Child Well-Being: Anthropological Perspectives.

A major contribution of anthropological approaches to child well-being is that they address variation across a wide range of cultures and settings. This broad perspective is necessary because cultures vary widely both in care practices and in definitions of child well-being. Anthropologists have derived models to explain variation in child development and well-being in relation to factors not only at the level of the caregiver or household (e.g., parents’ schooling and household wealth) but also at the level of the broader environment (e.g., political economy and disease ecology). These models pay special attention to culture both as a determinant of resource distribution within societies and as a source of ideologies that inform and motivate actions, including patterns of child-rearing. Relevant anthropological models can be grouped into two classes: heuristic models to be applied within particular cultures and predictive models to be applied across time or across cultures. We review a selection of these models, identify the specific issues they address, and describe the ways the models help explain how global transitions in vital rates, education, nutrition and disease, and politics, economics, and ecology are affecting child well-being worldwide. We illustrate the pragmatic value of this approach by describing some interventions to promote child well-being that are congruent with these models and supported by evidence. We close by advocating longitudinal, mixed-methods research to further develop anthropological models of child development and well-being, and to identify forces affecting child well-being across cultures

Reliability of salivary testosterone measurements: a multicenter evaluation.

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Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants' Outcomes

Pregnant mothers in South African townships face multiple health risks for themselves and their babies. Existing clinic-based services face barriers to access, utilization, and human resource capacities. Home visiting by community health workers (CHW) can mitigate such barriers. The Philani Plus (+) Intervention Program builds upon the original Philani CHW home-visiting intervention program for maternal and child nutrition by integrating content and activities to address HIV, alcohol, and mental health. Pregnant Mothers at Risk (MAR) for HIV, alcohol, and/or nutrition problems in 24 neighborhoods in townships in Cape Town, South Africa (n = 1,239) were randomly assigned by neighborhood to an intervention (Philani Plus (+), N = 12 neighborhoods; n = 645 MAR) or a standard-care control condition of neighborhood clinic-based services (N = 12 neighborhoods; n = 594 MAR). Positive peer deviant "Mentor Mother" CHWs are recruited from the township neighborhoods and trained to deliver four antenatal and four postnatal home visits that address HIV, alcohol, nutrition, depression, health care regimens for the family, caretaking and bonding, and securing government-provided child grants. The MAR and their babies are being monitored during pregnancy, 1 week post-birth, and 6 and 18 months later. Among the 1,239 MAR recruited: 26% were HIV-positive; 27% used alcohol during pregnancy; 17% previously had low-birthweight babies; 23% had at least one chronic condition (10% hypertension, 5% asthma, 2% diabetes); 93% had recent sexual partners with 10% known to be HIV+; and 17% had clinically significant prenatal depression and 42% had borderline depression. This paper presents the intervention protocol and baseline sample characteristics for the "Philani Plus (+)" CHW home-visiting intervention trial. © 2011 Society for Prevention Research.Article in Pres