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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."
Hygiene, Handwashing & Behaviour Change Coalition for COVID 19 response programme
UK - Foreign, Commonwealth Development Office (FCDO)
To develop an innovative partnership with Unilever to provide funding, for a ‘Hygiene, Handwashing & Behaviour Change’ Coalition for Covid19, matched with in-kind support and technical expertise by Unilever. Under Unilever leadership, the coalition will bring together academia (e.g. London School of Hygiene & Tropical Medicine), INGOs (e.g. Oxfam) and UN agencies, to deliver mass communications, hygiene products and digital behaviour change programmes on the importance of hand and environmental hygiene in low- and middle-income countries. This will build on recent investments Unilever has made in response to Covid19 and will allow scale up across multiple countries.
Strengthening disaster resilience in Nepal
UK - Foreign, Commonwealth Development Office (FCDO)
This project will strengthen disaster resilience in Nepal, particularly to earthquakes, by working with urban centres to build and plan more safely; supporting the strengthening of critical public infrastructure to earthquakes; working to strengthen national capacity to respond to crises and ensure that the international community is prepared; and ensuring that the UK is able to support a humanitarian response should a crises hit.
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.
Better Lives for Somali Women and Children
UK - Foreign, Commonwealth Development Office (FCDO)
To achieve UK's manifesto commitment of reducing preventable deaths, the Better Lives for Somali Women and Children will continue to respond to the health and nutrition needs of the Somali people. There will be a continued focus on delivering an essential package of health services. The programme will strengthen the Somali Health Authorities oversight of service provision, which will in turn promote local accountability and allow them increasingly to respond to the needs of their populations. This programme approach aims to support long term sustainability and state building that is part of the wider strategic agenda. There will also be a climate change mitigation component (ICF) within the programme.
Support to the Palestinian Authority to Deliver Basic Services, Build Stability and Promote Reform in the Occupied Palestinian Territories (SSRP)
UK - Foreign, Commonwealth Development Office (FCDO)
To support the Palestinian Authority (PA) to meet the needs of the Palestinian people. Funding will enable around 25,000 young Palestinians with access to an education, provide up to 3,700 immunisations for children, and 185,000 medical consultations each year. This will help to build and strengthen the capacity of PA institutions through public financial management reform, and build stability in the region by preserving the two state solution.
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.
Transparency and Accountability for Inclusive Development (TAcID)
UK - Foreign, Commonwealth Development Office (FCDO)
The programme has two areas of work: Pillar 1: Improving the quality of basic services: We will support efforts to strengthen civic engagement and accountability in the provision of basic services. These will include a range of initiatives, from community monitoring of services through scorecards and social audits at the facility level to national evidence-based advocacy for improved policies, planning and budget allocations to key services. Our programme will link with our interventions to increase access to services (eg health; water, sanitation and hygiene/WASH). A combination of grants, technical expertise, facilitation, media, campaigns, and innovative pilots will be used to drive change. Pillar 2: Promoting transparency and fighting corruption: We will work with Mozambican civil society organisations promoting transparency and integrity through research and advocacy. We will explore the possibilities of providing short-term, targeted assistance to government and state authorities
Mozambique Demographic Transition - Waala - Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To contribute to a more favourable enabling environment for the demographic transition in Mozambique, through coordinated action with others. The FCDO will use programming, evidence and diplomacy to influence decision-makers to increase investments towards cost-effective interventions that will accelerate changes in the population structure. These interventions will help young people to fulfil their potential by preventing unintended pregnancies and improving the literacy and numeracy skills among girls. The Government’s systems will be strengthened to include population issues in planning and budgeting. Over 130,000 unintended pregnancies will be averted resulting in 427,000 users of modern contraceptives. These investments should help to offset deteriorating human capital outcomes because of COVID-19.
Tristan da Cunha Provision of Technical Assistance and Essential Infrastructure 2023 to 2025
UK - Foreign, Commonwealth Development Office (FCDO)
To enable the Administration of Tristan da Cunha to provide appropriate public services to meet the basic health, education, safeguarding and governance needs of the island community, through the provision of professional expertise and training.
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
Responding to the needs of Women and Children in Yemen 301140
UK - Foreign, Commonwealth Development Office (FCDO)
This programme will address the devastating impact the conflict in Yemen is having on women and children, particularly the most marginalised. It will provide access to life-saving integrated health, nutrition, water, sanitation and hygiene (WASH) and protection services. This approach responds directly to two key UK humanitarian aims in Yemen: preventing famine and ensuring respect for International Humanitarian Law.
Bangladesh-Collaborative, Accountable and Peaceful Politics (B-CAPP) Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To protect civic space, foster political collaboration, reduce corruption, and mitigate conflict and violence in Bangladesh, the Bangladesh- Collaborative, Accountable and Peaceful Politics programme will mobilise civil society and media coalitions, provide citizens groups with tools to monitor public services, improve decision making within political parties and promote women and youth leadership.
Building Resilience and an Effective Emergency Refugee Response (BRAER)
UK - Foreign, Commonwealth Development Office (FCDO)
The programme will provide emergency life-saving assistance to the large influxes of refugees arriving in Uganda, build resilience among refugees and their host communities to reduce Uganda’s humanitarian burden, and deliver on UK Humanitarian Reform priorities. It will support the UK in its leadership role to develop new approaches to protracted crises and in delivering on the New York Declaration’s Comprehensive Refugee Response Framework, with regional and global impact.
Reducing high fertility rates and Improving SExual reproductive health outcomes in Uganda (RISE)
UK - Foreign, Commonwealth Development Office (FCDO)
To support the Government of Uganda in the implementation of the Family Planning Costed Implementation Plan in order to accelerate the uptake of contraception and reduce the negative health, social and economic consequences of high fertility rates
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).
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.
Essential Services for Maternal and Child Health [Services Essentiels de Santé Maternelle et Infantile en RDC (SEMI)]
UK - Foreign, Commonwealth Development Office (FCDO)
To support essential maternal, child and infant health services to end preventable deaths in one of the poorest provinces in DRC and strengthen the health system at national and provincial level.
South Sudan Health Pooled Fund Phase III
UK - Foreign, Commonwealth Development Office (FCDO)
To provide a government led effective health system that will deliver improved access to quality health services across seven states in South Sudan with a specific focus on reducing maternal and child mortality. The Health Pooled Fund (HPF3) will reduce maternal and under-five mortality rates in South Sudan, through (i) the delivery of a basic package of health and nutrition services; (ii) promoting community engagement in health as a public good and (iii) supporting local health systems stabilisation.
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