Towards a Multi-Dimensional Index of Child Growth to Combat the Double Burden of Malnutrition

Background: There is growing awareness in the field of public health that combatting the double burden of malnutrition requires approaches that address its multi-dimensional origin, rather than focusing primarily on the biomedical domain. Current frameworks of malnutrition like the UNICEF conceptual framework, and the Lancet Series 2013 framework have been instrumental in understanding the determinants of malnutrition and developing appropriate interventions. However, these frameworks fail to explicitly address issues of agency, that is, about being able to pursue one’s goal. The capability approach as originally developed by Amartya Sen includes agency in the causal chain.Summary and key Messages In the past 5 years, the International Union of Nutritional Sciences Task Force “Towards a multi-dimensional index for child growth and development” has developed a capability framework for child growth, and conducted empirical research applying this framework. The working group discussed what would be needed to further develop the approach and explained the added value to international organisations and policy makers. We suggest developing an index of advantage that will be a proxy for a child’s agency. We hypothesise that such an index will explain much of the variance in studying inequalities in child nutrition and thus call for action to improve this focal point

Varied patterns of catch-up in child growth: Evidence from Young Lives

The development of human capabilities for many disadvantaged children around the world depends on growth recovery ('catch-up growth'). Here we develop a novel framework that allows different types of catch-up growth to be classified and estimated. We distinguish between catch-up in the mean of a group toward that of a healthy reference population versus catch-up within the group. We show these different growth types can be tested in a unified setting using a latent growth framework. We apply the results to four developing countries, using longitudinal data on 7641 children collected over the period 2002-2013. The results show catch-up growth rates are generally modest but vary significantly between countries, and that local environmental factors are material to variation in child growth trajectories. The paper discusses the benefits of the new framework versus current methods, shows that the method is feasible, and suggests they call for intervention designs that are sensitive to community and country contexts

Social Media Use and Children’s Wellbeing

Childhood circumstances and behaviours have been shown to have important persistent effects in later life. One aspect of childhood that has changed dramatically in the past decade, and is causing concern among policy makers and other bodies responsible for safeguarding children, is the advent of social media, or online social networking. This research explores the effect of children’s digital social networking on their subjective wellbeing. We use a large representative sample of 10-15 year olds over the period 2010 to 2014 from the UK Household Longitudinal Study, and estimate the effect of time spent chatting on social websites on a number of outcomes which reflect how these children feel about different aspects of their life, specifically: school work; appearance; family; friends; school attended; and life as a whole. We deal with the potential endogeneity of social networking via an instrumental variables approach using information on broadband speeds and mobile phone signal strength published by Ofcom. Our results suggest that spending more time on social networks reduces the satisfaction that children feel with all aspects of their lives, except for their friendships; and that girls suffer more adverse effects than boys. As well as addressing policy makers’ concerns about the effects of digital technology on children, this work also contributes to wider debates about the socioeconomic consequences of the internet and digital technologies more generally, a debate which to date has largely been based on evidence from outside of the UK

Wellbeing in Public Policy: Contributions Based on Sen’s Capability Approach

The paper provides a brief introduction to the capability approach and its use in public policy-making around the world. Specifically, it shows the approach provides a definition of wellbeing and a framework for understanding how it is produced and distributed. It notes that the framework is useful across the entire life course and so helpful for understanding wellbeing in children and retirees as well as working age adults. The paper then discusses the practical impacts of the approach on the development of monitoring systems in the OECD and UN where the Human Development Index paved the way for the globally adopted Sustainable Development Goals. It highlights the fact that behavioural and psychological factors are an important contributor to understanding how resources are converted into wellbeing

Pathways to social well-being of children with intellectual disability : testing the Family Investment Model

