The Impact of Interventions Targeting Caregivers, Health Workers and the Community to Alter Vaccine Behaviours and Childhood Vaccination Uptake: A Rapid evidence assessment protocol

The Impact of Interventions Targeting Caregivers, Health Workers and the Community to Alter Vaccine Behaviours and Childhood Vaccination Uptake: A Rapid evidence assessment protocol

AUTHOR(S)
John O'Rourke; Andrea Yearwood; Greg Sheaf; Sergiu Tomsa; Viviane Bianco; Mario Mosquera; Shivit Bakrania; Benjamin Hickler

Published: 2022 Innocenti Working Papers

Vaccination is one of the most effective measures for preventing illness, disability and death. In Europe and Central Asia, routine immunization rates vary between countries and over time. Behavioural determinants of vaccine hesitancy in the region include diminished trust among caregivers and health professionals; knowledge and awareness of vaccination; perceptions of risk; and health professionals’ skills, knowledge and attitudes.

This rapid evidence assessment aims to summarize the impact of interventions targeting caregivers, healthcare workers and the community to improve intention and motivation to vaccinate and vaccination rates of children under 5 years old. The evidence will inform policy and programmatic recommendations.

The Evolving Epidemiologic and Clinical Picture of SARS-CoV-2 and COVID-19 Disease in Children and Young People

The Evolving Epidemiologic and Clinical Picture of SARS-CoV-2 and COVID-19 Disease in Children and Young People

AUTHOR(S)
Priscilla Idele; David Anthony; Lynne M Mofenson; Jennifer Requejo; Danzhen You; Chewe Luo; Stefan Peterson

Published: 2020 Innocenti Working Papers

The initial impression that paediatric SARS-CoV-2 infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children and adolescents across low-, middle-, and high-income countries, with recognition of a widening disease spectrum. Critical knowledge gaps, especially in low- and middle-income countries, remain that have significant public policy and programme implications. Insufficient data disaggregated by age, geography and race/ethnicity continue to hinder efforts to fully assess prevalence of infection and disease manifestations in children and adolescents and their role in transmission. Potential biologic differences in susceptibility to infection and transmissibility between children, adolescents and adults need to be assessed. Determination of mother-to-child SARS-CoV-2 transmission during pregnancy, the peripartum period, or through breastfeeding requires appropriate samples obtained with proper timing, lacking in most studies. Finally, predictors of disease progression, morbidity and mortality in children need to be determined and whether these predictors vary by geographic location and in settings where poor nutritional and health conditions and other vulnerabilities are more frequent. Countries, UN agencies, public health communities, donors and academia need to coordinate the efforts and work collectively to close the data and knowledge gaps in all countries (high-, middle- and low-income) for better evidence to guide policy and programme decision-making for children and COVID-19 disease.

Cite this publication | No. of pages: 62 | Thematic area: Health
Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries

Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries

AUTHOR(S)
Anna Gromada; Gwyther Rees; Yekaterina Chzhen

Published: 2020 Innocenti Report Card

A new look at children from the world’s richest countries offers a mixed picture of their health, skills and happiness. For far too many, issues such as poverty, exclusion and pollution threaten their mental well-being, physical health and opportunities to develop skills. Even countries with good social, economic and environmental conditions are a long way from meeting the targets set in the 2030 Agenda for Sustainable Development. Focused and accelerated action is needed if these goals are to be met.

The evidence from 41 Organisation for Economic Co-operation and Development (OECD) and European Union (EU) countries tells its own story: from children’s chances of survival, growth and protection, to whether they are learning and feel listened to, to whether their parents have the support and resources to give their children the best chance for a healthy, happy childhood. This report reveals children’s experiences against the backdrop of their country’s policies and social, educational, economic and environmental contexts.

Does COVID-19 Affect the Health of Children and Young People More Than We Thought? The case for disaggregated data to inform action

Does COVID-19 Affect the Health of Children and Young People More Than We Thought? The case for disaggregated data to inform action

AUTHOR(S)
Priscilla Idele; David Anthony; Kaku Attah Damoah; Danzhen You

Published: 2020 Innocenti Research Briefs

Contrary to the current narrative, the risks of COVID-19 disease in children and young people depend largely on where individuals live and how vulnerable they are to disease and ill health.

