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UNICEF Innocenti's complete catalogue of international peer reviewed journals

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11 - 20 of 106
The evolving picture of SARS-CoV-2 and COVID-19 in children: critical knowledge gaps

AUTHOR(S)
Priscilla Idele, David Anthony

Published: 2020

  • The initial impression that paediatric infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children across countries and by income group, with recognition of a widening disease spectrum.
  • Critical knowledge gaps remain that have significant public policy and programme implications.
  • Insufficient age and race/ethnicity disaggregated data are hindering efforts to assess fully the prevalence of SARS-CoV-2 infection and COVID-19 in children and the role of children in transmission.
  • Potential biologic differences in susceptibility to infection and transmissibility between children and adults need to be explored.
  • Determination of mother-to-child SARS-CoV-2 transmission requires appropriate samples obtained with proper timing, lacking in most studies.
  • Predictors of disease progression and morbidity and mortality in children need to be determined, particularly as the pandemic moves to low-income and middle-income countries.
  • The full spectrum of SARS-CoV-2 infection in children remains to be defined, and surveillance for and investigation of the pathogenesis of postinfectious sequelae, such as multisystem inflammatory syndrome, are vital.

Uptake of HIV testing among adolescents and associated adolescent-friendly services

AUTHOR(S)
Jennifer Waidler, Rachel Kidman, Tia Palermo

Published: 2020

HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents’ uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services.

Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p < 0.1) and SRH visits (RR = 1.44, p < 0.05). Less than half (44%) offered services for survivors of gender-based violence (GBV), a significant predictor of past-year HIV testing (RR = 1.20, p < 0.05) and SRH visits (RR = 1.41, p < 0.01) among sexuallyactive adolescents.

We find that national guidelines on AFHS have not been fully translated into practice at the local level. We highlight particular gaps in adolescent referral systems and GBV services. Scaling up these two essential services could encourage greater HIV testing among a high-risk population, in addition to providing much needed support for survivors of violence.

Measurement of Multidimensional Child Poverty

AUTHOR(S)
Alessandro Carraro, Lucia Ferrone

Published: 2020

Multidimensional child poverty defines children who experience a state of poverty that is more complex than that defined by a unidimensional measure of poverty, but encompasses child material needs and human rights, in a holistic way.

The definition of child poverty agreed by the UN General Assembly was used by Gordon, Townsend, and their colleagues from the University of Bristol for their study on child poverty in the developing world (Gordon et al. ). It gives full weight to material deprivation as the main element of child poverty, stating that children living in poverty are deprived in multiple domains of their lives (i.e., nutrition, water and sanitation, education, shelter, and protection among others) and that the lack of goods and access to services can represent a severe threat for their growth and development (United Nations General Assembly ).

Multidimensional child poverty encompasses the various deprivations experienced by children in their daily lives....

Contextualising the link between adolescents’ use of digital technology and their mental health: a multi‐country study of time spent online and life satisfaction

AUTHOR(S)
Daniel Kardefelt Winther, Gwyther Rees, Sonia Livingstone

Published: 2020

Evidence on whether the amount of time children spend online affects their mental health is mixed. There may be both benefits and risks. Yet, almost all published research on this topic is from high‐income countries. This paper presents new findings across four countries of varying wealth.

We analyse data gathered through the Global Kids Online project from nationally representative samples of Internet‐using children aged 9 to 17 years in Bulgaria (n  = 1,000), Chile (n  = 1,000), Ghana (n  = 2,060) and the Philippines (n  = 1,873). Data was gathered on Internet usage on week and weekend days. Measures of absolute (comparable across countries) and relative (compared to other children within countries) time use were constructed. Mental health was measured by Cantril’s ladder (life satisfaction). The analysis also considers the relative explanatory power on variations in mental health of children’s relationships with family and friends. Analysis controlled for age, gender and family socioeconomic status.

In Bulgaria and Chile, higher‐frequency Internet use is weakly associated with lower life satisfaction. In Ghana and the Philippines, no such pattern was observed. There was no evidence that the relationship between frequency of Internet use and life satisfaction differed by gender. In all four countries, the quality of children’s close relationships showed a much stronger relationship with their life satisfaction than did time spent on the Internet.

Time spent on the Internet does not appear to be strongly linked to children’s life satisfaction, and results from one country should not be assumed to transfer to another. Improving the quality of children’s close relationships offers a more fruitful area for intervention than restricting their time online. Future research could consider a wider range of countries and links between the nature, rather than quantity, of Internet usage and mental health.

Disclosure, reporting and help seeking among child survivors of violence: a cross-country analysis

AUTHOR(S)
Audrey Pereira, Amber Peterman, Anastasia Naomi Neijhoft, Alina Potts, Mary Catherine Maternowska

Published: 2020

Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence.

Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13–17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels.

The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services.

Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.