Background: Social well-being, including prosocial and peer relationship skills, independence and co-operation, is a particularly important developmental outcome in intellectual disability. The present study investigated pathways to social well-being through the early years’ family environment, particularly the role of parental investments in mediating the path from family poverty to child social well-being. Methods: In line with the Family Investment Model (FIM), we tested whether parental investments between three and five years of age mediate the impact of family poverty at nine months of age on children’s social well-being at seven years. Structural equation models were fitted to data from 555 children with intellectual disability identified from a UK population-based cohort. Results: Findings indicated that home learning investments and the structural home environment (though not play) significantly mediated the effect of family poverty on children’s social skills, albeit in different directions. While all parental investments reduced in the presence of poverty, the home learning environment appeared to promote social well-being, whereas the structural home environment did not. Sensitivity analyses controlling for co-occuring autism confirmed the pattern of findings. Child gender, ethnicity and parental educational qualifications did not moderate the mediational relationships, suggesting FIM pathways to social well-being were relevant to all families. Conclusions: FIM provides a helpful framework to map developmental pathways for children with an intellectual disability. Parental investments related to home learning, the structural home environment and play are reduced in the presence of poverty although their impact on child social well-being appears to differ

Wellbeing: alternative policy perspectives

Governments in liberal democracies pursue social welfare, but in many different ways. The wellbeing approach instead asks: Why not focus directly on increasing measured human happiness? Why not try to improve people’s overall quality of life, as it is subjectively seen by citizens themselves? The radical implications of this stance include shifting attention to previously neglected areas (such as mental health and ‘social infrastructure’ services) and developing defensible measures of overall wellbeing or quality of life indicators. Can one ‘master’ concept of wellbeing work to create more holism in policy-making? Or should we stick with multiple metrics? These debates have been live in relation to an alternative ‘capacities’ approaches, and they are well-developed in health policymaking. Most recently, the connections between wellbeing and political participation have come into sharper focus. Wellbeing remains a contested concept, one that can be interpreted and used differently, with consequences for how it is incorporated into policy decisions. By bringing together scholars from economics, psychology and behavioural science, philosophy and political science, the authors explore how different disciplinary approaches can contribute to the study of wellbeing and how this can shape policy priorities

Wellbeing

Governments in liberal democracies pursue social welfare, but in many different ways. The wellbeing approach instead asks: Why not focus directly on increasing measured human happiness? Why not try to improve people’s overall quality of life, as it is subjectively seen by citizens themselves? The radical implications of this stance include shifting attention to previously neglected areas (such as mental health and ‘social infrastructure’ services) and developing defensible measures of overall wellbeing or quality of life indicators. Can one ‘master’ concept of wellbeing work to create more holism in policy-making? Or should we stick with multiple metrics? These debates have been live in relation to an alternative ‘capacities’ approaches, and they are well-developed in health policymaking. Most recently, the connections between wellbeing and political participation have come into sharper focus. Wellbeing remains a contested concept, one that can be interpreted and used differently, with consequences for how it is incorporated into policy decisions. By bringing together scholars from economics, psychology and behavioural science, philosophy and political science, the authors explore how different disciplinary approaches can contribute to the study of wellbeing and how this can shape policy priorities

Saving the Future in the Swamp:a Capability Approach to Child Growth in haor areas of Bangladesh

Human capabilities to do or achieve something may vary according to the cultural and environmental context, and individual values. We aimed to identify the capabilities of children and their parents to achieve healthy growth at an early stage of life, particularly before two years of age in the haor areas of Bangladesh. Haor areas are geographically vulnerable due to long-term flooding and this reality creates a very challenging context that is different from the conditions in any other part of the country.We discussed with the communities of haor and identified a list of the capabilities for children and their parents that they valued important for their children’s healthy growth in haor. The findings indicated that child growth capabilities are multidimensional. Therefore, the existing child growth monitoring programme and policy instruments should embrace a multidimensional concept of child growth that includes the child's context; the biological, social, and cognitive dimensions of child growth; and the capabilities of the parents to provide good care to the children. Our findings shed light on the contextual elements that shape people’s health-seeking behaviour, and the patriarchal arrangements that affect women’s health care and wellbeing. These insights can be incorporated into the intervention components of existing policies and programmes of the government, and the NGOs that are working to address the social challenges to improve child growth and nutrition outcomes. We demonstrated the process of co-creating knowledge with the community in a democratic way that could guide nutritionists and capability scholars who want to apply the capability approach for child growth