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Evaluating the impact of a community–based parent training programme for children with cerebral palsy in Ghana

ZUURMOND, Maria
et al
January 2017

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"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".

Malnutrition and disability: unexplored opportunities for collaboration

GROCE, Nora
CHALLENGER, E
BERMAN-BIELER, R
FARKAS, A
YILMAZ, N
SCHUTLINK, W
CLARK, D
KAPLAN, C
KERAC, M
2014

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There is increasing international interest in the links between malnutrition and disability: both are major global public health problems, both are key human rights concerns, and both are currently prominent within the global health agenda. In this review, interactions between the two fields are explored and it is argued that strengthening links would lead to important mutual benefits and synergies. At numerous points throughout the life-cycle, malnutrition can cause or contribute to an individual's physical, sensory, intellectual or mental health disability. By working more closely together, these problems can be transformed into opportunities: nutrition services and programmes for children and adults can act as entry points to address and, in some cases, avoid or mitigate disability; disability programmes can improve nutrition for the children and adults they serve. For this to happen, however, political commitment and resources are needed, as are better data.



Paediatrics and International Child Health
Volume 34, 2014 - Issue 4: Nutrition and malnutrition in low- and middle-income countries
https://doi.org/10.1179/2046905514Y.0000000156

The interaction of malnutrition and neurologic disability in Africa

KERAC, Marko
et al
March 2014

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Malnutrition and neurodisability are both major public health problems in Africa. This review highlights key areas where they interact. These areas of interaction include maternal malnutrition, toxin ingestion, macronutrient malnutrition and micronutrient deficiencies - all of which cause or are caused by neurodisability, The article concludes that there is an urgent need for nutrition and disability programmes to work more closely together

Seminars in Pediatric Neurology, Volume 21, Issue 1

Assessment of neurodisability and malnutrition in children in Africa

GLADSTONE, Melissa
MALLEWA, Mac
ALUSINE JALLOH, Alhaji
VOSJUIKL, Wieger
POSTELS, Douglas
GROCE, Nora
KERAC, Marco
MOLYNEUX, Elizabeth
March 2014

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Neurodevelopmental delay, neurodisability, and malnutrition interact to contribute a significant burden of disease in global settings. Assessments which are well integrated with plans of management or advice are most likely to improve outcomes. Assessment tools used in clinical research and programming to evaluate outcomes include developmental and cognitive tools that vary in complexity, sensitivity, and validity as well as the target age of assessment. Few tools have been used to measure socioemotional outcomes and fewer to assess the disabled child with malnutrition. There is a paucity of tools used clinically which actually provide families and professionals with advice to improve outcomes. Brain imaging, electroencephalography, audiology, and visual assessment can also be used to assess the effect of malnutrition on brain structure and function. The interaction of neurodisability and malnutrition is powerful, and both need to be considered when assessing children.

Seminars in Pediatric Neurology, Child Neurology in Africa, Volume 21, Issue 1, March 2014, Pages 50–57

Childhood disability and malnutrition in Turkana Kenya : a summary report for stakeholders and policy

KISIA, James
et al
2014

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This study aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.   The report is intended for stakeholders to inform policy

Research summary : childhood disability and malnutrition in Turkana Kenya

KISIA, James
et al
2014

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This report summarises a study that aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.  The report is intended for stakeholders to inform policy 

Stronger together : nutrition-disability links and synergies|Briefing note

GROCE, Nora
CHALLENGER, Eleanor
KERAC, Marko
2013

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Malnutrition can lead to disability, and disability can also lead to malnutrition. This paper will focus mainly on under-nutrition causing disability and disability causing or contributing to under-nutrition. Both nutrition and disability are key human rights issues. There is increasing knowledge about optimal nutrition-related practices and implementation of often low cost interventions to tackle issues of malnutrition in children. It is essential that governments, international actors and service providers consider and include the needs of children with disabilities in these efforts to ensure that children with disabilities have equitable access to nutrition in order to allow them to grow and thrive

IDDC sustainable development statement

INTERNATIONAL DISABILITY AND DEVELOPMENT CONSORTIUM (IDDC)
2012

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This paper highlights that the issues of disability, poverty and environmental sustainability are inextricably linked and provides key recommendations for disability-inclusive sustainable development discussions and framework

