Barcelona 2013
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| Abstract #120 - Pregnancy and Childbearing | ||||
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Session: 34.6: Pregnancy and Childbearing (Parallel) on Tuesday @ 14.30-16.00 in Raval Chaired by Victorio Torres, Malega Kganakga Authors: Presenting Author: Mr Geoffrey Fatti - Kheth Impilo, South Africa |
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| Additional Authors: Dr. Jordi Casabona, | ||||
| Aim: Early childhood development (ECD) is the most important phase for overall development throughout life. Children affected by HIV/AIDS are particularly vulnerable to deficiencies in ECD due to ill parents, their own biological deficiencies, and poor environmental stimulation from overcrowded orphanages. South Africa has the highest numbers of HIV-infected and affected children worldwide. In addition, there is a lack of pre-school education in South Africa, with close to 70% of children not able to access formal ECD services. The aim of this study was to assess the effectiveness of an ECD training intervention for children?s caregivers in improving ECD for HIV-affected children. | ||||
| Method / Issue: The intervention was performed by social auxiliary workers (SAWs) in KwaZulu-Natal province of South Africa, who provided early childhood development skills for caregivers of young children (under the age of five) who were unable to attend formal ECD centres. KwaZulu-Natal has the highest HIV prevalence rate in South Africa (antenatal HIV prevalence of 37.4%). SAWs performed regular home visits and assessed the household regarding factors affecting ECD. Caregivers were trained on methods of child minding, parenting skills, health & safety, nutrition and stimulation activities for children through individual home-based counselling and group workshops. SAWs also assisted with securing of child support grants, birth certification and provided counselling regarding the importance of immunization. Home assessments were performed before and after the intervention, and the following outcomes were compared: A standardised 21-point mother-child interaction assessment score; a 36-point caregiver coping assessment score; and a 16-point hygiene and safety in the home environment assessment score. Childrens? immunization status, and receipt of child support grants and birth certificates were recorded. Data instruments were administered by SAWs. The two-sample test of proportions and paired t-tests were used to compare pre and post intervention outcomes. | ||||
| Results / Comments: A total of 802 children from 593 carers were included. Mean mother-child interaction scores increased by 43% from 12.2 (95% CI: 11.9-12.6) pre-intervention to 17.5 (95% CI: 17.2-17.9) post-intervention; P<0.0001. Mean caregiver coping assessment scores increased by 26% from 23.4 (95% CI: 22.8-23.9) to 29.6 (95% CI: 28.8-30.4) post-intervention; P<0.0001. Mean home environment hygiene and safety scores increased by 37% from 11.0 (95% CI: 10.7-11.3) to 15.1 (95% CI: 14.9-15.3); P<0.0001. The proportion of fully immunized children increased from 93.9% to 98.2%; P=0.004. The proportion of children with birth certificates increased from 88.9% to 93.3%; P=0.033. The proportion of children with child support grants increased from 85.2% to 89.4%; P=0.076. | ||||
| Discussion: Training for HIV-affected children?s caregivers on ECD by SAWs is effective in improving the quality of mother-child interactions, caregiver coping mechanisms, hygiene and safety in the home, as well as increasing access to birth certification, child support grants and immunizations. | ||||
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