Monica Lakhanpaul

• MB BS MRCP FRCPCH DM
• Professor at University College London

Introduction Appropriate and healthy feeding practices can enhance a child’s health, prevent obesity and reduce chronic metabolic disease risks. Given the ethnic variations in feeding practices and metabolic risk, interventions must be community specific. Culturally tailored grassroots interventions targeting infant feeding can induce behavioural c...

Background Slum communities face health risks influenced by environmental, human, and animal health factors, particularly antimicrobial resistance (AMR). Tailored, community-driven solutions are needed to address these multifactorial health determinants. This study explores One Health challenges in urban slums using a Patient and Public Involvement...

Objectives Children in Temporary Accommodation (TA) are the most vulnerable and forgotten in the UK.¹ The rising cost of living and the housing crisis led to more children growing up in TA² – an environment unfit to meet their developmental needs. Key to healthy cognitive, physical, social, and emotional development of children is play,³ a process...

Background Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a ne...

This article explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on racially minoritised children and young people. It draws on a study that investigated the factors that impacted the well-being and resilience of Black and Asian children and young people in the UK during the pandemic. The study employed a qualitative approach us...

South Asian Health Foundation, UK (SAHF) ‘Inequalities: Full Stop’ report article

Background The contribution of fathers in the early stages of child development, especially in feeding care and dental hygiene practices, is increasingly recognized but not well-documented. This rapid scoping review aims to broadly map the existing literature on this subject, focusing on children aged less than six years, and to identify areas wher...

Background The Nurture Early for Optimal Nutrition (NEON) programme was designed to promote equitable early childhood development by educating mothers of South Asian origin in east London on optimal feeding, care, and dental hygiene practices. This study conducts a cost analysis of the NEON programme and evaluates its financial sustainability. Meth...

Background: The first 1000-days of life are a critical window and can result in adverse-health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health-disparities, particularly in maternal and child-health. Community-based-interventions, often employing Participatory-Learning-and-Action (PLA) approaches, have...

Background Appropriate and healthy feeding practices can enhance a child’s health, prevent obesity, and reduce chronic metabolic disease risks. Given the ethnic variations in feeding practices and metabolic risk, interventions must be community specific. Culturally tailored, grassroots interventions targeting infant feeding can induce behavioural c...

Objectives Homelessness among families with children under 5 residing in temporary accommodation is a growing global concern, especially in high-income countries (HICs). Despite significant impacts on health and development, these ‘invisible’ children often fall through the gaps in policy and services. The study’s primary objective is to map the co...

Background: The Genomic Medicine Service (GMS) was launched in 2018 in England to create a step-change in the use of genomics in the NHS, including offering whole genome sequencing (WGS) as part of routine care. In this qualitative study on pediatric rare disease diagnosis, we used an implementation science framework to identify enablers and barrie...

Introduction Feeding practices developed in early life can impact a child’s nutrition, growth, dental health, cognitive development and lifetime risk of chronic diseases. Substantial evidence suggests ethnic health inequalities, and non-recommended complementary infant feeding practices among UK’s South Asian (SA) population. Nurture Early for Opti...

Background: While research has led to significant advancements in the health and life expectancy of children with Down Syndrome (DS), there remains a significant burden of disease and health inequity. Further research, focused on areas of greatest need, is imperative to address this. An understanding of what research has been undertaken, and any e...

Objectives Vitamin B-12 deficiency is common in many low- and low-middle-income countries. Vegetarian dietary practices often contribute to this high prevalence. Several observational studies have documented the association of B-12 deficiency in pregnancy with poor neurodevelopment amongst infants [1,2]. However, clinical trials are few and inconcl...

Objectives Qualitative research exploring impacts of the COVID-19 pandemic on children in the United Kingdom, consists of studies either done about, but not with children¹ or explore a general population.² Investigations exploring children living in temporary accommodation during COVID-19 lockdowns, from the child’s own voice, do not exist. To addr...

Low-income countries are struggling with the health impacts of both surface and groundwater chemical contamination. Although the impact of biological contaminants on children's health is acknowledged, the long-term effects of these and emerging contaminants on young children may be underestimated. To map the existing evidence on health impacts of w...

Aim: During humanitarian emergencies, women and children are particularly vulnerable to health complications and neonatal mortality rates have been shown to rise. Additionally, health cluster partners face challenges in coordinating referrals, both between communities and camps to health facilities and across different levels of health facilities....