Pandemics and Violence Against Women and Children

AUTHOR(S)
Amber Peterman, Alina Potts, Megan O'Donnell, Kelly Thompson, Niyati Shah, Sabine Oertelt-Prigione, Nicole van Geltert

Published: 2020
Times of economic uncertainty, civil unrest and disaster are linked to a myriad of risk factors for increased violence against women and children (VAW/C). Pandemics are no exception. In fact, the regional or global nature and associated fear and uncertainty associated with pandemics provide an enabling environment that may exacerbate or spark diverse forms of violence. Understanding mechanisms underlying these dynamics are important for crafting policy and program responses to mitigate adverse effects. Based on existing published and grey literature, we document nine main (direct and indirect) pathways linking pandemics and VAW/C, through effects of (on):(1) economic insecurity and poverty-related stress, (2) quarantines and social isolation, (3) disaster and conflict-related unrest and instability, (4) exposure to exploitative relationships due to changing demographics, (5) reduced health service availability and access to first responders, (6) inability of women to temporarily escape abusive partners, (7) virus-specific sources of violence, (8) exposure to violence and coercion in response efforts, and (9) violence perpetrated against health care workers. We also suggest additional pathways with limited or anecdotal evidence likely to effect smaller sub-groups. Based on these mechanisms, we suggest eight policy and program responses for action by governments, civil society, international and community-based organizations. Finally, as research linking pandemics directly to diverse forms of VAW/C is scarce, we lay out a research agenda comprising three main streams, to better (1) understand the magnitude of the problem, (2) elucidate mechanisms and linkages with other social and economic factors and (3) inform intervention and response options. We hope this paper can be used by researchers, practitioners, and policymakers to help inform further evidence generation and policy action while situating VAW/C within the broader need for intersectional gender- and feminist-informed pandemic response.
COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence

AUTHOR(S)
N. van Gelder, Amber Peterman, Alina Potts

Published: 2020
The ongoing pandemic caused by SARS-CoV-2, the causal agent of the acute respiratory distress syndrome COVID-19, is placing unprecedented stress on healthcare systems and societies as a whole. The rapid spread of the virus in the absence of targeted therapies or a vaccine, is forcing countries to respond with strong preventative measures ranging from mitigation to containment. In extreme cases, quarantines are being imposed, limiting mobility to varying degrees.
While quarantines are an effective measure of infection control, they can lead to significant social, economic and psychological consequences. Social distancing fosters isolation; exposes personal and collective vulnerabilities while limiting accessible and familiar support options. The inability to work has immediate economic repercussions and deprives many individuals of essential livelihoods and health care benefits. Psychological consequences may range from stress, frustration and anger to severe depression and post-traumatic stress disorder (PTSD). A recent review drawing on lessons from past pandemics shows the length of quarantine increases the risk for serious psychological consequences.

Beyond internal validity: Towards a broader understanding of credibility in development policy research

AUTHOR(S)
Gustavo Angeles, Sudhanshu Handa, Amber Peterman, et al...

Published: 2020
We provide evidence from the Transfer Project to show that methodological design is only one factor in determining credibility in the eyes of policymakers. Policymakers understand concerns around internal validity, but also value collaborative research engagement, which builds trust, allows co-creation of research questions, informs operations throughout the evaluation period and leverages national research expertise. Further, the mere act of engaging in a large-scale, transparent impact evaluation, across quasi- and experimental designs can change the culture of decision-making within an agency, leading to better policy choices in the long run. We advocate for a more inclusive approach to policy research that begins with identifying the most relevant research question and fitting the methods to the question rather than vice-versa. We challenge the field to engage more closely with policymakers to identify their evidence needs in order to prioritize the end objective of improving the lives of the poor—regardless of methodological design choices.
Can conditional cash transfers improve maternal health care? Evidence from El Salvador's Comunidades Solidarias Rurales program

AUTHOR(S)
de Brauw Alan, Amber Peterman

Published: 2020
There is growing evidence on positive human capital impacts of large, poverty‐focused cash transfer programs. However, evidence is inconclusive on whether cash transfer programs affect maternal health outcomes, and if so, through which pathways. We use a regression discontinuity design with an implicit threshold to evaluate the impact of Comunidades Solidarias Rurales in El Salvador on four maternal health service utilization outcomes: (a) prenatal care; (b) skilled attendance at birth; (c) birth in health facilities; and (d) postnatal care. We find robust impacts on outcomes at the time of birth but not on prenatal and postnatal care. In addition to income effects, supply‐side health service improvements and gains in women's agency may have played a role in realizing these gains. With growing inequalities in maternal health outcomes globally, results contribute to an understanding of how financial incentives can address health systems and financial barriers that prevent poor women from seeking and receiving care at critical periods for both maternal and infant health.
More evidence on the relationship between cash transfers and child height

AUTHOR(S)
Averi Chakrabarti, Sudhanshu Handa, Luisa Natali, David Seidenfeld, Gelson Tembo

Published: 2020
We examine the effect of the Zambia Child Grant Programme – an unconditional cash transfer (CT) targeted to rural households with children under age five – on height-for-age up to four years after programme initiation. The CT scheme had large positive effects on nutritional inputs like food expenditure and meal frequency, but no impact on child height-for-age. Production function estimates indicate that food carries little weight in the production of child height in the study sample. In settings with poor health infrastructure and harsh disease environments, a stand-alone CT is unlikely to address long-term chronic malnutrition unless accompanied by complementary interventions.
11 - 20 of 106