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Caregiver influences on child psychological adjustment following trauma; a longitudinal study of a high adversity South African population
DEPARTMENT FOR SCIENCE, INNOVATION AND TECHNOLOGY
"Children who experience very frightening or traumatic events (such as car accidents, assaults, serious injuries) are vulnerable to developing posttraumatic stress disorder (PTSD) and other psychological difficulties following their experiences. Such problems can be extremely distressing, and affect a significant proportion of trauma exposed children. One factor that has the potential to influence such outcomes is the informal support that children receive from their parents/caregivers posttrauma. In research we have conducted in the UK, we found that certain aspects of caregiver responses can have an impact upon children's psychological recovery following trauma. In particular, where caregivers encourage ways of coping in children that allow them to avoid being reminded of the trauma, and/or talk to children about what happened in a way that emphasizes high levels of threat associated with the trauma, children are more likely to experience persistent symptoms of PTSD. These caregiver responses may influence child symptoms as a consequence of children themselves then making more negative appraisals in relation to what happened, and by influencing child coping behaviours. We propose to extend our UK work to the study of a high adversity international population. To date, only a small proportion of PTSD research has been conducted in low-and-middle-income countries (LMICs). This omission is important, as LMIC children may be particularly vulnerable to trauma exposure for a variety of reasons (e.g., poverty, crime, regional conflict). It is essential to establish whether psychological and social processes that have been linked to child PTSD in lower risk settings still apply in contexts where levels of ongoing threat and the likelihood of exposure to recurrent traumas are high. In particular, although we know that caregiver support is a key predictor of child psychological recovery following trauma in high income countries, our understanding of the elements of support that can help children from high adversity, lower income contexts is almost non-existent. This is important, as such children are almost certain to rely on such informal support following trauma exposure, due to limited access to formal psychological services. To address this critical gap in our knowledge, we plan to study the psychosocial factors that contribute to PTSD in a group of children (aged 8-16 years) from a deprived community in South Africa, in which rates of serious trauma exposure are extremely high. We will recruit 250 children who have experienced trauma within 2 weeks following the event. We measure how caregivers provide support, as well as children's initial levels of symptoms. We will then follow-up children and caregivers 3 months and 6 months later, measuring their PTSD symptoms. We will examine whether there are particular elements of caregiver support in the aftermath of trauma that are associated with higher or lower levels of symptoms in children further down the line. We we also will test whether caregiver influences operate via changing key psychological processes (trauma appraisals, coping) in the child, and will take account of caregivers' own trauma-related distress in our study. In addition to helping us to understand what kind of social support is best for children who experience trauma, our project will provide much needed information about the development of PTSD in children from high adversity, low income communities. This is important: at the moment we are lacking even basic information about risk of PTSD in the acute aftermath of trauma among such children, including the proportion who will initially develop this disorder following trauma, the window of time during which children may recover naturally following the event, and the proportion likely to experience persistent disorder and need intervention. This is a major barrier to developing screening and intervention programmes, which our study will be able to address. " COVID-19
Highlight: Identifying barriers to mental healthcare for civilians affected by protracted armed conflict in Colombia
DEPARTMENT FOR SCIENCE, INNOVATION AND TECHNOLOGY
"This will be the first project to identify invisible victims using innovative data-linkage between i) a nationally representative psychiatric epidemiological study (N=12k+) that used active case ascertainment in the general population, and; ii) data fromthe national mental health programme (N=1 million+), and the first to examine quality of care at the population level. We will use robust statistical analysis to identify: 1) social, health, and demographic drivers of being an invisible victim of conflict - who has conflict-related mental health needs but who never accesses services 2) social, health, and demographic drivers of treatment delay, quality of care, and outcome in people with conflict-related mental health needs who successfully access services 3) the extent to which gender-based and sexual violence mediates conflict-related mental health needs and poor treatment access / outcome in women and girls All 3 aims address urgent national policy issues. Aim 3 was suggested, and most prioritised by, our panel of people with lived experience of the armed conflict who will continue to co-produce this project."