Background: Facility-based stillbirth review provides opportunities to estimate incidence, evaluate causes and risk factors for stillbirths, and identify any issues related to the quality of pregnancy and childbirth care which require improvement. Our aim was to systematically review all types and methods of facility-based stillbirth review proces...

Background Globally, the COVID-19 pandemic had a huge impact on patients and healthcare systems. A decline in paediatric visits to healthcare settings was observed, which might have been due to lower incidence of injury and infectious illness, changes in healthcare services and parental concern. The aim of our study was to examine parental experien...

Background Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges which require complex packages of multidisciplinary care. Cerebral palsy, an exemplar complex neurodisability condition, is the most common cause of serious physical disabilities among children globa...

Background: Children < 5 years living in temporary accommodation (U5TA) are vulnerable to poor health outcomes. Few qualitative studies have examined service provider perspectives in family homelessness; none have focused on U5TA with a cross-sector approach. This study explored professionals' perspectives of the barriers and facilitators, includi...

Plain English summary Involving families in health research gives children the opportunity to have more control over their healthcare and can help researchers/clinicians to better understand a child’s needs. However, involving children in research is still an uncommon practice despite international pressures to include children in decision making....

Significant strides have been made in eThekwini Municipality, Durban, towards achieving Sustainable Development Goal 6 (SDG6) but with 27% of households lacking access to basic sanitation in 2020, challenges remain. While there is global evidence of sanitation linking to all 17 SDGs, similar localised linkages between sanitation and the SDGs in the...

In 2020, 54% of the world had access to safe sanitation, but access further reduces to 21% in sub-Saharan Africa . With only eight years left to meet the Sustainable Development Goals (SDGs), there is an urgent need to accelerate action in the sanitation sector. Previous academic research highlights sanitation as vital for supporting cross-cutting...

Background: Traditional cookstoves that burn solid biomass are associated with inefficient burning, a high degree of household air pollution and high morbidity rates. A key barrier to the adoption of clean cookstoves has been the cost of fuels. Hence, a Thermo-Electric Generating (TEG) cookstove that used solid biomass fuels more efficiently and re...

Background: People with Down syndrome (DS) are one of the highest risk groups for mortality associated with COVID-19, but outcomes may differ across countries due to different co-morbidity profiles, exposures, and societal practices, which could have implications for disease management. This study is designed to identify differences in clinical pr...

UrbanizationUrbanization, climate changeClimate change, and pandemicsPandemic have put humanityHumanities’s future at a crossroads with complex challengesComplex challenge and overlapping vulnerabilities. The convolutionalConvolutionalnatureNature of the challenges warrants urgent actionsAction by experts from multiple disciplinesDiscipline to co-d...

The authors of the Integrated ScienceIntegrated science:MultidisciplinarityMultidisciplinarityandInterdisciplinarityInterdisciplinarityinHealthHealth were asked how you would see the future of your field 30 years later. This chapter presents the authors’ views on this subject in 2050. The Al-Samah danceDance. In the above poem, Hushang Ebtehaj says...

In the mid-twentieth century, a divide between the ‘two cultures’ of the arts and sciences was often seen as an impediment to effective science and policy. However, a number of philosophers of science have emphasized the common sources of imagination and creativity as well as the versatility of logic and method that cut across the two cultures. Thi...

Aims Rural communities and children are underrepresented in research. It is imperative that researchers engage with these populations, whether it be to disseminate findings or inform the research agenda. Post-pandemic, ensuring these communities are not forgotten is even more essential. Children may have more resistance to the virus but have had to...

Aims The UK has faced 3 major lockdowns since March 2020 due to the pandemic, affecting access to education, healthcare provision and social activities. Children with Down Syndrome are more likely to have chronic health conditions and require developmental support, therefore are more likely to be impacted by healthcare delays and the move to remote...

Aims The combined impact of race discrimination and COVID-19 on the everyday lives of Black Asian and minority ethnic families and communities has drawn to the fore the glaring inequalities that exist in British society today. Drawing from a socioecological framework this ongoing research focuses on the emotional and mental wellbeing and resilience...

Aims On 23rd March 2020, the first of many COVID-19 lockdown measures were implemented in England, which affected the general population, but especially those already considered vulnerable. Homelessness is a known determinant of poor mental health. The objective was to determine whether experiencing homelessness while living in temporary accommodat...

