Health and indigenous cultures: young children

Health and indigenous cultures programmes in the context of early childhood development are mostly based around the prevention of maternal and infant mortality, birthing practices, nutrition and inclusion of young children with special needs. Some initiatives build the case for combining traditional knowledge with modern technology: for example, involving traditional birth attendants as cultural mediators between traditional practices and modern obstetrical technology. In terms of exploring the current situation of health within indigenous populations as opposed to the population of a country as a whole, health equity initiatives show disparities. Equity in health is defined as 'the absence of systematic and potentially remediable differences in one or more aspects of health across populations or population subgroups defined socially, economically, demographically or geographically'. This key list includes a variety of case studies and tools that can support programmes in these areas.

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Selected resources

Books, reports, etc

1990 - 2005 Celebrating the Innocenti declaration on the protection, promotion and support of breastfeeding


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In 1990, the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding set an international agenda on breastfeeding and the recognition ofthe right of the infant to nutritious food enshrined in the Convention on the Rights of the Child. This publication reviews the context of the Innocenti Declaration and analyzes the achievements that have been realized towards the targets that were established in 1990. It describes the continuing and new challenges that exist to optimal feeding of infants and young children, and suggests a way forward towards the global aim of ensuring universal enjoyment of children’s right to adequate nutrition.

Child survival in sub-Saharan Africa : taking stock


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This paper presents the findings and recommendations of research, funded by USAID, to understand better the growing gap between Africa and the rest of the world in achieving the UN Millennium Development Goals that relate to child health. It aims to provide an analysis of child health trends in order to identify how USAID could improve its contribution to improving child health in Africa

Counting on communication : the Uganda Nutrition and Early Childhood Development Project

VERZOSA, Cecilia
April 2005

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This publication presents the activities and lessons learned from a project which sought to halve malnutrition among preschool children, raise primary school enrollment, reduce dropout and repetition rates, improve psycho-social and cognitive development, and increase the number of mothers practicing appropriate childcare. A strategic communication programme was designed to help mothers and other caregivers adopt new behaviours needed to achieve project outcomes. It helped the project team identify necessary changes in behaviour, knowledge or attitude for all target audiences; frame project-related issues relevant to different stakeholders, such as parliamentarians, mothers, community leaders, educators, and local government administrators; craft persuasive messages according to their needs, concerns and perceptions; and use the most appropriate communication channels. The communication strategy included a: national advocacy effort aimed at parliamentarians, health and education ministry officials, district and community leaders; multi-media campaign that emphasized three behaviour change interventions; training programme for health workers and pre-school teachers on their role; and monitoring and evaluation component to ensure that materials were disseminated via cost-effective channels of communication and that messages reached target audiences. Lessons learned emphasize the value of developing a comprehensive communication strategy during project design.

Inclusive early childhood care and development: a fair start for all children

EVANS, Judith

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The Co-ordinators' Notebook, published by The Consultative Group on Early Childhood Care and Development, provides a synthesis of the most recent information on topics of interest to people concerned about the well-being of young children and their families. This issue focuses on inclusive early childhood care and development (ECCD) for children with special needs. It cateogorises these children into 3 different groups: (i) established risk -- those that are born 'differently-abled', (ii) biological risk -- those that have a physical problem at birth that can be remediated (eg low-birth weight babies) and (iii) environmental risk -- those that develop special needs because their environment does them harm (eg children living in poverty or from ethnic minorities that do not receive the same services available to other children in the country). The report offers a brief history of those who are differently-ables, then defines principles of programming for inclusive ECCD programmes, and finally looks at the next steps

Progress for children : a report card on maternal mortality, number 7

September 2008

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This report describes global and regional progress in reducing maternal mortality and provides the latest statistics on Millennium Development Goal (MDG) 5 indicators for 192 countries and territories. Globally, the maternal mortality ratio declined from 430 deaths per 100,000 live births in 1990 to 400 in 2005, with significant regional disparities. The report examines differences in progress between regions and within regions and describes lifetime risk by region and country. Reductions in maternal mortality have come far too slowly, particularly in those regions where the problem is most acute (such as sub-Saharan Africa). Current progress is not sufficient to achieve the MDG target of reducing the maternal mortality ratio by three quarters between 1990 and 2015. This lack of progress has an enormous impact on children

