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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
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indicate that home visiting programs have a positive impact on child and family well-being
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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,
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WASH promotion, early identification of childhood illness and developmental disabilities,
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and monitoring and support for children on treatment.
Schools: Schools play a key role in health education
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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.
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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
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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.
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Sherr L, Zoll M. 2011. PEPFAR OVC Evaluation: How Good at Doing Good? Prepared for PEFPAR through USAID by Global Health Technical Assistance Project.
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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.
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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.
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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.
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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
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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.
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Caspe M, Lopez ME. 2006. Lessons from family-strengthening interventions: Learning from evidence-based practice. Cambridge, Mass.: Harvard Family Research Project.
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8.2.2 Reducing access barriers