Children In Community Research Articles

The moderating effect of Resilience on the effect of social stigma perceived by children using Community Child Centers on peer relationships and school life adaptation

The moderating effect of Resilience on the effect of social stigma perceived by children using Community Child Centers on peer relationships and school life adaptation

“We got to stand up and speak”: Youth in high-poverty, high-crime urban communities of color reflect on their cross-age mentoring program

This project draws from youth voices to develop theory about outcomes and change mechanisms in a cross-age mentoring out of school program with urban African American and Latine youth living in low-income communities. With instructors’ supports, African American and Latine mentors (N = 148, ages 14–20) in four U.S. urban, high-poverty communities of color mentored children weekly for an average of 16 sessions, followed by a debriefing session. Researchers used qualitative, participatory methods to elicit mentor perspectives about what made their program impactful. Diverse qualitative data were collected by staff and youth and analyzed thematically. Outcomes adolescent mentors deemed meaningful were 1) developing good character, specifically persistence, leadership and listening skills, patience, respectful collaborations, goal-oriented hopefulness, and more positive racial identities, and 2) building trustworthy, supportive relationships with mentees, peers, and instructors. Mechanisms mentors regarded as generating outcomes were 1) being active agents in program implementation and evaluation, and also contributing knowledge about themselves, and 2) the fulfillment of caring for community children, which youth regarded as a partial remedy for deprivations and injustices their communities experience. Differences in emphasis based on gender are described. Outcomes and generative mechanisms are discussed in relation to youths’ community cultural wealth. Comprehensively empowering youth to co-lead program development, implementation, evaluation and theorizing can improve the fidelity of scientific knowledge to youths’ strengths and priorities, and yield theories of intervention consonant with youths’ cultural wealth.

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study.

Soil-transmitted helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a study to investigate factors associated with STH infections among SAC in Narok County. A cross-sectional study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections. The overall prevalence of any STH infection was 24.6% (95%CI: 21.1-28.6). Trichuris trichiura 14.4% (95%CI: 11.7-17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9-15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45-19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29-15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81-33.63); p = 0.006. Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region's most common helminth. The study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.

Assessment of Erythrocyte Transketolase, Whole Blood Thiamine Diphosphate, and Human Milk Thiamine Concentrations to Identify Infants and Young Children Responding Favorably to Therapeutic Thiamine Administration: Findings from the Lao Thiamine Study, a Prospective Cohort Study

BackgroundThere is limited information on relationships among biomarkers of thiamine status (whole blood thiamine diphosphate [ThDP], erythrocyte transketolase activity coefficient [ETKac], and human milk thiamine [MTh]) and clinical manifestations of thiamine deficiency. ObjectivesThis study aimed to explore correlations among these biomarkers and thiamine responsive disorders (TRDs), a diagnosis based on favorable clinical response to thiamine. MethodsHospitalized infants and young children (aged 21 d to <18 mo) with respiratory, cardiac, and/or neurological symptoms suggestive of thiamine deficiency were treated with parenteral thiamine (100 mg daily) for ≥3 d alongside other treatments and re-examined systematically. Clinical case reports were reviewed by 3 pediatricians, who determined TRD or non-TRD status. Children in a community comparison group were matched by age, sex, and residence. Venous whole blood ThDP and MTh were determined by high-performance liquid chromatography fluorescence detection and ETKac in washed erythrocytes by ultraviolet spectrophotometry. Associations between biomarkers were assessed using Spearman correlations, and biomarker cutoffs predictive of TRD and ETKac >1.25 were explored using area under the receiver operating characteristic curve framework. ResultsThiamine biomarkers were available for 287 hospitalized children and 228 community children (mean age 4.7 mo; 59.4% male). Median (interquartile range [IQR]) ThDP and ETKac were 66.9 nmol/L (IQR: 41.4, 96.9 nmol/L) and 1.25 nmol/L (IQR: 1.11, 1.48 nmol/L), respectively, among hospitalized children, and 64.1 nmol/L (IQR: 50.0, 85.3 nmol/L) and 1.22 nmol/L (IQR: 1.12, 1.37 nmol/L) among 228 community children (P > 0.05 for both). Forty-five percent of breastfeeding mothers of infants <6 mo had MTh <90 μg/L. ThDP and ETKac, but not MTh, were significantly different between 152 children with TRD and 122 without TRD, but overlapping distributions undermined prediction of individual responses to thiamine. ConclusionsAlthough ETKac, ThDP, and MTh are useful biomarkers of population thiamine status, none of the biomarkers reliably identified individual children with TRD. ThDP is more practical for population assessment because preparing washed erythrocytes is not required.This trial was registered at clinicaltrials.gov as NCT03626337.

