Incorporating health and nutrition in child-focused activities

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8.2 Evidence-based Implementation Recommendations

8.2.1 Incorporating health and nutrition in child-focused activities

The strong community and household presence of PEPFAR programs for children provides multiple oppo tu ities to i p o e hild e s a d fa ilies a ess to health a d nutritional services covering early nutrition screening and referral; malaria, TB, and child pneumonia and diarrhea services; and routine vaccinations. Most often these opportunities result from effective integration with child-focused community- and home-based activities. In particular, programs should continue to incorporate key elements such as water, sanitation, and hygiene WASH; nutrition; and HIV prevention and care knowledge into child-focused activities. The venues and interventions below can serve as important conduits to health information and services for children and their families: Home visits: Evaluations 144 indicate that home visiting programs have a positive impact on child and family well-being 145 when staff or volunteers regularly visit households and spend adequate time with children and families, especially those at high risk for poor health outcomes who do not present at health centers or at community venues. ECD: ECD programs provide an excellent venue for accomplishing multiple objectives, including nutritional education and supplementation, 146 WASH promotion, early identification of childhood illness and developmental disabilities, 147 and monitoring and support for children on treatment. Schools: Schools play a key role in health education 148 and can also serve as an important channel for identifying and referring children who need further health services and assistance. Kids clubs: Kids clubs that meet regularly and feature health messages in curricula have produced positive results. 149 International research indicates that afterschool and other kids clubs are most productive when they involve parents and caregivers. They can provide an entry point for increasing knowledge and health-seeking behaviors, particularly for children who are not in school and are therefore missed in school-based health interventions. Parenting skills groups, education: Interventions aimed at facilitating child-caregiver bonding and imparting knowledge on child development 150 and positive discipline can also play a key role in promoting basic health and nutritional knowledge. Health events: National or local campaigns to increase coverage of key health interventions, such as insecticide-treated bed nets ITNs, vaccinations, or micronutrients, should be leveraged for and include children affected and infected by HIVAIDS. Such campaigns can utilize OVC community volunteers and other OVC program investments to enhance their success. 144 Sherr L, Zoll M. 2011. PEPFAR OVC Evaluation: How Good at Doing Good? Prepared for PEFPAR through USAID by Global Health Technical Assistance Project. 145 Richter L, Sherr L, Adato M, et al. 2009. Strengthening families to support children affected by HIV and AIDS. AIDS Care: Psychological and Socio-medical Aspects of AIDSHIV. 21 S1, 3-12. 146 Shonkoff J, Richter L, van der Gaag J, Bhutta Z. 2012 An Integrated Scientific Framework for Child Survival and Early Childhood Development. Pediatrics. 129 2, 460-472. 147 Irwin LG, Siddiqi A, Hertzman C. 2007. Early Child Development: A Powerful Equalizer. Final report for the World Health Organization. Commission on Social Determinants of Health. Geneva, Switzerland: World Health Organization. 148 Gregson S, Nyamukapa C, Garnett G, et al. 2005: HIV infection and reproductive health in teenage women orphaned and made vulnerable by AIDS in Zimbabwe. AIDS Care: Psychological and Socio-medical Aspects of AIDSHIV, 17 7, 785-794 149 Nyangara F, Thurman T, Hutchinson P, Oblero W. 2009. Effects of Programs Supporting Orphans and Vulnerable Children: Key Findings, Emerging Issues, and Future Directions from Evaluations of Four Projects in Kenya and Tanzania. MEASURE Evaluation for USAID. New Orleans: Tulane University School of Public Health. 150 Caspe M, Lopez ME. 2006. Lessons from family-strengthening interventions: Learning from evidence-based practice. Cambridge, Mass.: Harvard Family Research Project. 50

8.2.2 Reducing access barriers