Aims Children experiencing homelessness while living in temporary accommodation (TA) have a higher life-long risk of developing chronic conditions, repeated cycles of homelessness and adverse childhood experiences. The COVID-19 pandemic has disproportionally negatively impacted vulnerable populations. The study objective was to quantitively explore...

The disproportional burden of coronavirus (COVID-19) and vulnerability to containment measures in informal settlements have been recognised; however, the role of poor housing conditions in propagating these remains neglected. Poor housing conditions makes it difficult to effectively implement social distancing measures. With increased time spent in...

Introduction: The Nurture Early for Optimal Nutrition (NEON) study is a multiphase project that aims to optimize feeding, care and dental hygiene practices in South Asian children <2 years in East London, United Kingdom. The multiphase project uses a participatory learning and action (PLA) approach facilitated by a multilingual community facilitat...

Introduction Every year 2.4 million deaths occur worldwide in babies younger than 28 days. Approximately 70% of these deaths occur in low-resource settings because of failure to implement evidence-based interventions. Digital health technologies may offer an implementation solution. Since 2014, we have worked in Bangladesh, Malawi, Zimbabwe and the...

Objective This interdisciplinary qualitative study aims to explore the health, education, engineering and environment factors impacting on feeding practices in rural India. The ultimate goal of the Participatory Approach for Nutrition in Children: Strengthening Health Education Engineering and Environment Linkages project is to identify challenges...

The notion of ‘mental health literacy’ has been proposed as a way of improving mental health problem recognition, service utilisation and reducing stigma. Yet, the idea embodies a number of medical-model assumptions which are often at odds with diverse communities’ spiritual traditions and local belief systems. Twenty participants were recruited to...

Ignoring race, gender and class when tackling a pandemic can undermine not only wellbeing across Black, Asian and Minority Ethnic families and communities (BAME FC) but also their levels of trust in government. A framework to protect wellbeing and resilience in BAME FC during public health emergencies was developed by Co-POWeR to ensure that laws a...

Disproportional burden of COVID-19 and vulnerability to containment measures in informal settlements have been recognised, however, the role of poor housing conditions in propagating these remains neglected. Poor housing conditions will make it difficult to effectively implement social distancing measures. With increased time spent in cramped, dark...

Background Neonatal mortality is high in low-resource settings. NeoTree is a digital intervention for neonatal healthcare professionals (HCPs) aiming to achieve data-driven quality improvement and improved neonatal survival in low-resource hospitals. Optimising usability with end-users could help digital health interventions succeed beyond pilot st...

Objective India has been struggling with infant malnutrition for decades. There is a need to identify suitable platforms for community engagement to promote locally feasible, resource efficient Infant and Young Child Feeding (IYCF) interventions. This study aims to explore if and how schools could represent a site for community engagement in rural...

Individuals with Down syndrome (DS) are among the groups with the highest risk for severe COVID-19. Better understanding of the efficacy and risks of COVID-19 vaccines for individuals with DS may help improve uptake of vaccination. The T21RS COVID-19 Initiative launched an international survey to obtain information on safety and efficacy of COVID-1...

Introduction Participatory learning and action (PLA) is a form of group reflection and learning with documented efficacy in low-income countries to improve social and health outcomes. PLA represents both a learning philosophy and a practical framework that could be applied to a variety of contexts. To date, PLA has not been widely implemented withi...

Background The interdisciplinary Participatory Approach for Nutrition in Children: Strengthening Health, Education, Engineering and Environment Linkages ( PANChSHEEEL ) study used a participatory approach to develop locally-feasible and tailored solutions to optimise Infant and Young Child Feeding (IYCF) practices at an individual, household, commu...

This manuscript describes the differences in symptoms, disease severity, co-morbid risk factors associated COVID19 infection among individuals with Down syndrome from high and low income countries.

Background: Facility-based stillbirth review provides opportunities to estimate incidence, evaluate causes and risk factors for stillbirths, and identify any issues related to the quality of pregnancy and childbirth care which require improvement. Our aim was to systematically review all types and methods of facility-based stillbirth review process...

Introduction: Understanding the extent and cause of high neonatal deaths rates in Sub-Saharan Africa is a challenge, especially in the presence of poor-quality and inaccurate data. The NeoTree digital data capture and quality improvement system has been live at Kamuzu Central Hospital, Neonatal Unit, Malawi, since April 2019. Objective: To describe...