Farewell to the Young: Early Iron Age Mortuary Practices in the Middle Danube Region

ABSTRACT The study of burials and mortuary practices in the past provides essential information on the role and treatment of children in past communities. This study aims to better understand the status of children by reviewing the material culture provided by child burial contexts. Early Iron Age (800–300 BC) mortuary practices in the southern Middle Danube (present–day eastern Croatia and northwestern Serbia) are characterized mostly by the cremation of the dead. The Iron Age is an important time for funerary transitions. The standard practice of cremating the dead was replaced by the practice of inhumation during the 6th century BC. The manner of treatment of the dead body affected the preservation of objects and data in the graves. This paper studies 74 burials with child remains, costumes, jewellery, tool items, and pottery grave goods. In Early Iron Age mortuary practices, children were treated just like the adult members of the community.

Mothers, social capital and children’s physical literacy journeys in rural Australia

ABSTRACT In rural communities in Australia, the provision of sport and physical activities for children almost exclusively relies upon parents and their ability to access and contribute to facilities, funding, volunteers, and administration. This paper brings Putnam’s social capital framework to Whitehead’s conceptualisation of physical literacy as a journey to offer original insight into children’s sport participation and the opportunities arising for physical literacy development in rural communities in Australia. Changes in sport participation in Australia and directions in sport policy set an important context for the project, which is located in a small rural community in Western Australia. It was recognised that access to and engagement with both formal and informal sport environments were important to examine, particularly given participation trends and the need to consider issues of equity and inclusivity concerning the physical literacy opportunities for children in diverse rural communities. Narrative inquiry methodology enabled in-depth exploration of issues of access and opportunity created through rural mothers’ social resources and identity. Participants provided rich insights into the realities and complexities of the rural social landscape and how this impacts their children’s participation. Data illustrates the importance of conceptual links between social capital and physical literacy development. The paper provides new perspectives for policymakers and the local community to consider in seeking more significant equity in children’s sport participation and physical literacy development in rural communities.

Promoting historical empathy with a local history research project about the pandemic

PurposeWe examined how high school students demonstrated historical empathy through conducting local history place-based research to create an exhibit and companion book about the impact of the COVID-19 pandemic on their community. The majority of existing historical empathy scholarship focuses on classroom-based inquiry of historical events, people and time periods. We contend that broader examination of how historical empathy can be promoted beyond school-based instruction can contribute to the field by examining how student analyses of historical contexts and perspectives, and making affective connections to historical topics of study are needed when engaging in placed-based local history projects.Design/methodology/approachQualitative case study methodology was implemented for this study. A Likert-scale survey with a questionnaire was distributed to 30 high school study participants. Thirteen students gave follow-up interviews. Students’ responses on the surveys, interviews and questionnaires were organized into three categories that aligned to the theoretical framework – identification of historical contexts of the sources that students collected, analysis of how contexts shaped the perspectives expressed in the collected sources and expression of reasoned connections between the students’ emotions and experiences during the pandemic. A rubric was used to examine how students’ writing samples and reflections reflected demonstration of historical empathy.FindingsStudents responded that their local history research about the pandemic contributed to their displays of historical empathy. Students displayed weaker evidence of historical empathy while examining archival resources to explain the historical contexts of the pandemic. Student demonstration of historical empathy was stronger when analyzing community-sourced documents for perspectives and making reasoned affective connections to what they learned about the historical significance of the pandemic. The place-based aspects of this project were strongly connected to the students’ engagement in historical empathy because the sources they analyzed were relevant to their experiences and identities as citizens in their community.Originality/valueDocumenting the diverse human experiences during the COVID-19 pandemic is crucial to preserving the history of this extraordinary time. Every person around the globe experienced the pandemic differently, hence riding out the same storm in different boats. At some point, the pandemic will appear in historical narratives of the social studies curriculum. Therefore, now is an opportune time to ascertain whether place-based local history research about the contexts, perspectives and experiences of community members and children themselves, during the pandemic can foster historical empathy.

Nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State, Southwest Nigeria.

Nutritional imbalance is an underlying cause of 2.6million death annually and a third of child's death globally. This study assessed and compared the nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State. This is a cross-sectional comparative study carried out among 983 urban and rural primary school children in Ekiti State (495 in urban and 488 in rural) using interviewer-administered semi-structured questionnaire. A multi-stage sampling technique was used and data collected was analyzed using SPSS 23 with level of statistical significance set at p < 0.05. Underweight and stunting were relatively higher in rural (6.5% and 22.7% respectively) than in urban (6.3% and 19.4% respectively) and these differences are not statistically significant (p = 0.898, p = 0.197). However, wasting, overweight and obesity were higher in urban (12.7%, 6.1% and 7.7% respectively) than rural (11.5%, 3.7% and 7.5% respectively) but the difference is not statistically significant. (p = 0.242). Majority of the caregivers in both settings had good knowledge of malnutrition though higher in urban mothers (89.5%) with statistical significance than their rural counterparts (71.5%). However, there is no significant association between caregiver's knowledge and malnutrition in this study. Being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver were the common predictors of malnutrition among the school children in both community settings. Generally, the prevalence of malnutrition was high in both urban and rural primary school children in this study. However, while underweight and stunting were more prevalent among the children in the rural communities, wasting, overweight and obesity were more prevalent in the urban. The caregivers in both communities had good knowledge of malnutrition (better in the urban) but this is not good enough to bring a significant relationship with the occurrence of malnutrition in the children. Common predictors of malnutrition in both community settings are being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver. It is therefore recommended that regular continuous public enlightenment, nutritional education programmes and other programmes targeted at improving the economic power of the caregivers are measures that will improve the nutritional status of the primary school children.

Prevalence and predictors of residual antibiotics in children's blood in community settings in Tanzania

ObjectivesChildren account for a significant proportion of antibiotic consumption in low- and middle-income countries, with overuse occurring in formal and informal health sectors. This study assessed the prevalence and predictors of residual antibiotics in the blood of children in the Mbeya and Morogoro regions of Tanzania. MethodsThe cross-sectional community-based survey used two-stage cluster sampling to include children aged under 15 years. For each child, information on recent illness, healthcare-seeking behaviour, and use of antibiotics, as well as a dried blood spot sample, were collected. The samples underwent tandem mass spectrometry analysis to quantify the concentrations of 15 common antibiotics. Associations between survey variables and the presence of residual antibiotics were assessed using mixed-effects logistic regression. ResultsIn total, 1742 children were surveyed, and 1699 analysed. The overall prevalence of residual antibiotics in the blood samples was 17.4% (296/1699), the highest among children under the age of 5 years. The most frequently detected antibiotics were trimethoprim (144/1699; 8.5%), sulfamethoxazole (102/1699; 6.0%), metronidazole (61/1699; 3.6%), and amoxicillin (43/1699; 2.5%). The strongest predictors of residual antibiotics in the blood were observed presence of antibiotics at home (adjusted odds ratio [aOR] = 2.9; 95% CI, 2.0–4.1) and reported consumption of antibiotics in the last 2 weeks (aOR = 2.5; 95% CI, 1.6–3.9). However, half (145/296) of the children who had residual antibiotics in their blood, some with multiple antibiotics, had no reported history of illness or antibiotic consumption in the last 2 weeks, and antibiotics were not found at home. DiscussionThis study demonstrated a high prevalence of antibiotic exposure among children in Tanzanian communities, albeit likely underestimated, especially for compounds with short half-lives. A significant proportion of antibiotic exposure was unexplained and may have been due to unreported self-medication or environmental pathways. Incorporating biomonitoring into surveillance strategies can help better understand exposure patterns and design antibiotic stewardship interventions.

