Infant and Child Health

The author with a small child in Zambia

My first experience in international development was as a Peace Corps Volunteer in a rural village in northern Zambia. During my 2 years as a health volunteer, I saw time and time again projects designed by “experts” in Washington, D.C., that failed in my small village. 

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Scant data exists on the prevalence of violence against children worldwide. However, available information shows that violence against children is a global problem. This desktop study aims to glean from published and grey literature the extent of sexual violence and exploitation against children in Lesotho. The goal of this study is to better understand the government of Lesotho's national response efforts to reduce violence against children.

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Research shows that early childhood development (ECD) is critical to both mental and physical health later in life. However, programming targeting orphans and vulnerable children (OVC) is almost exclusively focused on school-aged OVC, and only rarely are very young children included in program activities. This technical brief, aimed at program planners and implementers, highlights the benefits of ECD interventions and outlines essential elements of ECD programming targeted towards OVC.

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There are no reliable estimates of the number of children living with disabilities. Estimates vary greatly, depending on the definition of disability, the methodology, and the measurement tool used (World Bank 2011; WHO 2012b). The most commonly used estimates are that approximately 93 million children aged 14 or younger live with a moderate or severe disability of some kind (UNICEF 2013c); and that globally, up to 150 million children (aged 0-18) experience some form of disability: learning, speech, physical, cognitive, sensory, or emotional (Global Partnership for Children 2012).

Among children under five years of age in the developing world, nearly one-quarter are underweight (127 million) and one-third are stunted (195 million). Over 90 percent of those who are stunted live in Africa and Asia (U.N. Children’s Fund [UNICEF] 2009, 2011a). These forms of undernutrition can have long-lasting and damaging effects on children, especially when it occurs during critical developmental years.

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Gender inequality is cited as a major contributor to Swaziland's high HIV prevalence rate. There is no routine screening for gender-based violence by health providers in Swaziland to provide statistical data relating to the incidence or prevalence of GBV. However, a national population-based household study on violence against children (mostly girls) and young women revealed an epidemic of sexual assault against girls.

Both the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Health Initiative (GHI) emphasize preventing, monitoring, and responding to gender-based violence (GBV) as critical to strengthening overall health outcomes. Yet, significant barriers impede the provision of meaningful, effective services for children and adolescents who have experienced sexual violence.

The purpose of this situation analysis, conducted for AIDSTAR-One, was to understand what supports and hinders effective care for children who have experience sexual violence and exploitation in Lesotho. The study examined the services being implemented, facilitated, or provided by community- and facility-based partners for children who have experienced sexual violence and exploitation; what is working well; and where there are gaps.

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Community health workers (CHWs), and the barriers they face in providing services, have been studied extensively. Less examined is how CHWs respond to these barriers. The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project conducted a qualitative study of the challenges and opportunities Accredited Social Health Activists (ASHAs) in India encounter and how they respond.

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The purpose of this curriculum is to prepare health care and social welfare workers to gain a combination of knowledge, attitudes, skills, and wider attributes of gender-based violence (GBV) and violence against children (VAC) competencies in provision of services at different levels of health and social welfare settings. It was developed with the Tanzanian Ministry of Health. Other resources in this training package include:

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