Objective To assess the impact of the COVID-19 lockdown on parents’ health-seeking behaviour and care for a sick or injured child in the Netherlands. Design and setting An online survey on parents’ experiences with a sick or injured child during the COVID-19 lockdown periods was disseminated through social media. Participants Parents living in th...

Background: A new nationally commissioned NHS England Genomic Medicine Service (GMS) was recently established to deliver genomic testing with equity of access for patients affected by rare diseases and cancer. The overarching aim of this research is to evaluate the implementation of the GMS during its early years, identify barriers and enablers to...

Background: A new nationally commissioned NHS England Genomic Medicine Service (GMS) was recently established to deliver genomic testing with equity of access for patients affected by rare diseases and cancer. The overarching aim of this research is to evaluate the implementation of the GMS during its early years, identify barriers and enablers to...

Background In 2019, 585 000 children in England were homeless or at risk of becoming homeless. The pressure of the COVID-19 pandemic on the health-care delivery system has amplified the inequalities faced by marginalised children. Although the UK has had a series of successful health sector reforms, few have designed or implemented strategies that...

Background Feeding practices developed during the first 1000 days of life can affect growth, development, and lifetime risk of nutrition related and dental-related diseases. In the UK, barriers to recommended complementary feeding practices among South Asian caregivers include food access, bicultural issues, and inconsistent advice from health prof...

Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical cha...

Background Respiratory Tract Infections (RTIs) and Gastro-Intestinal (GI) infections are the leading causes of child mortality and morbidity. This study investigates the associations between the individual, household and slum-level determinants of children’s health and vulnerability to RTIs and GI infections in peri-urban slums in India; an area of...

Background Usability is the quality of a user’s experience when interacting with an intervention, encompassing the effectiveness, efficiency and overall satisfaction of the user. It is crucial for user engagement and therefore success of digital health interventions. Agile, user-centred approaches are being applied more commonly to the development...

Background Neonatal mortality remains high in low-income countries; 22/1000 in Malawi. The World Health Organisation has called for actionable information systems to monitor and impact and outcomes. Electronic Audit and Feedback dashboards are an increasingly used healthcare quality improvement strategy which summarise clinical practice over a spec...

Background Neonatal deaths still account for a large proportion of child deaths. Understanding the extent and characteristics of neonatal deaths in Sub-Saharan Africa is a significant challenge with poor quality, inaccurate record-keeping in these settings. The process of audit is considered the foundation of quality improvement. With mHealth gaini...

The CHIP Consortium (a partnership of global North & South non-governmental organisations and universities that include University College London, Columbia University, Hong Kong University, St Luke's University Tokyo, Save the Children India, Indonesia One Health University Network, Jeevan Ashram Sansthan, Kerala Veterinary + Animal Sciences Univer...

Objective: We aimed to identify key barriers to Water Sanitation and Hygiene (WASH) promotion and infant diarrhea prevention services delivered by Accredited Social Health Activists (ASHAs) in rural India. Methods: A case-study was conducted across nine tribal villages in Banswara district (Rajasthan), where in-depth observational and qualitativ...

Background During the COVID‐19 pandemic, the first UK lockdown (March to May 2020) witnessed a dramatic reduction in children presenting to primary/emergency care, creating concern that fear of the virus was resulting in children presenting late. Methods An online survey was co‐developed with UK parents to understand the impact of the lockdown on...

As factors influencing the health and well-being of children are complex and cross-sectoral, integrated interventions are required to improve child health and hence address the Sustainable Development Goals. This paper explores linkages between environmental factors, feeding practices and potential infection pathways in India. The PANChSHEEEL proje...

Background Despite clear linkages between poor Water, Sanitation, Hygiene (WASH) and enteric disease, the design of effective WASH interventions that reduce child enteric infections and stunting rates has proved challenging. WASH factors as currently defined do not capture the overall exposure factors to faecal pathogens through the numerous infect...

Importance: Adults with Down syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19), but further evidence is required to determine the exact risks for children with DS. The clinical features and epidemiological characteristics of COVID-19 in children with DS, and risk factors for severe outcomes, must be establi...

Background Our study aimed to evaluate to what extent Zero2 Expo's ‘Birthing a Better Future’, a co‐created multimedia exhibition, was effective in raising awareness on the importance of the first 1001 days of life and explore what refinements would help to optimize the impact of future exhibitions. Methods We conducted a mixed‐methods evaluation...