Policy brief : HIV, food security and nutrition : expanded version

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
May 2008

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This policy brief focuses on the interrelationship between food security, nutrition and HIV, and highlights the actions that governments, civil society and international partners can take to promote food security and nutrition in the context of the AIDS epidemic

Challenging assumptions : breastfeeding and HIV/AIDS

PROGRAM FOR APPROPRIATE TECHNOLOGY IN HEALTH (PATH)
March 2008

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This policy brief considers the risks of HIV transmission from mother to child through breastfeeding, and the benefits of breast milk in preventing child malnutrition and morbidity and mortality in the first two years of life

The Millennium Development Goals report 2008

UNITED NATIONS (UN)
2008

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This UN Report summarizes progress towards the Millennium Development Goals between 2000 and 2008, for the world as a whole and for various country groupings. It also considers factors that may affect future progress towards achieving the goals by 2015

The state of Asia-Pacific's children 2008 : child survival

COSSEY, Megan
2008

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This report complements UNICEF’s ‘State of the World’s Children 2008’. It provides an overview of child survival in the Asia-Pacific region, including progress towards the related Millennium Development Goals; causes of child deaths in the region; and creating a supportive environment for child survival strategies. It considers ways to improve child survival in the region, for example creating demand within a community; health financing and an equity approach to health-care provision; and strengthening data collection and monitoring

Infant and young child feeding in emergencies : making it happen, proceedings of a regional strategy workshop

EMERGENCY NUTRITION NETWORK (ENN)
et al
2008

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Young child feeding in emergencies is often poorly managed and supported, yet is a crucial component of an adequate emergency response and an important intervention to save lives and prevent malnutrition. This four day workshop aimed to reach consensus on how to protect and support Infant and young child Feeding in Emergencies (IFE) in the region. The particular focus was on emergency preparedness and the early humanitarian response on IFE

State of the world's mothers 2007 : saving the lives of children under 5

SAVE THE CHILDREN
2007

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This year’s State of the World’s Mothers report shows which countries are succeeding, and which are failing, to save the lives of mothers and children. It examines how investments in health care and nutrition can make a difference for children, mothers, communities and society as a whole. It also points to proven, low-cost solutions that could save the majority of these young lives

Community-based management of severe acute malnutrition : a joint statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund

WORLD HEALTH ORGANIZATION (WHO)
et al
2007

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This statement advocates a community-based approach to the management of severe malnutrition, combined with a facility-based approach for those malnourished children with medical complications. It outlines actions that countries can take and suggests how WHO, WFP, SCN, UNICEF and other partners can support these actions

Mainstreaming children into national poverty strategies : a child-focused analysis of the Ethiopian sustainable development and poverty reduction program (2002-05)

JONES, Nicola
et al
2005

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This paper assesses how the needs of children are incorporated in Ethiopia’s Poverty Reduction Strategy Paper (PRSP) - the Ethiopian Sustainable Development and Poverty Reduction Program 2002-05 (SDRDP) - and seeks to develop policy recommendations for the second PRSP, based on a comparative content analysis with other countries’ PRSPs

ProPAN: process for the promotion of child feeding

PAN AMERICAN HEALTH ORGANIZATION (PAHO)
April 2004

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This manual describes a step-by-step process, which begins with the quantitative identification of nutritional and dietary problems, and also with the collection of qualitative information on why these problems occur, and ends with the design of and evaluation plan for an intervention to address the problems identified. It is intended for Ministries of Health, non-governmental organisations, and bilateral and international organisations interested in improving infant and young child feeding (from birth to 24 months) to prevent early childhood malnutrition. It includes steps on how to collect, analyse, and integrate both quantitative and qualitative information, provides guidance on how to design an intervention, and reviews evaluation strategies

Guiding principles for feeding infants and young children during emergencies

WORLD HEALTH ORGANIZATION (WHO)
2004

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The guiding principles presented here are intended to serve as a starting point for organizing sustained pragmatic interventions that will ensure appropriate feeding and care for infants and young children at all stages of an organized emergency response. Responsible national authorities and concerned international and nongovernmental organizations are invited to use these guiding principles as a basis for training personnel responsible for emergency preparedness and response, and for reacting directly on behalf of needy populations during emergencies. Meeting the specific nutritional requirements of infants and young children, including promoting and supporting optimal feeding practices, should be a routine part of any emergency relief response. Indeed, it should be at the centre of efforts to protect the right of affected children to food, life and a productive life

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