Project Lead(s): Tuan Tran, Thach Duc Tran
Vietnamese researchers point to eight major risks to optimal early childhood brain development around the time of birth in resource-constrained settings: intrauterine growth restriction; stunting; iron deficiency anaemia; iodine deficiency; unresponsive caregiving; insufficient cognitive stimulation; maternal mental health problems, and exposure to family violence.
These risks interact: the poorest women who have experienced intimate partner violence are at the highest risk of common mental disorders. And, even when all other factors are controlled, those who experience common mental disorders during pregnancy are less likely to participate in essential preventive healthcare, including the use of iodized salt to prevent iodine deficiency and taking iron supplements to counter anaemia.
Risks continue in early infancy, both for mom and baby: a third of mothers have common mental disorders, 22% of infants are moderately or severely anaemic and 7.4% are stunted. Six-month-old infants of mothers with antenatal common mental disorders have infant cognitive development scores on average significantly lower than infants of mothers without common mental disorders in pregnancy.
To date, interventions in these settings have focused on one or at most two of these risks, and outcomes for child development have been, at best, only partially effective.
Capitalizing on 15+ years of experience in rural Vietnam, this project (led by Vietnam’s Research and Training Centre for Community Development in Hanoi) aims to pioneer a low-cost program addressing all eight risks through a structured, universal program combining information, learning activities and social support with groups of women at the same life stage: Learning Clubs for Women and Infants.
Content will include interventions to address all eight risks to early childhood brain development, recognizing and integrating consideration of each woman's health and social circumstances during pregnancy and in the years in which they are providing primary child care.
The benefit envisioned: enhanced fetal, newborn and early infant development through improved maternal nutrition, mental health, birth outcomes, sensitivity and responsiveness in care-giving and feeding, and reduced exposure to family violence.
We estimate that this comprehensive approach will reduce preterm birth, anaemia, stunting, rates of cognitive and social emotional development at age six months, with the effects maintained at least to age three among young children in rural Vietnam.