What do you mean that drug prevention should target infants? A look at prenatal and infancy visitation
Welcome to the first post of the new series by UNODC on evidence-based prevention strategies! Thank you for being here with us to hear about the strategies that have been found to be effective in preventing drug use, substance abuse and other risky behaviours in the UNODC/WHO International Standards on Drug Use Prevention.
When they hear ‘drug prevention’, most people think about campaigns raising awareness about the dangers of drugs and would find it very difficult to even think about targeting a strategy to children, let alone infants!
However, think about what we know from the science that looks at the factors that make people vulnerable to starting to use drugs and to develop drug use disorders (the ‘aetiology’). We know that each of the stages of development of a child (including during infancy) can be compromised and can result in unhealthy behaviours (including starting to use psychoactive substances) later in adolescence. It should not be surprising, therefore, that if we manage to support the development of a child, this will result in positive outcomes during adolescence. And this is exactly what happens in this case.
Prenatal and infancy visitation programmes are intensive programmes delivered by trained health workers (sometimes social workers) to mothers-to-be in difficult circumstances. Difficult circumstance can refer, for example, to mothers-to-be in a marginalised community and/or that are teenage and/or single.
The key in this kind of programmes is that the services do not wait for mothers-to-be to come to the services, but the services go to the mothers-to-be. The trained health (social) workers provide broad support including: ante-natal care, basic parenting skills, addressing other socio-economic issues (shelter, employment, legal issues, other health issues, etc.).
Crucially, mothers-to-be are not left on their own once the baby is born. Service providers visit up until the baby is two years of age, very intensively at first, less so later on.
Some studies have followed groups of babies until they were adolescents, comparing those whose mothers had received these services and those who had not. Results among the babies that benefited from the programme include less substance use later in life, less mental health disorders and better academic results. Finally, WHO recommends this kind of programmes to prevent child maltreatment.
Does this kind of programme exist in your country?
If yes, can you share a little bit about its implementation and results, so that other people can learn?
If not, do you think this could work in your country? Why so?
Thank you for participating and see you next week!
As ever, so many valid points about the need for prevention focussed activities to begin at an early age from Giovanna. Once again it suggests to me that these inputs are not just necessary for helping to address prevention of substance use disorders but are necessary if we are to address broader issues of negative behaviours and issues associated with preventing mental health problems. Perhaps this is the problem of having to address these matters from within our own "box of concern" . for ISSUP the box is drug demand reduction. However this bix fits into a much bigger box of prevention. I hope too that we will not forget that the focus on young people and prevention should be viewed from the perspective of health promotion and how we can encourage positive behaviour from parents and others whose path crosses the lives of young people. A further thought - again not rocket science and very obvious - is that we should not forget that as we focus on prevention and health promotion of our children and what that means for the education of those who have responsibility and have care for them, is our need to consider the other issues and factors that impact on their behaviour and their growth into adulthood. We can focus on the need to address the individual needs but without addressing the environmental and "situational" needs that many young people, and their parents and communities face, we are unlikely to have positive outcomes for many of our children. Poverty, adequate resources, housing, employment, access to education, proper food and rest - the list is long - are also vital issues that have to be addressed if our young people are to grow as positive contributors to our - and their - societies. It may sound obvious but as with prevention generally people always agree with the sentiment but are less prominent in doing something about it.
I firmly believe that prevention needs to be tackled from a holistic perspective. Traditional prevention techniques used 40 year, or even 10 years, ago are not really relevant or beneficial in modern times. At present there is a major drive in South Africa to educate prospective mothers around FASD (Foetal Alcohol Syndrome Disorder). However, i firmly believe that a programme as outline by Giovanna has tremendous benefits in the prevention of substance use disorder. With the specific set of circumstances that abound in different areas (globally, nationally, and locally) programmes such as this could easily be adapted to factor in local conditions and cultural perspectives, particularly in a country like South Africa that has numerous definitive cultural ideologies. As yet, I am not aware of a structured programme like this in operation in South Africa but am open to correction by my South African Colleagues.
One aspect that I think needs to be included is the role of both genders in the childhood development, and how both can impact on early childhood development.
This programme also appears to be more 'hands on' where previous prevention were more educational, this in itself can be extremely beneficial, giving more practical techniques. A new view on prevention is welcome as in many instances we are not achieving the desired impact.
Thank you Giovanna and ISSUP
Dear Giovanna,
In Brazil there is no program made in a systematic way, what there are are some specific actions, but without evidence support.
The theme this year of our 6th. Conference, held by Freemind and ISSUP Brazil is Prevention in Early Childhood, will be "LOSING THE FUTURE WOULD BE A DRUG, What is the impact of Alccol and Tobacco on the future of our children", we will have several panels with this focus, the Federal Government and some State governments will participate with many actors in the social, education, health and other related sectors.
Our idea is to form a prevention network in Families, Schools and Communities.
I strongly believe in evidence-based prevention and it will be a big challenge in a country like ours of continental dimensions to implement these actions.
But we have very strong support from the federal government and in September we will sign a cooperation agreement between the government and the national chapter of ISSUP.
God bless your work.