Fostering empathy through critical literacy in early childhood education in Colombia

ABSTRACT In Colombia, some educational settings, particularly territories with high levels of educational inequality, uphold conventional teaching strategies where emotional education and critical thinking receive little attention. This study is rooted in our intention to contribute to peace education in early childhood educational environments by fostering critical thinking and empathy, a predictor of prosocial behavior in children. The aim of this study is, first, that young children develop empathy by recognizing situations of oppression and injustice in children’s literature using critical literacy practices; and second, to contribute to young children’s development of critical thinking. Utilizing Critical Discourse Analysis, we suggest that critical literacy practices enhance empathy and critical thinking in young children through three strategies: reading selected children’s literature aloud, responding through multimodal texts, and having an open dialogue about critical issues that affect children in local communities. This article contributes to the literature about literacy, empathy development, and peace education with young children.

Big Lots Foundation accepting applications grants for health care, housing and more

The Big Lots Foundation, the charitable giving arm of national discount retailer Big Lots, was established with the mission to improve and enrich the lives of families and children in communities where the company has business operations. In support of that mission, the foundation is currently accepting applications for funding—which may come in the form of monetary gifts, gift cards and/or in‐kind merchandise—from nonprofits serving its communities and whose programming is focused on health care, housing, hunger relief or education.

Performance of the non-invasive point-of-care device, EzeCheck, for haemoglobin assessment in adults and children in community and institutional care settings.

Anaemia is a major public health problem, especially in resource constrained settings. Dependency on assessment of blood hemoglobin (Hgb) concentration impedes anemia detection, risk stratification and intervention. Thus, valid, frugal and scalable technologies are needed. EzeCheck is a noninvasive portable device developed in India for predicting hemoglobin levels in human beings aged 4 years and above using a finger-tip biosensor. In this assessment, we aimed to: (i) evaluate EzeCheck's performance with an automated whole blood hemato-analyzer (Sysmex XN 1000) as the gold standard, and (ii) estimate EzeCheck's agreement with Sahli's method and HemoCue (Hb-301) in real-world primary and higher care facilities. Paired assessments were done at five sites across India i.e., Bhubaneshwar, Shimla, Solan and Mashobra and Ulhasnagar. Participants across all age groups (4 years and above) were assessed. We used a range of statistical tests to evaluate the performance of EzeCheck. It was found that EzeCheck performed well across age and gender categories with convincing validity, concordance, precision and accuracy, and acceptable bias. While comparing EzeCheck with Hemato-analyzer, no statistically significant systematic bias was found. However, EzeCheck showed significant systematic bias when compared to Sahli's method and HemoCue. We concluded that EzeCheck could detect anemia (as per WHO Hgb cut-offs) in 'real-world settings' and 'across age and gender categories', with high sensitivity, specificity and accuracy, and can serve as a replacement to traditional methods of hemoglobin assessment. Further, for countries with higher prevalence of anemia where universal screening may be mandated, the positive predictive value of EzeCheck will be higher. The likelihood ratios also indicated that the device had moderate-to-good utility. EzeCheck is suitable for embedment into program and out-patient health care settings in resource constrained contexts as a spot-check hemoglobinometer.

A qualitative study on the adaptation of community programmes for the promotion of early detection and health-seeking of perinatal depression in Nepal

BackgroundDespite the high burden of perinatal depression in Nepal, the detection rate is low. Community-based strategies such as sensitization programmes and the Community Informant Detection Tool (CIDT) have been found to be effective in raising awareness and thus promoting the identification of mental health problems. This study aims to adapt these community strategies for perinatal depression in the Nepalese context.MethodsWe followed a four-step process to adapt the existing community sensitization program manual and CIDT. Step 1 included in-depth interviews with women identified with perinatal depression (n=36), and focus group discussions were conducted with health workers trained in community mental health (n=13), female community health volunteers (FCHVs), cadre of Nepal government for the prevention and promotion of community maternal and child health (n=16), and psychosocial counsellors (n=5). We explored idioms and understanding of depression, perceived causes, and possible intervention. Step 2 included draft preparation based on the qualitative study. Step 3 included a one-day workshop with the psychosocial counsellors (n=2) and health workers (n=12) to assess the understandability and comprehensiveness of the draft and to refine the content. A review of the CIDT and community sensitization program manual by a psychiatrist was performed in Step 4.ResultsThe first step led to the content development for the CIDT and community sensitization manual. Multiple stakeholders and experts reviewed and refined the content from the second to fourth steps. Idioms of depression and commonly cited risk factors were incorporated in the CIDT. Additionally, myths of perinatal depression and the importance of the role of family were added to the community sensitization manual.ConclusionBoth the CIDT and community sensitization manual are grounded in the local context and are simple, clear, and easy to understand.

