in-depth semi-structured interviews with Black and Coloured staff and mothers at a community-based organization (CBO) in the Western Cape Province (WCP) in South Africa (SA). Purposive sampling was utilized in this research via the CBO and narratives from a total of twenty-three (twelve mothers and eleven staff) interviews form the basis of this manuscript. Data was collected between January – February 2017 and was analyzed through the phenomenological and inductive thematic analysis approach. The staff interviews revealed that child abandonment and neglect and the abuse of women are the two main environmental contextual factors that impact program participation. According to staff, improved self-esteem and positive life changes were identified as successful outcomes of participant involvement. The parent interviews provided examples of emotional issues such as domestic abuse and personal issues with alcohol and drugs as individual factors that impact their program participation. Changes in parenting styles was identified as successful outcomes among parent participants. The goal of this study was to provide much-needed insight into this community by presenting a variety of voices, specifically Black and Coloured men and women, that are underreported in the literature. Findings from this research adds to the knowledge of community-based parenting programs (CBPPs) for low-income and underserved populations in SA and internationally.

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders, they did so from perspectives so different as to appear diametrically opposed. Service systems exist at multiple levels, including the practice, program, and system levels (Rosenblatt, 1988, 2005; Rosenblatt & Woodbridge, 2003). Research on health and mental health service systems similarly varies, often by level of the service system, with the research methods, independent and dependent variables, populations of interest, and ultimately the consumers of the research product interacting differentially in the creation and understanding of what constitutes a knowledge base for service delivery. Systems of care and, with limited exceptions, evidence-based practices exist at different levels of the service delivery structure, require and derive from different research approaches, and speak to overlapping but historically different audiences.

Community support is an integral aspect of health and well-being for Indigenous peoples. The purpose of this paper is to demonstrate the valuable role of community support for Indigenous women specifically, who experience reproductive health disparities at alarming rates. This study helps fill an important gap in Indigenous scholarship by centering the resilience of women and Indigenous tribes and by using a framework that is consistent with Indigenous holistic views of health.

The data for this paper was collected as part of a larger study exploring the reproductive health experiences of a state-recognized Gulf Coast tribe. A total of 31 semi-structured interviews were conducted with individuals who identify as women and as members of this tribe using qualitative descriptive methodology. This method is recommended for research with Indigenous communities. A community advisory board with representatives from this tribe provided feedback throughout the project.

Themes expressed by participants included Community Closeness and Support; Community Support in Raising Children; Informal Adoption Common; and Community Values of Mutual Aid and Self-Sufficiency. The findings support current literature noting the value of generational and communal ties for Indigenous peoples. Implications of this research include the need to value and support community networks in programs serving tribes, in addition to meaningfully including Indigenous communities in developing interventions.

This paper centers Indigenous women’s resilience, approaches the health and well-being of Indigenous tribes holistically and helps to fill an important gap in literature describing informal adoption (outside the legal system) in state-recognized Indigenous communities.

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.

This chapter aims to give an overview of key mental health policy and service provision, highlighting the need for specific attention to Black and minority ethnic children and young people. The focus is on mental health provision in the UK provided through the statutory sector and the voluntary and community sector, the issues raised are likely to have resonance across wider geographic locations. The themes examined include: the relevance of terminology regarding race and ethnicity and related impact on the planning and provision of services; the extent to which policy and commissioning of services give due focus and attention to the mental health of Black and minority ethnic children and young people; views young people themselves have contributed on the issue; and a case study illustrating work being undertaken to redress some of the imbalances encountered by young people in accessing appropriate support. The chapter argues that the supply chain to young people receiving support that is relevant and appropriate to their needs is a long and complex one. It is fundamental to take a holistic approach and consider how the components of this chain impact specifically on the mental health of children and young people from Black and minority ethnic communities.

Child and adolescent mental health services (CAMHS) – This term refers to all services that work with children and young people to address their behavioural and emotional wellbeing needs. The services may be provided by the National Health Service (NHS), local authority, school, private sector or charitable organisation and span early intervention support through to specialist treatment.

Care Quality Commission – The independent regulator of health and social care services in England.

Commissioning – The process by which health services are procured and should be based on an up-to-date assessment and understanding of needs of the target population.

Co-production – A process for planning and delivery of health and social care services that involves partnership working and power sharing between those responsible for the planning and provision of services, service users, their family members, carers and other citizens.

National Service Framework – Ten year programmes that, until the health and social care reforms started in 2010, defined standards of care in the NHS including measurable goals within set timeframes.

Population Needs Assessments – The collection and study of relevant data to understand and estimate current and future needs of a population in order to inform the planning of services that meet identified needs.

Voluntary and Community Sector – Also referred to as the Third Sector and encompassing a diverse range of organisations, services and groups that are seen as distinct from the public (also referred to as statutory) and private sectors.

Youth Information, Advice and Counselling Services (YIACS) – Most YIACS have charitable status and provide services to young people on a range of issues, a key feature associated with YIACS is the provision of holistic, young person centred support provided under one roof.