Exploring Early Childhood Development Interventions for Building Human Capital in Sub-Saharan Africa: A Scoping Review.

Background: Inequalities in the provision and implementation of early childhood development (ECD) interventions in Sub-Saharan Africa remain a challenge. This scoping review aimed to investigate the types and extent of ECD interventions in this region, using the Nurturing Care framework (NCF).

Methods: This review included randomised controlled trial (RCT) studies related to ECD interventions in Sub-Saharan Africa.

Perceptions of preconception health messaging and responsibility: engaging with 'health helpers' in the Healthy Life Trajectories Initiative-South Africa trial.

Premised on the Developmental Origins of Health and Disease theory and on the limited effectiveness of antenatal interventions, interventions in the preconception period are being conducted to potentially improve intergenerational health and non-communicable disease burdens. The Healthy Life Trajectories Initiative (HeLTI) is an international health research consortium primarily investigating the intergenerational effects of behavioural interventions on obesity via a complex four-phase intervention initiated preconceptionally, through pregnancy, and into early childhood. HeLTI, in partnership with the World Health Organization, aims to generate evidence that will shape health policy focused on preconception as part of a life course approach to population health.

Associations Between Sedentary Behaviour and Fine and Gross Motor Skills in 3- to 4-Year-Olds: A Secondary Data Analysis From Sunrise International Study Pilot Studies.

Background: The evidence on associations between sedentary behaviour (SB) and motor skills in 3- to 4-year-olds is unclear and mostly from high-income countries.

Objective: The objective of this study is to examine associations between (1) screen time (h/day) and total daily SB (h/day), and gross and fine motor skills, and (2) meeting the restraint, screen time and overall SB (restraint and screen time) guidelines and fine and gross motor skills.

Methods: Cross-sectional study of 1394 3- to 4-year-olds from the pilot phase of the SUNRISE International study.

The sleep and activity database for the early years (SADEY) study: design and methods.

Background: Canada, Australia, the World Health Organization and other countries have released 24-hour movement guidelines for the early years which integrate physical activity, sedentary behaviour, and sleep, focusing on supporting children to achieve a healthy 24-hour day. The guideline evidence synthesis, however, highlighted the dearth of high-quality evidence, particularly from large-scale studies. The Sleep and Activity Database for the Early Years (SADEY) project aims to assemble a large, pooled database of 24-hour movement behaviours and health indicators in young children (birth to 5.

Expectations, Tensions, and Brokerage: A Discourse Analysis of Community Engagement with Health Research in South Africa.

Research is increasingly claimed to be done in collaboration with communities, but community members may have entirely different expectations of engagement and research participation than what typically follows the logic of academia. In South Africa, intersecting inequalities further complicate relationships with communities and stakeholders. To understand how different actors view and construct the relationships between academic institutions and communities, we undertook a multiperspective discourse analysis.

Prospective harmonisation of four international randomised controlled trials in Canada, China, India and South Africa: the Healthy Life Trajectories Initiative.

Objectives: The Healthy Life Trajectories Initiative (HeLTI) is an international multistudy consortium that supports the development and integration of four randomised controlled trials (RCTs) conducted in South Africa, India, China and Canada. HeLTI aims to evaluate interventions to improve the health and well-being of mothers and children, starting from preconception through pregnancy and early childhood until age 5 years. This paper describes the process by which we prospectively harmonised the participating studies and provides a descriptive analysis of the study-specific harmonisation potential.

A survey of perceptions and behavioural responses towards the COVID-19 pandemic in South Africa.

Background:  The South African response to the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was swift and assertive, although it came with economic and social costs. An understanding of the pandemic experiences of different population groups is integral to enhancing disease control.

Aim:  The aim of this study was to identify behavioural responses and public perceptions relating to the coronavirus disease 2019 (COVID-19) pandemic.

Retention in the trial in Soweto, South Africa: a qualitative analysis using self-determination theory.

Introduction: There is limited research on applying theory to retention in complex intervention trials. To address this gap, this study aimed to qualitatively examine retention in the randomised controlled trial, from the perspective of trial participants and staff, through the lens of self-determination theory (SDT). The trial is part of the Healthy Life Trajectories Initiative in Soweto, South Africa, with young women.

"You go an extra mile": a qualitative study of community health worker perspectives in a health promotion intervention in urban South Africa.

Background: As part of the Healthy Life Trajectories Initiative in South Africa, the Bukhali health promotion intervention is being implemented by community health workers (CHW's) with young women in urban Soweto. The perspectives of these CHW's have not been fully explored.