It is commonly accepted, at least for now, that children and young people under 20 years of age have largely been spared the direct epidemiological effects on their own health and survival of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for COVID-19 disease. This narrative is based predominantly on early data from the countries first affected by the virus, notably China (Wuhan province) and Italy in early 2020, and also from other high-income countries (HICs) including the United States and some European nations. This narrative has conditioned the subsequent screening and testing for SARS-CoV-2 virus in children and young people under 20, which have been notably lower than for other age cohorts in many, but not all, countries. But demographic profiles differ widely between countries, and assumptions and narratives based on evidence taken from ageing societies, typical of HICs, may not hold for more youthful and growing populations, as illustrated by the contrast between the age-cohort profiles of COVID-19 cases for Italy and Kenya. For this reason, and given that the vast majority of the world’s children and young people live in low- and middle-income countries (LMICs) and territories, we began to investigate the burden of COVID-19 cases among children and young people under 20 globally.

Cite this publication | Thematic area: Health
Adolescents’ Mental Health: Out of the shadows. Evidence on psychological well-being of 11-15-year-olds from 31 industrialized countries

Adolescents’ Mental Health: Out of the shadows. Evidence on psychological well-being of 11-15-year-olds from 31 industrialized countries

AUTHOR(S)
Zlata Bruckauf

Published: 2017 Innocenti Research Briefs

Mental health is increasingly gaining the spotlight in the media and public discourse of industrialized countries. The problem is not new, but thanks to more open discussions and fading stigma, it is emerging as one of the most critical concerns of public health today. Psychological problems among children and adolescents can be wide-ranging and may include attention deficit hyperactivity disorder (ADHD), disruptive conduct, anxiety, eating and mood disorders and other mental illnesses. Consistent evidence shows the links between adolescents’ mental health and the experience of bullying. Collecting internationally comparable data to measure mental health problems among children and adolescents will provide important evidence and stimulate governments to improve psychological support and services to vulnerable children.

Child Malnutrition, Consumption Growth, Maternal Care and Price Shocks: New Evidence from Northern Ghana

Child Malnutrition, Consumption Growth, Maternal Care and Price Shocks: New Evidence from Northern Ghana

AUTHOR(S)
Richard de Groot; Sudhanshu Handa; Luigi Peter Ragno; Tayllor Spadafora

Published: 2017 Innocenti Working Papers

Childhood malnutrition remains a significant global health concern. In order to implement effective policies to address the issue, it is crucial to first understand the mechanisms underlying malnutrition. This paper uses a unique dataset from Northern Ghana to explain the underlying causes of childhood malnutrition. It adopts an empirical framework to model inputs in the production of health and nutrition, as a function of child, household and community characteristics. The findings suggest that child characteristics are important in explaining inputs and nutritional outcomes, and that maternal agency and health contribute to improved health status. Household resources in the form of consumption are positively associated with food intake and nutritional outcomes. Simulations show that income growth, improving maternal care and avoiding sudden price shocks have a positive but rather limited effect on the reduction of malnutrition. Effects are greater in children under two. Hence, policies that address underlying determinants simultaneously, and target the youngest population of children, could have the largest effect on reducing malnutrition in this population.

The Impact of Cash Transfers on Food Security

The Impact of Cash Transfers on Food Security

AUTHOR(S)
Lisa Hjelm

Published: 2016 Innocenti Research Briefs

Vulnerable populations in sub-Saharan African countries often face high levels of food insecurity which disproportionately affect households living in poverty and children are particularly at risk. This review of eight social cash transfer programme evaluations has shown that cash transfers have an impact on several different dimensions of food security. However, few evaluations include child-specific questions and to make stronger links between food security and nutrition status individual-level indicators are needed. Despite limitations, there is good evidence that cash transfers have a large impact on food security.

