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The importance of caregiver-child interactions for the survival and healthy development of young children. A review.
Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2004. viii, 95 p.From recent research, the review identifies two fundamental qualities that determine the caregiver’s ability to provide effective care: sensitivity and responsiveness to the child. These skills enable the caretaker to detect the child’s signals and to respond appropriately, in synchrony, to meet the child’s needs. Second, the review summarizes what we have learned about how a strong and supportive caregiving relationship supports the development of a child who is physically, intellectually and socially healthy, and more resilient to the damaging effects of poverty and violence. The review shows us what it looks like when this relationship works, and identifies the consequences when the caregiver and child fail to engage. The most vulnerable children – those who are premature, low birth weight, non-organic failure to thrive, and malnourished – are the ones to suffer the most from the effects of this failure on the child’s health. We also see the human cost on children living in institutions, conflict, refugee camps and other settings that deprive them of stable, caring relationships. Finally, this review calls us to work with the whole child and with the child’s closest caring environment. It presents a solid foundation for the need to integrate interventions to promote better caregiver-child interactions into the design of primary health care programmes for mothers, other caregivers, newborns, and young children. These interventions are also appropriate for community-based nutrition, early child care, violence prevention, orphan care and parent education programmes. A response to this call has implications for the training of physicians, nurses, child care workers, and others who assist families in caring for their children. (excerpt)
IN POINT OF FACT 1990 Sep; (70):1-4.About 50% of children <1 year old in developing countries die during the 1st month of life, and 97% of all infant deaths occur in developing countries. Major factors contributing to these deaths are the mother's poor health before and during pregnancy, unhygienic childbirth practices, and inadequate care after delivery. Low birth weight, linked to mother's health, is considerably related to survival and development and growth. >500,000 women in developing countries die annually due to pregnancy and childbirth. Maternal mortality risk in the poorest countries can be 200 times that of developed countries. Inappropriate timing and spacing, too many pregnancies, unsafe abortion, and insufficient prenatal care and care during delivery contribute to high maternal mortality in developing countries. Mothers <18 years old are at the highest risk of pregnancy complications, delivering a premature infant, and/or death. Postponement of marriage and better access to family planning would improve their and their infants chances of survival. Access to and acceptability of family planning promotes the health of women and children. Literate women and their children are healthier than those of illiterate women. A trained person attends only 20% of births in developing countries. Increasing the number of deliveries with a trained attendant and increasing immunizations of mothers with the tetanus toxoid will greatly reduce mortality. Infants leaving the uterus experience a drop in ambient temperature from 37 to 20 degrees Celsius. If they are not dried off, covered in a dry cloth, and/or allowed to be in physical contact quickly, they can experience considerable heat loss or even death. Further all infants should be exclusively breastfed for 4-6 months to ensure healthy growth and development and to provide protection against infections.