Kassa Getachew Mullu, Yu Zhiyuan, Minwuyelet Fentahun, Gross Deborah
Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
J Glob Health. 2025 Jan 24;15:04018. doi: 10.7189/jogh.15.04018.
Globally, 10% of children and adolescents live with mental health problems and often lack high-quality care. Over 80% of people facing mental health issues reside in low- and middle-income countries (LMICs). Failing to address children's mental health may prolong these challenges into adulthood, impeding their chances for a healthy life. This scoping review aims to describe the types, implementation strategies, effectiveness, and gaps of existing interventions for preventing and treating mental health problems in early childhood (<10 years) in LMICs.
The study employed a scoping review of experimental studies published 2007-2023. Major databases including PubMed, Embase, Web of Science, and PsycINFO were searched using key terms related to the population (children), intervention (mental and/or behavioural health programmes), and outcome (mental health problems). Three authors independently conducted search strategy, article screening, data extraction, and quality assessment. The findings were presented using descriptive analysis and narrative synthesis.
Of 39 499 identified articles, 33 were included in the study, covering 7629 children and published between 2009-2022. Seventeen studies (51.5%) were from upper-middle-income countries, 13 (39.4%) were from lower-middle-income, and three (9.1%) were from low-income countries. Enrolment was community-based in 23 studies and health-facility based in 10 studies; the majority (79%) focused on children aged 3-8 years old. Almost two-third (63.6%) of studies were conducted in urban settings. Programmes encompassed various interventions such as parenting programmes (33.3%). A majority of studies (57.5%) employed group therapy for delivering the programme, with mental health professionals (21.2%) acting as the primary intervention providers. Interventions were primarily received by children (39.4%), followed by mothers/caregivers (33.3%). Most studies explored disruptive disorders (20 studies), social and behavioural problems (16 studies), and anxiety disorders (12 studies). Statistically significant intervention effects on child mental health outcomes were reported for 90% of published studies.
Diverse behavioural programmes that improve the mental health of young children are available and effective in LMICs. Most interventions were delivered in urban settings and focus was on the use of health care professionals. Diverse intervention approaches, including parenting programmes and group therapy, were effective in addressing various mental health issues among young children.
在全球范围内，10%的儿童和青少年存在心理健康问题，且往往缺乏高质量的护理。超过80%面临心理健康问题的人生活在低收入和中等收入国家（LMICs）。未能解决儿童的心理健康问题可能会使这些挑战延续至成年期，阻碍他们拥有健康生活的机会。本综述旨在描述低收入和中等收入国家中针对预防和治疗幼儿期（<10岁）心理健康问题的现有干预措施的类型、实施策略、有效性和差距。
本研究对2007年至2023年发表的实验性研究进行了综述。使用与人群（儿童）、干预措施（心理和/或行为健康项目）和结果（心理健康问题）相关的关键词，检索了包括PubMed、Embase、Web of Science和PsycINFO在内的主要数据库。三位作者独立进行检索策略制定、文章筛选、数据提取和质量评估。研究结果采用描述性分析和叙述性综合呈现。
在39499篇检索到的文章中，33篇被纳入研究，涵盖7629名儿童，发表时间为2009年至2022年。17项研究（51.5%）来自中高收入国家，13项（39.4%）来自中低收入国家，3项（9.1%）来自低收入国家。23项研究的招募基于社区，10项基于医疗机构；大多数（79%）关注3至8岁的儿童。近三分之二（63.6%）的研究在城市环境中进行。项目包括各种干预措施，如育儿项目（33.3%）。大多数研究（57.5%）采用团体治疗来实施项目，心理健康专业人员（21.2%）作为主要干预提供者。干预措施主要针对儿童（39.4%），其次是母亲/照顾者（33.3%）。大多数研究探讨了破坏性行为障碍（20项研究）、社会和行为问题（16项研究）以及焦虑障碍（12项研究）。90%已发表的研究报告了对儿童心理健康结果有统计学意义的干预效果。
在低收入和中等收入国家，有多种改善幼儿心理健康的行为项目，且这些项目是有效的。大多数干预措施在城市环境中实施，重点是使用医疗保健专业人员。包括育儿项目和团体治疗在内的多种干预方法，在解决幼儿的各种心理健康问题方面是有效的。
