Browsing by Author "Sherr, L."

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    Evaluating the effectiveness of a multi-component intervention on early childhood development in paediatric HIV care and treatment programmes : a randomised controlled trial
    (BioMed Central, 2018-07-09) Chingono, R.; Mebrahtu, H.; Mupambireyi, Z.; Simms, V.; Weiss, H. A.; Ndlovu, P.; Charasika, F.; Tomlinson, M.; Cluver, L. D.; Cowan, F. M.; Sherr, L.
    Background: HIV infection in a family may affect optimum child development. Our hypothesis is that child development outcomes among HIV-exposed infants will be improved through a complex early childhood stimulation (ECS) programme, and income and loans saving programme for HIV positive parents. Methods: The study was a cluster-randomized controlled trial in 30 clinic sites in two districts in Zimbabwe. Clinics were randomised in a 1:1 allocation ratio to the Child Health Intervention for Development Outcomes (CHIDO) intervention or Ministry of Health standard care. The CHIDO intervention comprises three elements: a group ECS parenting programme, an internal savings and lending scheme (ISALS) and case-management home visits by village health workers. The intervention was aimed at caregiver-child dyads (child aged 0–24 months) where the infant was HIV exposed or infected. The primary outcomes were cognitive development (assessed by the Mullen Scales of Early Learning) and retention of the child in HIV care, at 12 months after enrolment. A comprehensive process evaluation was conducted. Discussion: The results of this cluster-randomised trial will provide important information regarding the effects of multi-component interventions in mitigating developmental delays in HIV-exposed infants living in resource-limited environments. Trial registration: This trial is registered with the Pan African Clinical Trials Registry ( www.pactr.org), registration number PACTR201701001387209; the trial was registered on 16th January 2017 (retrospectively registered).
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    Parenting, the other oldest profession in the world – a cross-sectional study of parenting and child outcomes in South Africa and Malawi
    (Taylor & Francis Open, 2017-01-30) Sherr, L.; Macedo, A.; Cluver, L. D.; Meinck, F.; Skeen, S.; Hensels, I. S.; Sherr, L. T. S.; Roberts, K. J.; Tomlinson, M.
    ENGLISH ABSTRACT: Parenting quality is important in child development. In the presence of HIV poverty and life stress, parenting may be challenged and child development affected. This study examines cross-sectional associations of situational factors such as poverty, mental health, HIV status, living with a biological parent, and stigma with good parenting and child outcomes (n = 989; age = 4–13 years) within the Child Community Care study (South Africa and Malawi). A parenting measure was created from 10 variables comprising 6 child and 4 parent ratings. These were highly correlated. Total parenting score was generated on a 10-point continuous scale, with a good parenting cut-off then defined as ≥8 out of a possible 10. Five factors were associated with good parenting. Positively associated with good parenting were being the biological parent of the child, parental mental health and dwelling in households with multiple adults. Poverty and stigma were negatively associated with good parenting. Using multiple mediation analysis, a positive direct effect of good parenting was found on child self-esteem, child behaviour and educational risks with a partial mediation via child depression and trauma. These data highlight possible intervention points. Influences on parenting could be seen through being the biological parent, parental mental health, poverty and stigma. In these challenging environments, health, nutrition, mental health, education and treatment to keep parents alive are all clearly identified as potential pathways to ensure child well-being.