Multiple-Community-Based Epidemiological Study of Stuttering among 3-Year-Old Children in Japan

Introduction: Many epidemiological studies of the disorder of stuttering have been conducted during the 20th century, continuing during the current one. Unfortunately, only a few were carried out in Japan. This study aimed at assessing (1) the incidence and prevalence of stuttering in 3-year-old children in multiple Japanese communities and (2) factors associated with the onset of stuttering among these children. Methods: A questionnaire aimed at screening for the presence of stuttering was employed for 2,055 children aged 3 years, who underwent a standard nationwide health checkup. Positive responses were confirmed in several ways: (1) direct interviews and assessment of the child’s speech, (2) confirmatory questionnaire, or (3) telephone interviews by licensed Speech Language Hearing Therapists. Results: Approximately 6.5% of the children were found to exhibit stuttering at the time of their health checkup. This figure rose to 8.9% after including individuals who previously, but not currently, were reported to have exhibited stuttering. Among the putative risk factors, higher stuttering odds (odds ratio, OR = 3.27) were detected in those with a family history of stuttering, those whose guardians had concerns about their child’s development (OR = 1.75), and those with diagnosed diseases or disabilities (OR = 2.13). Discussion/Conclusions: It was concluded that, in Japan, both the risk of stuttering incidence (8.9%) in children up to, and including, the age of 3 years, as well as its prevalence (6.5%) in this population, was similar to those reported by recent studies in other countries. Additionally, our findings also confirmed that an increased risk for stuttering at age 3 is associated with a family history of stuttering.

Early childhood caries among pre-school children in rural areas

Background: Early childhood caries can occur and exist among children in slums areas, rural areas and under-served communities. Africa has countries with rural areas inhabited by diverse ethnic populations of pre-school children, with their parents and family members. Method: An electronic literature search in Science direct and PubMed was done in January, 2024 using the Population, Concept and Context framework. Search terms and keywords were combined by Boolean operators. Two independent investigators screened titles and abstracts of publications on early childhood caries among pre-school children in rural areas. The inclusion criteria was original (primary) research articles with accessible full text, related to early childhood caries among pre-school children in rural areas, carried out in Africa, published in English and in electronic databases. Original research articles related to early childhood caries among pre-school children in urban, semi-urban or sub-urban areas, hospital based studies, studies with participants selected from rural and urban or rural and semi-urban communities, review articles, systematic reviews, thesis or dissertations were excluded during screening. Results: Three articles with accessible full texts were included as it was assessed to meet the aim of the review. The study designs of the included studies were cross-sectional study, randomized, controlled field trial and a case-control study respectively. The studies were carried out in rural areas of Uganda and Egypt respectively. Conclusion: Early childhood caries has multifactorial aetiology. More studies from diverse ethnic population in Africa countries will fill the gaps in knowledge and add to the existing literature.

Early childhood parenting programs and community peacebuilding behaviors: A case study from postconflict Liberia.

Early childhood parenting programs and community peacebuilding behaviors: A case study from postconflict Liberia.

