Girl child and environment.
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Children's work has largely been overlooked by researchers of many disciplines due to sociohistorical trends that fostered the notion that childhood should be a time free of work. Likewise, it has received little attention in occupational therapy most likely due to the influence of these historical developments on occupational therapy rhetoric and values. This paper begins by describing the influence of child labor laws and reformation on children's participation in work. Next, using a comprehensive review of the literature gathered from social sciences, a critical examination of the historical and current research on children's work is provided. This synthesis is framed in concepts of occupational science analyzing the evidence that describes the nature, form, function, and meaning of children's work. For occupational therapists working with children with disabilities, this research provides beginning guidelines for occupation-based work interventions and typical expectations for nondisabled children that may be applied using clinical reasoning to populations with disabilities.
Some challenges facing occupational epidemiology in developing countries are outlined in this case study of agriculture drawing on Southern African research. These include the characterization of exposures in resource- and data-poor environments typical of developing countries, the assessment of outcomes where cross-cultural and socio-environmental confounders may be substantial obstacles, and the impact of environmental exposures on workplace health. Traditional assignment of low priority to the chronic effects of low-dose exposures relative to acute morbidity in developing countries must be critically examined, as must the gender bias of much occupational epidemiology in agriculture. Advocacy issues involving child labor and the ethics of research among vulnerable groups deserve rigorous attention. It is argued that, if occupational epidemiology is to have meaningful impact on the health of the most marginalized groups of workers in developing countries, it must redefine itself in terms of a public health approach. The boundaries of epidemiologic inquiry need to be broad, and amenable to interfacing with policy research, using qualitative methods and participatory approaches. More so than in order industrial settings, epidemiologists must move from research to practice, seeking to take action where interventions are needed, and to evaluate such actions.
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The consequences of different birth intervals on dietary energy requirements and dependency ratios at different stages of the family lifecycle are modelled for Gambian agriculturalists and !Kung hunter-gatherers. Energy requirements reach a peak at between 20 and 30 years after starting a family for the Gambians, and between 15 and 20 years for the !Kung. For the Gambians, shorter birth interval confers no economic advantage over the traditional birth interval of 30 months. For the !Kung, the lack of participation in subsistence activities by children gives an output:input ratio in excess of that reported in other studies, suggesting that they are in a state of chronic energy deficiency.
The aim of this study is to determine the magnitude of the problem of using children as an economic asset to the family thus, in one way increasing the prevalence of child abuse in Egypt and also hindering the family planning program. Two focus-group interviews were conducted in urban & rural areas for 10 women with the same age range and socioeconomic background. All were non-users of any contraception. Subsequently an interview was conducted for all women who attended the Ob. & Gyn. Clinic at Ain Shams University Hospital in the period from June to August 1991, their ages ranged from 30-35 years and they never used contraception. Another group of women with the same characteristics were interviewed from a rural area at Fayoum Governorate. A questionnaire was filled for each interviewed woman. The total women interviewed in urban area is 340 while in the rural area they were 400 women. Sixty percent of urban women and 80% of rural women are illiterate, 70% of the urban & 100% of rural women are housewives. Their years of marriage ranged between 10-20 years and all of them have more than five children. A percentage of 73.5% of urban women and 85% of rural women stated that children are used as an economic asset to their families, they work in urban areas as assistants in motor repairs, hair-dressers, beggars, bakeries, shops, restaurants and factories while in rural areas they work as agricultural workers.
To document the problem of child labor as a health issue, we report here three case-studies in Ecuador: exposure to mercury among gold washers, exposure to organophosphates and carbamates in the fruit-growing industry, and exposure to solvents among shoe cleaners. We measured the relevant biological indicators of exposure (mercury in urine, urinary levels of phenols, and acetylcholine esterase in erythrocytes) among selected samples of 10 children for each working place. In all the case studies, the values of the biological indicators showed elevated exposure to well-known toxicants, which are now rare in developed countries, even among adult workers. The findings meld with a previously reported case study of intoxication from inorganic lead among children employed in the manufacture of roof tiles in Ecuador. This study highlights the need to properly evaluate and control the potential health effects due to exposure to toxic substances among children employed in different occupations in several parts of the world.