Caregiver influences on child psychological adjustment following trauma; a longitudinal study of a high adversity South African population
DEPARTMENT FOR SCIENCE, INNOVATION AND TECHNOLOGY
"Children who experience very frightening or traumatic events (such as car accidents, assaults, serious injuries) are vulnerable to developing posttraumatic stress disorder (PTSD) and other psychological difficulties following their experiences. Such problems can be extremely distressing, and affect a significant proportion of trauma exposed children. One factor that has the potential to influence such outcomes is the informal support that children receive from their parents/caregivers posttrauma. In research we have conducted in the UK, we found that certain aspects of caregiver responses can have an impact upon children's psychological recovery following trauma. In particular, where caregivers encourage ways of coping in children that allow them to avoid being reminded of the trauma, and/or talk to children about what happened in a way that emphasizes high levels of threat associated with the trauma, children are more likely to experience persistent symptoms of PTSD. These caregiver responses may influence child symptoms as a consequence of children themselves then making more negative appraisals in relation to what happened, and by influencing child coping behaviours. We propose to extend our UK work to the study of a high adversity international population. To date, only a small proportion of PTSD research has been conducted in low-and-middle-income countries (LMICs). This omission is important, as LMIC children may be particularly vulnerable to trauma exposure for a variety of reasons (e.g., poverty, crime, regional conflict). It is essential to establish whether psychological and social processes that have been linked to child PTSD in lower risk settings still apply in contexts where levels of ongoing threat and the likelihood of exposure to recurrent traumas are high. In particular, although we know that caregiver support is a key predictor of child psychological recovery following trauma in high income countries, our understanding of the elements of support that can help children from high adversity, lower income contexts is almost non-existent. This is important, as such children are almost certain to rely on such informal support following trauma exposure, due to limited access to formal psychological services. To address this critical gap in our knowledge, we plan to study the psychosocial factors that contribute to PTSD in a group of children (aged 8-16 years) from a deprived community in South Africa, in which rates of serious trauma exposure are extremely high. We will recruit 250 children who have experienced trauma within 2 weeks following the event. We measure how caregivers provide support, as well as children's initial levels of symptoms. We will then follow-up children and caregivers 3 months and 6 months later, measuring their PTSD symptoms. We will examine whether there are particular elements of caregiver support in the aftermath of trauma that are associated with higher or lower levels of symptoms in children further down the line. We we also will test whether caregiver influences operate via changing key psychological processes (trauma appraisals, coping) in the child, and will take account of caregivers' own trauma-related distress in our study. In addition to helping us to understand what kind of social support is best for children who experience trauma, our project will provide much needed information about the development of PTSD in children from high adversity, low income communities. This is important: at the moment we are lacking even basic information about risk of PTSD in the acute aftermath of trauma among such children, including the proportion who will initially develop this disorder following trauma, the window of time during which children may recover naturally following the event, and the proportion likely to experience persistent disorder and need intervention. This is a major barrier to developing screening and intervention programmes, which our study will be able to address. " COVID-19
Highlight: Identifying barriers to mental healthcare for civilians affected by protracted armed conflict in Colombia
DEPARTMENT FOR SCIENCE, INNOVATION AND TECHNOLOGY
"This will be the first project to identify invisible victims using innovative data-linkage between i) a nationally representative psychiatric epidemiological study (N=12k+) that used active case ascertainment in the general population, and; ii) data fromthe national mental health programme (N=1 million+), and the first to examine quality of care at the population level. We will use robust statistical analysis to identify: 1) social, health, and demographic drivers of being an invisible victim of conflict - who has conflict-related mental health needs but who never accesses services 2) social, health, and demographic drivers of treatment delay, quality of care, and outcome in people with conflict-related mental health needs who successfully access services 3) the extent to which gender-based and sexual violence mediates conflict-related mental health needs and poor treatment access / outcome in women and girls All 3 aims address urgent national policy issues. Aim 3 was suggested, and most prioritised by, our panel of people with lived experience of the armed conflict who will continue to co-produce this project."
Umoyo Wathu Health System Strengthening Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To reduce rates and inequalities in maternal, under-5 and new-born deaths; as well as reduce stunting in under-5s, by strengthening the quality and coverage of a package of essential health services through lower level district administration. The programme will increase the provision and uptake of quality, highly cost effective life-saving primary healthcare services provided free at the point of use, and so better protect the most vulnerable against the financial consequences of ill health. By 2028, the programme will contribute to reducing maternal mortality from 439 to 350 per 100,000 births; neonatal mortality from 27 to 22 per 1,000 live births; child mortality from 64 to 48 per 1,000 live births; stunting in children under five years of age reduced from 37% to 31%; and impact of communicable disease outbreaks and epidemics.
LAFIYA -UK Support for Health in Nigeria
UK - Foreign, Commonwealth Development Office (FCDO)
To save lives, reduce suffering and improve economic prospects for the poorest and most vulnerable in Nigeria through: i. Encouraging Government of Nigeria to increase resources invested in health (through advocacy, community accountability; and data to inform government prioritisation using a “delivery” approach, as used successfully in Pakistan) ii. Improving effectiveness and efficiency of public and private basic health services (through innovative financing mechanisms, strengthening health systems and working with private sector to deliver affordable health services for the poorest populations) iii. Reducing total fertility rate (through addressing social norms, demographic impact analysis, and support to family planning commodities and services).
Investing in Human Capital through Partnerships Beyond Aid in the Social Sectors Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To improve governance and accountability in education, health and social protection sectors and contribute to policy and research which will inform interventions to improve equity and reduce poverty.
Empowering Women for Better Reproductive Health Outcomes (EMPOWER)
UK - Foreign, Commonwealth Development Office (FCDO)
Empowering Women for Better Reproductive Health Outcomes” (EMPOWER) will contribute to (a) a reduction in preventable deaths of mothers, babies, and children, and (b) women and girls’ empowerment through choices about whether and when to have children and economic opportunities – both UK priorities. By the end of the programme, it will have averted over 2.4 million unwanted pregnancies and 3,700 maternal deaths.