A Scoping Review of Research Trends in Forest Therapy Programs by Subject Types: Focused on KCD-8

Background and objective: This study reviewed forest therapy program studies by applying the scoping review methodology to provide recommendations for future research and basic data for the development of forest therapy programs.Methods: Data collection was conducted from April 1 to 5, 2022 using South Korean literature databases (RISS, KISS, Science ON, DBpia) and international literature databases (SCOPUS, PubMed, MEDLINE, EMBASE). Focusing on papers published by March 31, 2022, while considering the publication year, we finally selected 118 papers (99 from South Korea and 19 from other countries).Results: Starting with the first study in 1996, research in South Korea was conducted in earnest since 2006. The study subjects primarily comprised those who were vulnerable to stress, such as office and labor workers, children at community child care centers, and families of patients, followed by mental health and physical patients. In terms of program characteristics, the site types primarily included general forests and forest welfare facilities, and in terms of seasons, summer accounted for the highest proportion, followed by spring and fall, which showed similar proportions. The programs primarily included one-day multiple-session and lodging types. Upon examining the structure of the programs, we observed that the majority of lodging type programs were 3 days and 2 nights programs and 2 days and 1night programs. In contrast, one-day multiple-session programs were primarily conducted in a once-a-week cycle, with 6 to 10 sessions.Conclusion: Through the results of this study, we examined the current status and scope of forest therapy program research. The findings are expected to be used as a basis for expanding forest therapy program research to collaborate with stakeholders in the health and medical fields in the future.

Randomized Feasibility Pilot of an Executive Functioning Intervention Adapted for Children's Mental Health Settings.

The critical role of executive functioning in autism as well as the co-occurring mental health challenges common among autistic youth support to the immense value of interventions targeting executive functioning for enhancing mental health services for autistic children. The goal of the present study was to conduct a randomized feasibility trial of Unstuck and On Target, an executive functioning intervention, adapted for delivery in children's community mental health setting. Mental health therapists (n = 26) enrolled with participating autistic clients (n = 32) were randomized to receive training in and deliver the adapted Unstuck intervention or to deliver care as usual. We completed masked observational measures of Unstuck strategy use (fidelity) during recorded sessions of participating therapist-client dyads and collected measures of acceptability from participating clients and their caregivers. We also collected measures of pre-post changes in executive functioning and mental health symptoms. Therapists trained in Unstuck demonstrated significantly higher use of Unstuck strategies compared to usual care therapists. Caregivers and autistic clients perceive adapted Unstuck as highly acceptability and helpful. Autistic clients whose therapists were trained in adapted Unstuck demonstrated larger pre-post changes in executive functioning compared to usual care. Across all participating clients, changes in executive functioning were significantly related to changes in mental health symptoms. Finally, clients of therapists trained in adapted Unstuck demonstrated moderate improvements in overall mental health symptoms. The current study provides preliminary evidence of the feasibility and impact of Unstuck and On Target for children's community mental health settings.

How far? Travel burdens for children admitted to hospitals in the Western Cape Province of South Africa.

The ability to access effective hospital care for children is a significant determinant of good health outcomes. The Western Cape is a large land area with a wide array of human settlements- both in urban and rural spaces. For many children in the Western Cape, after-hours access to healthcare becomes constrained when primary care clinics close and hospitals are either far away or difficult to get to. The cumulative travel burden of communities across this area is not known. The recently established data gathering capacity of the Provincial Health Data Centre of the Western Cape represents a new capacity to study this. This study intends to describe the cumulative travel burdens of children in communities throughout the Western Cape, and how they compare relative to one another, with a particular focus on the after-hours period in a week. Over a period of 5 years from 2017-2021, all the admission details to every hospital in the Western Cape of children under 18 years of age were collected, with basic demographic and disease data including place of residence. The distance each child travelled to their first admission facility was calculated and represented within defined communities across the metro of Cape Town and the rural Western Cape. There were 574 220 admissions over the 5-year period, of which 360 783 were able to be used for travel analysis. The majority of admissions were for children under 5 years of age, were in the City of Cape Town and occurred after hours. Median travel distance was less for children outside of Cape Town, but the range of travelled distances was greater. Communities across the Western Cape, particularly rural communities, reflected significant variation in their cumulative travel burdens. Using a large health dataset, this study demonstrates in a novel way for South Africa, the distances children travel to access admission facilities. A wide variation exists across all parts of the province, but particularly in rural areas. These findings could be further interrogated for people's choices of facility and method of travel. Detailed service area modelling and extending primary care working hours are potential considerations for improving access at scale and at the local community level.

Strength-Based approaches to providing an Aboriginal Community Child Health Service

Strength-Based approaches to providing an Aboriginal Community Child Health Service