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This report represents the first attempt to assemble existing data from a variety of sources regarding children less than 18 years of age in the work force in Texas. These data include the frequency of detected violations of child labor laws, reports of injuries to the Texas Workers' Compensation Commission, and work-related deaths as ascertained from death certificates. More than 1,000 minors were detected as being illegally employed in Texas each year since 1986 and nearly 1,100 work-related injuries in children 18 years of age and younger were reported to the Texas Workers' Compensation Commission in 1991. A review of Texas death certificates from 1980 to 1990 revealed 125 work-related fatalities among children. The leading cause of death was motor vehicle injuries, followed by injuries from machinery (usually agricultural machinery). The magnitude and severity of occupational illnesses in working children are unknown. Because of physiologic differences in size, metabolism, and absorption, children may be especially susceptible to work-related injury and illness. Health and safety data on working children in Texas, as in most other places, are fragmented and incomplete. These data are needed to identify children at high risk of injuries and illnesses, to target prevention programs, and to identify areas for additional legislation. More rigorous enforcement of current legislation is also needed.
The history of Maternal and Child Health (MCH) in the United States provides some important lessons for us today. Emerging from the child labor abolition and progressive reform movements of the late 1800s, the basis of MCH in the United States can be traced to fundamental concerns regarding how our society should protect children from a host of threats, including abuse, the adverse practices of childhood labor, disease, and the ill effects of unclean milk and water, poor sanitation, and an unsafe environment. These and additional concerns about how to assure that children and families have access to adequate healthcare and to health and social systems that understand the special developmental needs of children persist to this day. A review of the history of MCH fosters an appreciation of the many accomplishments made by early MCH leaders during some very difficult times in this country. Today, with the advent of war and an unclear economic forecast, to say nothing of continuing health care reforms and the reinvention of the roles and purposes of public health, it may offer modest comfort to know that our predecessors faced grim circumstances too and prevailed. As MCH continues to evolve in response to the major social events of the times, there is an ongoing need to revisit and reflect upon the role and purpose of MCH in the society. Our inherited legacy of leadership in MCH both inspires and challenges us as we strive to responsibly advocate, align constituencies, build and use data capacities for need assessment and evaluation, question our premises, identify and courageously confront pressing health and social issues, and continue our efforts to formulate and articulate a vision for the future of MCH.
BACKGROUND: There are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and middle-income countries, despite consistent evidence for the impact of family support on mental health and well-being. This study aims to evaluate the effectiveness of a brief family systemic mental health intervention, deliverable by non-specialists in mental health. METHODS: We conducted an assessor-blind type I hybrid effectiveness-implementation multi-site randomized controlled trial comparing the locally developed family intervention to a waitlist control group for randomly allocated families residing in North Lebanon and Beqa'a governorates. Eligible families presented with medium-to-high risk for child protection concerns (abuse, neglect, child labor, early marriage) and had at least one adolescent aged 12-17 who demonstrated psychological distress. Outcomes at the family, caregiver, and adolescent level were measured pre- and post-intervention, and at 3-month follow-up. RESULTS: Intent-to-treat analyses found a significant between-group effect of the intervention on adolescent-reported family functioning, caregiver mental health, and parenting. No change was found for adolescent psychological distress. Further analyses found effects on adolescent well-being for those who completed the intervention, and that father attendance was associated with better outcomes for adolescent well-being in the intervention group. No other significant moderators were found. At the 3-month follow-up for the intervention condition, family functioning and caregiver well-being significantly dropped from endline. CONCLUSIONS: The study demonstrates mixed results for a non-specialist-delivered family-systemic intervention developed in the context of humanitarian crises in Lebanon. While the intervention did not result in benefits in adolescent-reported symptoms of psychological distress, the intervention group did show greater improvements than the control group on a number of other outcomes, showing the potential impact of working with the wider family system to support adolescents in humanitarian settings.