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Caregiver influences on child psychological adjustment following trauma; a longitudinal study of a high adversity South African population
DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY
"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
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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).
Somaliland Development Fund (SDF) Phase II Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To improve governance, accountability and public service delivery by the Government of Somaliland. This will promote long-term stability in the region and improve the lives of poor Somalilanders. This programme contributes to our SDGs by delivering public services, and building core government capacity and functions and will result in improved planning and delivery for development priorities by 2022.
Nepal Health Sector Programme III
UK - Foreign, Commonwealth Development Office (FCDO)
To improve the health of women, children, the poor and socially excluded in Nepal, including by restoring health services in areas affected by the 2015 earthquake, and improving the quality and governance of health services nationwide.
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UK - Foreign, Commonwealth Development Office (FCDO)
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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 Health in Bangladesh (BHB) Programme
UK - Foreign, Commonwealth Development Office (FCDO)
To deliver more and higher quality services, contributing to better health through technical assistance and policy engagement. The programme is contributing to ending preventable deaths of mothers, babies and children, tackling antimicrobial resistance and addressing climate change impact on health.
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.
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
Scaling up Family Planning in Tanzania
UK - Foreign, Commonwealth Development Office (FCDO)
This is a national programme to scale up access to family planning across Tanzania. Specific activities will include: • Outreach work in rural and urban areas as well as in Tanzania’s refugee camps and host communities. • Specific work to improve access to family planning as well as sexual and reproductive health information to youth, people with disabilities as well as services for victims of sexual violence. • Procure family planning commodities, strengthen the supply chain, and train of public health providers
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.
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
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.
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.
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.
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