Outcomes for street children and youth under multidisciplinary care in a drop-in centre in Tegucigalpa, Honduras

Abstract

Background: There is little evidence to describe the feasibility and outcomes of services for the care of street children and youth in low-income countries. Aims: To describe the outcomes of a multidisciplinary case management approach delivered in a drop-in centre for street children and youth. Methods: A longitudinal study of street children and youth followed in an urban drop-in centre. Four hundred (400) street children and youth received a multidisciplinary case management therapeutic package based on the community reinforcement approach. The main outcomes were changes in psychological distress, substance abuse and social situation scores. Results: The median follow-up time for the cohort was 18 months. There were reductions in the levels of psychological distress (p = 0.0001) and substance abuse (p ≤ 0.0001) in the cohort as well as an improvement in the social situation of street children and youth (p = 0.0001). There was a main effect of gender (p < 0.001) and a significant interaction of gender over time (p < 0.001) on improvements in levels of psychological distress. Survival analysis showed that the probability of remaining on substances at 12 months was 0.76 (95% CI: 0.69-0.81) and 0.51 (95% CI: 0.42-0.59) at 24 months. At 12 months, fewer female patients remained using substances compared to male (p < 0.01). Conclusion: To be most effective, programmes and strategies for children and youth in street situations in developing countries should target both their health and social needs.

The epidemiology of substance use among street children in resource‐constrained settings: a systematic review and meta‐analysis

“…The life-time drug use prevalence varied substantially world-wide, from 14% in Nigeria [5] to 92% in Honduras [44] and Brazil [39]. Additionally, life-time substance use varied substantially intracontinentally.…”

Physical and sexual violence, mental health indicators, and treatment seeking among street-based population groups in Tegucigalpa, Honduras

“…Honduran government policy has recognized the need for public health interventions to alleviate the health consequences of violence in the general population (47). However, there are an acute shortage of qualified health professionals, constraints in the current provision of basic health and social services, and inherent challenges in creating effective programs targeting street-based population groups (20,22,48).…”

“…Street-based populations are particularly vulnerable to violence and abuse (21)(22)(23). Increased risks faced by streetbased population groups toward experiencing violence have been documented in different settings (21,(24)(25)(26).…”

“…Increased risks faced by streetbased population groups toward experiencing violence have been documented in different settings (21,(24)(25)(26). In Tegucigalpa, high levels of distress were documented among street-based adolescents and youth (22), but no data on the factors associated with exposure to violence in the population groups studied were available in Honduras. This information would allow for identifying the health services these most at-risk population groups require.…”

Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street‐connected children and young people: a systematic review

“…Interventions aiming to improve the situations of street‐connected children and young people include educational projects (Malindi 2012; Ouma 2004), vocational training (Ali 2004; Ferguson 2007), harm reduction (Ferguson 2006; Poland 2002), HIV prevention (Kasirye 2004), family therapeutic intervention (Roberts 2010) and multi‐disciplinary programmes (Scivoletto 2011; Souza 2010). Interventions may take the form of single projects, drop‐in centres or peer education interventions, and many will be underpinned by the ‘children's rights’ discourse, more recently taking a holistic approach to the needs of young people (Ennew 2000; Thomas de Benitez 2011).…”