Abstract
A principle strategic insight of the Final Report for WHO’s Commission on Social Determinants of Health (SDOH) is that the nurturant qualities of the environments where children grow up, live, and learn matter the most for their development. A key determinant of early childhood development is the establishment of a secure attachment between a caregiver and child. We report initial field-tests of the integration of caregiver-child attachment assessment by community health workers (CHWs) as a routine component of Primary Health Care (PHC), focusing on households with children under 5 years of age in three slum communities near Nairobi, Kenya. Of the 2,560 children assessed from July–December 2010, 2,391 (90.2%) were assessed as having a secure attachment with a parent or other caregiver, while 259 (9.8%) were assessed as being at risk for having an insecure attachment. Parent workshops were provided as a primary intervention, with re-enforcement of teachings by CHWs on subsequent home visits. Reassessment of attachment by CHWs showed positive changes. Assessment of caregiver-child attachment in the setting of routine home visits by CHWs in a community-based PHC context is feasible and may yield valuable insights into household-level risks, a critical step for understanding and addressing the SDOH.
Highlights
A principle strategic insight of the Final Report for the World Health Organization’s (WHO’s)Commission on Social Determinants of Health is that the nurturant qualities of the environments where children grow up, live, and learn matter the most for their development [1]
The key findings of this project to-date relate to the process of incorporating assessment of caregiver-child attachment within a community-based Primary Health Care (PHC) system, the basic description of attachment levels in these slum communities, and initial findings related to field-based interventions to address insecure attachments
The primary contribution of this project is to provide a description of caregiver-child attachment in a sample of residents of Nairobi slums when derived from PHC visits
Summary
A principle strategic insight of the Final Report for the World Health Organization’s (WHO’s)Commission on Social Determinants of Health is that the nurturant qualities of the environments where children grow up, live, and learn matter the most for their development [1]. Advances in the science of early childhood development (ECD) provide powerful evidence that what a child experiences during the early years - this biological embedding—sets a critical foundation for the entire life-course: ECD—including physical, social/emotional and language/cognitive domains—strongly influences basic learning, school success, economic participation, social citizenry, and health [1,2,3,4]. Recent research has identified two fundamental qualities that determine the caregiver’s ability to provide effective care: sensitivity and responsiveness to the child [4] These skills enable the caregiver to detect the child’s signals and to respond appropriately, in synchrony, to meet the child’s needs, promoting the development of a child who is physically, intellectually, and socially healthy and more resilient to the damaging effects of poverty, violence, and other social determinants of health. This review lays the groundwork for including interventions to improve the relationship between the caregiver and child in an overall strategy to improve the child’s survival, health, and development
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
