A pilot to promote early child development within health systems in Mozambique: a qualitative evaluation.

Autor: Jeong J; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Bliznashka L; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Ahun MN; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Karuskina-Drivdale S; PATH, Maputo, Mozambique., Picolo M; PATH, Maputo, Mozambique., Lalwani T; PATH, USA., Pinto J; PATH, Maputo, Mozambique., Frey M; PATH, USA., Velthauz D; Maraxis, Maputo, Mozambique., Donco R; Maraxis, Maputo, Mozambique., Yousafzai AK; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Jazyk: angličtina
Zdroj: Annals of the New York Academy of Sciences [Ann N Y Acad Sci] 2022 Mar; Vol. 1509 (1), pp. 161-183. Date of Electronic Publication: 2021 Dec 02.
DOI: 10.1111/nyas.14718
Abstrakt: Health systems offer unique opportunities for integrating services to promote early child development (ECD). However, there is limited knowledge about the implementation experiences of using health services to target nurturing care and ECD, especially in sub-Saharan Africa. We conducted a qualitative implementation evaluation to assess the delivery, acceptability, perceived changes, and barriers and facilitators associated with a pilot strategy that integrated developmental monitoring, nutritional screening, and early learning and nutrition counseling into the existing health facility, and community-based services for young children in rural Mozambique. We completed individual interviews with caregivers (N = 36), providers (N = 27), and district stakeholders (N = 10), and nine facility observational visits at three primary health facilities in October-November 2020. We analyzed data using thematic content analysis. Results supported fidelity to the intended pilot model and acceptability of nurturing care services. Respondents expressed various program benefits, including strengthened health system capacity and improved knowledge, attitudes, and practices regarding nurturing care and ECD. Government leadership and supportive supervision were key facilitators, whereas health system resource constraints were key barriers. We conclude that health systems are promising platforms for supporting ECD and discuss several programmatic recommendations for enhancing service delivery and maximizing potential impacts on nurturing care and ECD outcomes.
(© 2021 New York Academy of Sciences.)
Databáze: MEDLINE
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