To better leverage opportunities arising out of sustainable and inclusive management of sanitation services there is a need for robust and comprehensive evidence of the wide-ranging benefits that sanitation can deliver. The Sustainable Development Goals (SDGs) provide a comprehensive framework for sustainable development broken down into 169 interc...

Introduction The craniofacial abnormalities found in infants with cleft palate (CP) decrease their airway patency and increase their risk of obstructive sleep apnoea (OSA). We hypothesise that optimising sleep position in infants with CP may improve airway patency and offer a ‘low-cost, high-impact’ intervention to prevent the negative impacts of O...

Background In rural India, child stunting remains a pressing concern that is being targeted by national flagship programmes. Poor child hygiene and exposure to enteric pathogens are important drivers of child stunting. Enteric pathogens can be transmitted from contaminated faeces to infants via water, food, hands, objects, soil, and flies. Objecti...

Stunting is a major unresolved and growing health issue for India. There is a need for a broader interdisciplinary cross-sectoral approach in which disciplines such as the environment and health have to work together to co-develop integrated socio-culturally tailored interventions. However, there remains scant evidence for the development and appli...

Disproportional burden of COVID-19 and vulnerability to containment measures in informal settlements have been recognised, however, the role of poor housing conditions in propagating these remains neglected. Poor housing conditions will make it difficult to effectively implement social distancing measures. With increased time spent in cramped, dark...

Objective Systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups. Design Review based on PRISMA guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour model and Behaviour Change Wheel Framework constructs used to under...

BACKGROUND: The first 5 years of life are crucial for optimising growth, health, and cognitive development. However, many children do not reach their full cognitive and developmental potential because of multilevel barriers, including those resulting from poverty and homelessness. This review summarises the evidence characterising the barriers to a...

Background Health conditions, immune dysfunction, and premature aging associated with trisomy 21 (Down syndrome, DS) may impact the clinical course of COVID-19. Methods The T21RS COVID-19 Initiative launched an international survey for clinicians or caregivers on patients with COVID-19 and DS. Data collected between April and October 2020 (N=1046)...

BACKGROUND Emergency and urgent care healthcare services are overburdened and the use of these services by acutely ill infants and children is increasing. A large proportion of these visits could be sufficiently addressed by other healthcare professionals. Uncertainty about the severity of a child’s symptoms is one of many factors that play a role...

Background Urgent and emergency care health services are overburdened, and the use of these services by acutely ill infants and children is increasing. A large proportion of these visits could be sufficiently addressed by other health care professionals. Uncertainty about the severity of a child’s symptoms is one of many factors that play a role in...

To better leverage opportunities arising out of sustainable and inclusive management of sanitation services there is a need for robust and comprehensive evidence of the wide ranging benefits that sanitation can deliver. The Sustainable Development Goals (SDGs) provide a comprehensive framework for sustainable development broken down into 169 interc...

Purpose: Infectious diseases are one of the leading causes of death among children under five (U5s) both in India and globally. This is worse in slum environments with poor access to water, sanitation and hygiene (WASH), good nutrition and a safe built environment. Globally, a One Health (i.e. human, animal and environment) approach is increasingly...

Background Implementation of innovations in healthcare, including new medicines, in the United Kingdom is often lacking behind other countries [1]. The slow uptake of new medicines can delay improvements in patient care and healthcare efficiency. This systematic review aimed to identify factors affecting the uptake of new medicines into practice wi...

This paper identifies opportunities from targeted and integrated sanitation action to achieve the Sustainable Development Goals (SDGs). This is contextualised to the case of Brazil through a systematic approach applied to the sanitation sector that considers the range of infrastructure, management services and people involved in different phases of...

Studies have shown linkages between water, sanitation and hygiene (WASH) and stunting in children under 2 years in sub-Saharan Africa. WASH interventions have shown to reduce stunting rates; however, the biological mechanisms and socioeconomic influences responsible for this trend remain poorly understood. This paper reviews the literature regardin...

Studies have shown linkages between water, sanitation and hygiene (WASH) and stunting in children under 2 years in sub-Saharan Africa. WASH interventions have been shown to reduce stunting rates; however, the biological mechanisms and socio-economic influences responsible for this trend remain poorly understood. This paper reviews the literature re...