Early-life Exposure to Income Inequality and Adolescent Health and Well-being: Evidence from the Health Behaviour in School-aged Children Study

Early-life Exposure to Income Inequality and Adolescent Health and Well-being: Evidence from the Health Behaviour in School-aged Children Study

AUTHOR(S)
Frank J. Elgar; Candace Currie

Published: 2016 Innocenti Working Papers

Children and adolescents living in relative poverty – regardless of overall material conditions – tend to experience more interpersonal violence, family turmoil, and environmental hazards that increase risk of injury, engage in more health compromising behaviours (e.g., physical inactivity, poor nutrition, smoking), report lower subjective well-being, and exhibit more social skills deficits and emotional and behavioural problems.

Why Income Inequalities Matter for Young People’s Health: A look at the evidence

Why Income Inequalities Matter for Young People’s Health: A look at the evidence

AUTHOR(S)
Aixa Y. Alemán-Díaz; Emilia Toczydlowska; Joanna Mazur; Diana Frasquilho; Marina Melkumova; Goran Holmqvist

Published: 2016 Innocenti Working Papers

Although child and adolescent inequalities are still less understood than those of adults, we have made progress in understanding the pathways that lead to negative outcomes and the limitations of some ‘adult-specific’ indicators as proxies of young people’s health and well-being. Nonetheless, the academic literature has been able to establish a clear negative relationship between a person’s material circumstances and their health outcomes and behaviours such as being overweight, lack of physical activity, higher levels of smoking and mental health problems, all of which persist throughout a person’s life. The personal and societal toll of these effects is clear, yet policies are still lagging behind, tackling proximal causes rather than ‘the causes of the causes’ of these health inequalities. This paper aims to summarise relevant knowledge on the socio-economic causes of health inequalities in children. It will not only provide a foundation to the Innocenti Report Card 13 in terms of outlining our knowledge regarding the drivers of health inequality but it will also help us shed light on its consequences.

Cite this publication | No. of pages: 24 | Thematic area: Adolescents, Health | Tags: adolescent health, income, inequality
Inequalities in Adolescent Health and Life Satisfaction: Evidence from the Health Behaviour in School-aged Children study

Inequalities in Adolescent Health and Life Satisfaction: Evidence from the Health Behaviour in School-aged Children study

AUTHOR(S)
Yekaterina Chzhen; Zlata Bruckauf; Kwok Ng; Daria Pavlova; Torbjorn Torsheim; Margarida Gaspar de Matos

Published: 2016 Innocenti Working Papers

International studies of inequalities in adolescent health tend to focus on the socio-economic gradient in average outcomes rather than their dispersion within countries. Although understanding the extent to which differences in health are related to socio-economic disadvantage is important, focusing exclusively on socio-economic status risks neglecting differences in the distribution of health outcomes within and between countries. To fill this research gap, this study analyses variation in the extent of inequality in the lower half of the distribution in five indicators of adolescent health and well-being – health symptoms, physical activity, healthy eating, unhealthy eating, and life satisfaction – across EU and/or OECD countries that took part in the latest cycle of the Health Behaviour in School-aged Children study.

Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014

Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014

AUTHOR(S)
Yekaterina Chzhen; Irene Moor; William Pickett; Emilia Toczydlowska; Gonneke Stevens

Published: 2016 Innocenti Working Papers

A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.

Poverty and Children’s Cognitive Trajectories: Evidence from the United Kingdom Millennium Cohort Study

Poverty and Children’s Cognitive Trajectories: Evidence from the United Kingdom Millennium Cohort Study

AUTHOR(S)
Zlata Bruckauf; Yekaterina Chzhen

Published: 2016 Innocenti Working Papers

Existing evidence is inconclusive on whether a socio-economic gradient in children’s cognitive ability widens, narrows or remains stable over time and there is little research on the extent of ‘cognitive mobility’ of children who had a poor start in life compared to their peers. Using data from five sweeps of the United Kingdom (UK) Millennium Cohort Study (MCS) at the ages of 9 months, 3 years, 5 years, 7 years and 11 years, this paper explores the cognitive ability trajectory of children in the bottom decile of the distribution at a given age, and the factors that drive or hinder their progress relative to their peers. The paper analyses children’s risks of moving in and out of the bottom decile of the cognitive ability distribution. The findings indicate a relatively high level of cognitive mobility between ages 3 and 11, especially in the pre-school period (between ages 3 and 5), with children from income-poor households more likely to get ‘trapped’ in the bottom of the age-specific cognitive ability distribution.

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