12.3 Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030): sexual and reproductive health, interpersonal violence, and early childhood development

World Health Organization // World Health Assembly

Global Health Council, in collaboration with Living Goods, the American Academy of Pediatrics, and the Elizabeth Glaser Pediatric AIDS Foundation, welcome the opportunity to comment on agenda item 12.3. We applaud WHO’s commitment to the safety and well-being of women, children, and adolescents. The environments in which children grow affect their developing brains, and children can only reach their full potential when they have access to healthcare in the communities in which the live—through community health workers (CHWs).

HIV- positive and exposed children are at risk for developmental delays, including premature birth, poorer growth and stunting, and behavioural and cognitive delays. Fetal development is also compromised by HIV viral load and low immunity of the mother, which often leads to other infections as well. Comprehensive guides, like The Nurturing Care Framework for ECD, promises to provide guidance and principles for countries to strengthen their own responses and improve development outcomes for their children.

Further, toxic stress and violence can disrupt development. Child- and gender-based violence are global public health threats, as they can disproportionately affect women and children in hard-to-reach communities who have limited access to resources to establish and maintain household safety. Because survival targets have still not been met, there is growing consensus around how to ensure all vulnerable children, including those affected by HIV, can be supported to achieve their full developmental potential.

With acute and personal knowledge of their communities, CHWs are essential tools in achieving health targets. CHWs can also bridge the divide between facility and community, bringing knowledge, care, and access to those at risk. Further, CHWs can be trained to identify and respond to signs of abuse, neglect, violence, or toxic stress, and they can help promote long-term safety for those in high-risk settings.