Lia Fernald: Interventions Addressing Socioeconomic and Health Disparities

Date: 
Tuesday, February 25, 2014 - 5:00pm to 7:00pm
Note: 
5pm reception, 5:30pm talk
Location: 

CERAS Learning Hall, Stanford

Lia Fernald is Associate Professor of Community Health and Human Development in the School of Public Health at U.C. Berkeley. She received her Ph.D. in International Nutrition and Child Development from the University of London, and her M.B.A. from the University of California, Berkeley, with a focus on health management. She was a Fulbright Scholar in Jamaica and has been working in the field of public health nutrition for over fifteen years, focusing largely on children in developing countries. Fernald studies how inequalities in socioeconomic position contribute to growth and developmental outcomes in children, and how interventions can address disparities. The majority of her work is focused on the examination of large samples of low-income populations in rural and urban Mexico, Ecuador, South Africa and Madagascar. Much of her work for the past decade has centered on looking at the effects conditional cash transfer programs, microcredit interventions, and community based nutrition interventions and their effects on child development.

Readings: 

Inequality in early childhood: risk and protective factors for early child development

Susan P Walker, Theodore D Wachs, Sally Grantham-McGregor, Maureen M Black, Charles A Nelson, Sandra L Huff man, Helen Baker-Henningham, Susan M Chang, Jena D Hamadani, Betsy Lozoff , Julie M Meeks Gardner, Christine A Powell, Atif Rahman, Linda Richter, 2011

Inequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Evidence on risks resulting from prenatal maternal nutrition, maternal stress, and families affected with HIV is emerging. Interventions are urgently needed to reduce children’s risk exposure and to promote development in affected children. Our goal is to provide information to help the setting of priorities for early child development programmes and policies to benefit the world’s poorest children and reduce persistent inequalities.

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries

Patrice L Engle, Lia C H Fernald, Harold Alderman, Jere Behrman, Chloe O’Gara, Aisha Yousafzai, Meena Cabral de Mello, Melissa Hidrobo, Nurper Ulkuer, Ilgi Ertem, Selim Iltus, and the Global Child Development Steering Group, 2011

This report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrollment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include children’s educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Effective investments in early child development have the potential to reduce inequalities perpetuated by poverty, poor nutrition, and restricted learning opportunities. A simulation model of the potential long-term economic effects of increasing preschool enrollment to 25% or 50% in every low-income and middle-income country showed a benefit-to-cost ratio ranging from 6·4 to 17·6, depending on preschool enrollment rate and discount rate.