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USAID releases policy guidance for children in adversity worldwide

Goals include reducing numbers of exploited, abused children


The US Agency for International Development (USAID) along with representatives from 7 government agencies and departments released last December the first-ever “Action Plan on Children in Adversity,” saying that the plan provides overall policy and guidance for US international assistance “to ensure that children not only survive, but thrive.”

In lower- and middle-income countries, an estimated 200 million children younger than 5 years—more than 30% of the world’s children—fail to reach their development potential, limiting their future ability to contribute to their communities and families or obtain gainful employment.

The government says that the plan will apply to US assistance globally, but its specific target for its first 5 years is to reach basic goals in 6 priority countries. Basic goals are to significantly reduce the number of children not meeting growth and development milestones, living outside of family care, and experiencing sexual violence or exploitation.

“Research shows that children who experience violence or are exploited, abandoned, abused, or severely neglected (in or out of families) also face significant threats to their survival and well-being, as well as profound life cycle risks that have an impact on human, social, and economic development,” according to the plan.

The report says further: “Efforts to assist vulnerable girls and boys in low- and middle-income countries have often focused on single vulnerability cohorts and categories—for example, children affected by HIV/AIDS, in emergencies, or in the worst forms of child labor, including those who have been trafficked.”

The American Academy of Pediatrics (AAP) applauded the plan, saying, “Early childhood adversity can trigger a toxic stress response in children’s bodies and brains, leaving them at higher risk in learning, behavior and health.”

Before the White House launch of the plan, Robert Block, MD,  past president of AAP,  said that science now confirms that who people are as adults and what their health status is are “very much predicated on what happens to [them] during those first 1,000 days. And maybe before, and certainly afterwards.”

Among other things the plan pledges, the US government agencies will work with other nations’ governments and local organizations on problems such as children failing to the meet growth and developmental milestones, living outside of family care, exploited in the worst forms of child labor, and experiencing sexual violence.

The plan commits to facilitating efforts of governments and other partners to prevent and respond to violence, exploitation, abuse, and neglect and to strengthen child welfare and protection systems.

The plan also calls for measuring outcomes within target populations in US government-funded projects to document changes in ways that are comparable across countries and are similar to what has been done to document the great improvements in child survival over the past 30 years, as well as for increasing the prevalence of studies that measure children’s exposure to adverse conditions.

A new technique facilitates collection of infant urine samples. Spanish investigators reported a technique for obtaining a midstream clean urine sample in newborns in a median time of 45 seconds.

Investigators studied the relationship of attention-deficit/hyperactivity disorder (ADHD) in adolescence and adult physical and mental health, work performance, and financial stress.

You are called to see a 17-year-old Hispanic girl in the pediatric emergency department (ED) complaining of abdominal pain for 1 week. She describes a “stabbing” pain in the epigastrium and flanks that radiates to the lower back. She says that the pain comes intermittently in attacks that occur throughout the day and may last up to several hours. She feels pain most of the day, but it is worse at night and frequently causes her to awaken from sleep.

The mother of a 9-year-old boy brings him to the office for urgent evaluation of undiagnosed widespread blistering of the skin and mouth. The eruption has occurred 2 to 3 times a year for the last 3 years, and the oral lesions have been severe enough on several occasions to prompt hospitalization for dehydration. She wants an answer to the mystery now. What are you going to tell her?


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