Reflections on Health Promotion and Disability in Low and Middle-Income Countries: Case Study of Parent-Support Programmes for Children with Congenital Zika Syndrome

Abstract

Universal health coverage (UHC) has been adopted by many countries as a national target for 2030. People with disabilities need to be included within efforts towards UHC, as they are a large group making up 15% of the world’s population and are more vulnerable to poor health. UHC focuses both on covering the whole population as well as providing all the services needed and must include an emphasis on health promotion, as well as disease treatment and cure. Health promotion often focusses on tackling individual behaviours, such as encouraging exercise or good nutrition. However, these activities are insufficient to improve health without additional efforts to address poverty and inequality, which are the underlying drivers of poor health. In this article, we identify common challenges, opportunities and examples for health promotion for people with disabilities, looking at both individual behaviour change as well as addressing the drivers of poor health. We present a case study of a carer support programme for parents of children with Congenital Zika Syndrome in Brazil as an example of a holistic programme for health promotion. This programme operates both through improving skills of caregivers to address the health needs of their child and tackling poverty and exclusion.

Growth and Development of Children with Microcephaly Associated with Congenital Zika Virus Syndrome in Brazil

“…In this context, situations of vulnerability of children with CZS are created, with limited health conditions and the low socioeconomic status associated with increasing needs for health services, as a result of their physical and intellectual disabilities [ 18 ]. Thus, through the high risk of alterations, it is necessary to permanently monitor the growth and development of these children.…”

Congenital Zika Syndrome—Assessing the Need for a Family Support Programme in Brazil

“…However, meeting the health care and specialist needs of children was onerous, especially given the need to travel long distances to access the relevant services. This finding is echoed in recent publications, which have described several family impacts, notably isolation, stress, lack of access to services, and powerlessness [31] and the importance of a holistic approach to meet the broad needs of children with neurodevelopmental disabilities and caregivers [32]. b) Would a family support programme be potentially useful in the post Zika context in Brazil?…”

Mothers as facilitators for a parent group intervention for children with Congenital Zika Syndrome: Qualitative findings from a feasibility study in Brazil

“…This study is part of a larger pre post intervention design in Greater Salvador and Rio de Janeiro, which has been described in detail previously [24]. This qualitative study was undertaken between August 2017 and May 2018 in three municipalities of Greater Salvador, Bahia.…”

“…We therefore developed a group intervention ("Juntos", meaning 'together' in Portuguese) to provide psychosocial support and improve the skills of caregivers of children with CZS in Brazil, to optimally care for their child [24,25]. The Juntos programme consists of ten sessions offered over a period of 3 months held in the local community.…”