Evidence for Better Lives Study: a comparative birth-cohort study on child exposure to violence and other adversities in eight low- and middle-income countries - foundational research (study protocol)

Abstract

IntroductionViolence against children is a health, human rights and social problem affecting approximately half of the world’s children. Its effects begin at prenatal stages with long-lasting impacts on later health and well-being. The Evidence for Better Lives Study (EBLS) aims to produce high-quality longitudinal data from cities in eight low- and middle-income countries—Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam—to support effective intervention to reduce violence against children. EBLS-Foundational Research (EBLS-FR) tests critical aspects of the planned EBLS, including participant recruitment and retention, data collection and analysis. Alongside epidemiological estimates of levels and predictors of exposure to violence and adversity during pregnancy, we plan to explore mechanisms that may link exposure to violence to mothers’ biological stress markers and subjective well-being.Methods and analysesEBLS-FR is a short longitudinal study with a sample of 1200 pregnant women. Data are collected during the last trimester of pregnancy and 2 to 6 months after birth. The questionnaire for participating women has been translated into nine languages. Measures obtained from mothers will include, among others, mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence, substance use and social/community support. Hair and dry blood spot samples are collected from the pregnant women to measure stress markers. To explore research participation among fathers, EBLS-FR is recruiting 300 fathers in the Philippines and Sri Lanka.Ethics and disseminationThe study received ethical approvals at all recruiting sites and universities in the project. Results will be disseminated through journal publications, conferences and seminar presentations involving local communities, health services and other stakeholders. Findings from this work will help to adjust the subsequent stages of the EBLS project.

Feasibility of a Birth-cohort In Pakistan: Evidence For Better Lives Study

“…We could do all of the set our objectives of this feasibility study with good recruitment and responses rates both for biological samples and electronically collected interview-based data. Thus, illustrating that Pakistan can feasibly be involved as one of the sites for the global birth cohort called Evidence for Better Lives Study [3].…”

“…The main strengths of our feasibility study were its approach to identify eldigible sample using both facility based and a community based approach, high response rate at recruitment, postpartum follow-up and acquiring varied biological samples, using constructs informed by expert opinion through a delphi technique [34], use of validated instruments used in all other EBLS sites making interesting cross cultural comparisons [3]. Speci c to the Pakistan site, this study is novel in the local context in that it takes prenatal life as a period of exposure to adversity and aims to collate these ndings with follow-up data over the childhood years.…”

“…Evidence for Better Lives Study (EBLS) is one of the rst initiatives in the world aiming to establish a multisite birth cohort, comprising 12000 children across the low and middle-income countries (LMIC), who will be followed from intrauterine life to early childhood. One of the main goals of this global cohort will be to assess variety of maternal and environmental exposures and their longer-term effects on child wellbeing and resilience [2,3].…”

“…In summary, the biological, psychological, environmental, social, and cultural in uences which shape children's lives and inform their experiences and behaviors will be the focus of this global cohort set up across diverse resource settings. The current paper reports the feasibility of establishing such a birth cohort in Pakistan which is one of the resource poor countries taking part in this global initiative called the Evidence for Better Lives Study [3].…”

Depression and its associated factors among pregnant women in central Vietnam

“…This research formed part of a pilot baseline study conducted as part of the Evidence for Better Lives Foundational Study (EBLS-FS)—among eight medium-sized cities from low- and middle-income countries, including Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka, and Vietnam. Details of the protocol have been published elsewhere ( Valdebenito et al, 2020 ). In Vietnam, a cross-sectional study was conducted from February to May 2019 to estimate the prevalence of maternal health in Hue city.…”