Reducing maternal mortality : experience of the Iganga district in Uganda


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The World Bank has an Indigenous Knowledge Programme. It is a gateway to development approaches that rely on traditional knowledge systems to help achieve the millenium development goals. One of the activities within this programme is a cross regional, peer-to-peer learning exchange aimed at enhancing local capacity to identify and apply indigenous/traditional knowledge and practices. Outcomes from this activity include toolkits based on a particular project that outlines the lessons learned in CD-ROM and web based format. One toolkit is based on a project in the Iganga district in Uganda, seeking to reduce maternal mortality by equipping traditional birth attendants with modern communication technology. A notable impact of the project was that maternal mortality declined by 50% over three years

The interaction of public assets, private assets and community characteristics and its effect on early childhood height-for-age in Peru

et al

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"Child health in general and long-term nutritional status in particular are related to family characteristics and assets (including maternal education) and community characteristics (including access to public services), as well as to child-specific characteristics...This paper particularly explores how mothers' education interacts with access to clean water and sewerage, availability and quality of health facilities, proximity to paved or engineered roads, and access to electricity"

Undernutrition in Bolivia : geography and culture matter

MORALES, Rolando
AGUILAR, Ana Maria

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This publication addresses the issues of health problems and malnutrition in Bolivia. Specifically, it analyses the association between a bidimensional measure of child heath (composed of height an weight scores) and a set of child nutrition determinants related to physical and cultual contexts, the mother's characteristics, household assets and access to public services. A major finding is that geogrpahical and cultural variables are significant determinants of nutritional status and that the role of the mother's anthropometrical characteristics is substantial. This publication is aimed at quite a technical audience, and all the information is qualified by detailed statistics. Section 4.2 focuses particularly on cultural variables and how this affects nutrition in young children

Journal articles

Grandmothers promote maternal and child health : the role of indigenous knowledge systems' managers

February 2006

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IK Notes report on indigenous knowledge initiatives in sub-Saharan Africa and occasionally on such initiatives outside the region. It is published by the World Bank Africa region's Knowledge and Learning Centre as part of an evolving partnership between the World Bank, communities, NGOs, development institutions and multilateral organisations. This edition outlines the role of grandmothers as 'managers' of indigenous knowledge systems that deal with the development, care and well being of women and their children. The paper outlines a rationale for involving grandmothers in community programmes based around child and maternal health, and nutrition

How high is infant mortality in Central and Eastern Europe and the CIS?

ALESHINA, Nadezhda
November 2003

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Official statistics seem to suggest that in post-communist Europe infant mortality rates have significantly decreased through the 1990s. As infant mortality rate is a key indicator of the Millennium Development Goals, reliable measurement is crucial to assess progress. This paper argues that official counts may understate the gravity of the problem in at least 15 countries in the region. This may be due to unclear definitions of 'live birth' and 'stillbirth', misreporting of infant deaths, nonregistration of births or deaths. The paper also discusses the uncertainties associated with survey based estimates, and call for further work to be done to improve collection of data and effectiveness of surveys

Mali : traditional knowledge and the reduction of maternal and infant mortality

GIANI, Sergio
November 2003

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IK Notes report on indigenous knowledge initiatives in Sub-Saharan Africa and occasionally on such initiatives outside the region. It is published by the World Bank Africa region’s Knowledge and Learning Centre as part of an evolving partnership between the World Bank, communities, NGOs, development institutions and multilateral organisations. This edition outlines the high rate of maternal and infant mortality in Mali, despite interventions by the government and donors in the past ten years. It then outlines the methodology used in developing a close collaboration between the traditional system of assistance to pregnancy and childbirth (of which traditional birth assistants (TBAs) are the protagonists) and the modern system of management of obstetrical emergencies. This involved a new role for the TBAs in breaking down cultural barriers in access to modern health care. The first results appear promising, and the authors stress the importance of taking into account traditional knowledge in birthing practices when developing a national strategy for the control of maternal and infant mortality

Sociocultural explanations for delays in careseeking for pneumonia

December 2003

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This article is printed in the Health and Science Bulletin produced by the Centre for Health and Population Research, based in Bangladesh. It outlines research conducted among parents in Matlab, Bangladesh, revealing how their beliefs affect household treatment of childhood pneumonia and influence delays in seeking care from trained providers. Many indigenous beliefs and social factors prevent primary care providers, particularly mothers, of pneumonia cases from obtaining prompt and appropriate help. For example, in fear of being blamed for poor caring practices, mothers are reluctant to share information about the illness with other family members. Intervention strategies designed to reduce child mortality associated with pneumonia need to address the cultural beliefs and challenges. Efforts should focus on involving family members such as the child's father or grandmother in early recognition of pneumonia cases. It also suggests that health workers use local terminology and cultural knowledge to communicate the need for prompt treatment with a trained provider