Methods: A qualitative study was conducted to describe CHW's perspectives and experiences of delivering the Bukhali intervention.

Geocultural differences in preschooler sleep profiles and family practices: an analysis of pooled data from 37 countries.

Study Objectives: To examine (1) multidimensional sleep profiles in preschoolers (3-6 years) across geocultural regions and (2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, and Latin America) and the Minority World (the Western world).

Methods: Participants were 3507 preschoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n = 1950) and family practices (parental questionnaire) were measured.

The cost of not investing in the next 1000 days: implications for policy and practice.

Building on the evidence from the first paper in this Series highlighting the fundamental importance of healthy and nurturing environments for children's growth and development in the next 1000 days (ages 2-5 years), this paper summarises the benefits and costs of key strategies to support children's development in this age range. The next 1000 days build on the family-based and health-sector based interventions provided in the first 1000 days and require broader multisectoral programming. Interventions that have been shown to be particularly effective in this age range are the provision of early childhood care and education (ECCE), parenting interventions, and cash transfers.

The next 1000 days: building on early investments for the health and development of young children.

Following the first 1000 days of life that span from conception to two years of age, the next 1000 days of a child's life from 2-5 years of age offer a window of opportunity to promote nurturing and caring environments, establish healthy behaviours, and build on early gains to sustain or improve trajectories of healthy development. This Series paper, the first of a two-paper Series on early childhood development and the next 1000 days, focuses on the transition to the next 1000 days of the life course, describes why this developmental period matters, identifies the environments of care, risks, and protective factors that shape children's development, estimates the number of children who receive adequate nurturing care, and examines whether current interventions are meeting children's needs. Paper 2 focuses on the cost of inaction and the implications of not investing in the next 1000 days.

Urban Versus Rural Differences in Meeting 24-h Movement Behaviour Guidelines Among 3-4-Year-Olds: An Analysis of SUNRISE Pilot Study Data From 10 Low- and Middle-Income Countries.

Background: Insufficient physical activity, excessive screen time and short sleep duration among young children are global public health concerns; however, data on prevalence of meeting World Health Organisation 24-h movement behaviour guidelines for 3-4-year-old children in low- and middle-income countries (LMICs) are limited, and it is unknown whether urbanisation is related to young children's movement behaviours. The present study examined differences in prevalence of meeting 24-h movement behaviour guidelines among 3-4-year-old children living in urban versus rural settings in LMICs.

Methods: The SUNRISE Study recruited 429, 3-4-year-old child/parent dyads from 10 LMICs.

Optimal levels of sleep, sedentary behaviour, and physical activity needed to support cognitive function in children of the early years.

Background: Sleep, sedentary behaviour, physical activity, and the composition of these movement behaviours across the 24-h day are associated with cognitive function in early years children. This study used a Goldilocks day compositional data analysis approach to identify the optimal duration of sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity associated with desired cognitive function outcomes in early years children.

Methods: This cross-sectional study included 858 children aged 2.

Examining the psychometric properties of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 among young urban South African women.

Background: Valid, reliable, and easy-to-administer scales are crucial for identifying mental health conditions, especially in LMICs where such scales tend not to be validated. This study aims to address this gap by investigating the psychometric properties and factorial structure of the PHQ-9 and GAD-7 in a sample of young women in Soweto, South Africa.

Methods: The PHQ-9 and GAD-7 were administered to 6028 women aged 18-28 years old.

Risk and Protective Factors for Executive Function in Vulnerable South African Preschool-Age Children.

Executive function (EF) theory and research continues to under-represent the contexts in which the majority of the world's children reside, despite their potential to support, refute, or refine our current understandings. The current study sought to contribute to our understanding of EF in low-income settings in South Africa by investigating longitudinal associations of context-specific risk and protective factors for EF development in three- to five-year-old children who had limited access to ECCE services before the age of five. Child-caregiver dyads (N = 171) participated in two rounds of data collection (approximately seven months apart) during which child EF was assessed using the Early Years Toolbox; context-specific risk and protective factors were assessed through a caregiver questionnaire.

Cost-effectiveness of a complex continuum of care intervention targeting women and children: protocol for an economic evaluation of the Bukhali trial in South Africa.

Introduction: As nearly two-thirds of women presenting at their first antenatal visit are either overweight or obese in urban South Africa, the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and non-communicable diseases. This protocol describes the planned economic evaluation of an individually randomised controlled trial of a complex continuum of care intervention targeting women and children in Soweto, South Africa (Bukhali trial).

Methods And Analysis: The economic evaluation of the Bukhali trial will be conducted as a within-trial analysis from both provider and societal perspectives.