Tanzania Health Resilience Programme
UK - Foreign, Commonwealth Development Office (FCDO)
Drawing on the UK’s comparative advantage and priorities, and in line with Tanzania’s health sector strategy, the programme will: 1. Increase access, quality and equity of life-saving primary health care services by strengthening health systems that support ending preventable deaths of mothers, new-borns, and children (EPD). 2. Strengthen government ability to respond to health threats by supporting integrated disease surveillance systems at community level, and support preparedness systems and the initial response to disease outbreaks. 3. Support the increase and use of data to inform decision making and resource allocation to deliver equitable health outcomes. The programme will support Tanzania to regain momentum towards achieving Universal Health Coverage (UHC) by 2030 as measured by a change in Tanzania’s UHC index.
Transparency and Accountability to improve economic development and service delivery(TRACTION)
UK - Foreign, Commonwealth Development Office (FCDO)
To improve accountability responsiveness in the delivery of public goods (including business environment) and services at local and national levels. This will be achieved through changes in the way government does business such as improvements in oversight in use of public finances, improvements in how budgets are allocated to reflect needs and more politicians seeking to legitimise themselves based on the delivery of public goods - both at election time and between elections.
Strengthening the Health System and Provision of Essential Services in South Sudan (SHAPES)
UK - Foreign, Commonwealth Development Office (FCDO)
To provide a government led effective health system that will deliver improved access to quality health services across ten states and three administrative areas in South Sudan with a specific focus on reducing maternal and child mortality.
Ethiopia Crises 2 Resilience (EC2R)
UK - Foreign, Commonwealth Development Office (FCDO)
The Ethiopia Crises to Resilience (EC2R) programme is aimed to alleviate the impact of the conflict and drought to the poorest Ethiopians. The programme tries to address urgent humanitarian needs while maintaining the delivery of essential services across the country.
UK-SA Health Systems Strengthening Partnerships Programme
UK - Foreign, Commonwealth Development Office (FCDO)
Support to strengthen South Africa’s health systems to achieve Universal Health Coverage, and drive collaboration on pandemic preparedness
HEALTH Systems Connect
UK - Foreign, Commonwealth Development Office (FCDO)
Official Development Assistance (ODA) Flag ODA (100% ODA) Title Health Systems Connect: NHS England Description The Programme aim is to provide posts and host governments with access to British health expertise through technical exchange with experts working across the UK’s health policy, planning and delivery ecosystem to support countries across the official development assistance (ODA) eligible FCDO network to achieve universal health coverage.
UK investment in the Global Fund to Fight AIDS, Tuberculosis and Malaria 2023-2025
UK - Foreign, Commonwealth Development Office (FCDO)
To tackle the immediate impact of the three most deadly infectious diseases – HIV/AIDS, tuberculosis and malaria – and put the international community on the right track to end the three diseases as epidemics by 2030.
Enhancing the bilateral relationship between the UK and Laos
UK - Foreign, Commonwealth Development Office (FCDO)
This programme will consist of six small projects that will all work towards supporting our overall Embassy Country Business Plan goals. This will specifically include – - Supporting poverty reduction - Improving basic healthcare - Empowering the participation of women in defending environmental rights - Implementing a mobile veterinary unit in Laos - Enhancing the collaboration of the UK and Lao government through supporting attendance at global conferences
Building a Resilient Health System to End Preventable Maternal, New-born and Child Deaths in Ethiopia
UK - Foreign, Commonwealth Development Office (FCDO)
In line with Manifesto commitments and FCDO Ethiopia’s strategic business planning, this programme will help to prevent avoidable maternal, new born and child deaths and accelerate the fertility transition in Ethiopia by building the capacity of the health system to self-finance quality health services for all its citizens, without financial hardship by 2030. It builds upon the gains made and lessons learned from current and past health investments, moving beyond increasing access to health services by supporting efforts to . improve quality of care for better reproductive, maternal, new-born and child health (RMNCH) outcomes; . target more effectively the poorest and most vulnerable to drive health equity; •increase the health system’s capacity to respond to crises; and •reduce reliance on external actors for health financing and technical assistance as DFID prepares to exit from bilateral financial aid for health by 2025.
International Finance Facility for Immunisation
UK - Foreign, Commonwealth Development Office (FCDO)
Reduce vaccine preventable diseases (VPDs) in poor countries in a sustainable way using innovative financing approach
Eliminating Lymphatic Filariasis in Africa ELFA
UK - Foreign, Commonwealth Development Office (FCDO)
The new FCDO Neglected Tropical Diseases NTDs programme ELFA is a £15m (ODA RDEL) programme contributing to the Reaching the Last Mile Fund (RLMF)
FY2025-26 ODA projects in Vanuatu
UK - Foreign, Commonwealth Development Office (FCDO)
Two projects will be delivered with bilateral ODA to Vanuatu: 1. Strengthening remote health facilities in Vanuatu with basic but essential medical equipment 2. Strengthened climate-resilient emergency preparedness and response for Vanuatu (education and WASH)
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