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1
Sununtnasuk, Celeste, Phuong Nguyen, Anjali Pant, Lan Mai Tran, Shivani Kachwaha, Deborah Ash, Mohsin Ali, et al. "Provision and Utilization of Health and Nutrition Services During the COVID-19 Pandemic in Urban Bangladesh." Current Developments in Nutrition 5, Supplement_2 (June 2021): 690. http://dx.doi.org/10.1093/cdn/nzab045_072.
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Abstract Objectives The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake. Methods We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children < 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Results Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children). Conclusions Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute; and Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI Solutions.
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Romsaiyud, Walisa, and Wichian Premchaiswadi. "Adaptive Multi-Services System for Maternal and Child Health Care on Mobile Application (AM-Care)." International Journal of Healthcare Information Systems and Informatics 5, no. 3 (July 2010): 27–43. http://dx.doi.org/10.4018/jhisi.2010070103.
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Addressing efforts towards the improvement of maternal and child health management can often prove to be problematic in context to successfully obtaining healthcare and medical treatment information from health care professionals. In this regard, the authors propose an adaptive multi-service system that contains fully integrated health care services, medical treatment services, and maternal and child health management. The system utilized both web-based and mobile technology for implementing the application. A practical framework for generating individual maternal and child health care is also presented from data repositories and fully integrated functional health care services to support an improved quality of life for both mother and children. The application, namely AM-Care, consists of the three main components, i.e., Control Centre Component, Web-based Components, and Mobile Components. Also, AM-Care has the important add-on features such as emergency services and warning services.
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Kaur, S., R. Gupta, I. D. Khan, S. Jindal, S. Prajapati, A. Makkar, and K. S. Rajmohan. "INFRASTRUCTURE, RESOURCES, SERVICES EVALUATION AND GAP ANALYSIS OF INTEGRATED MATERNAL AND CHILD DEVELOPMENT SERVICES IN INDIA." International Journal of Medicine and Medical Research 4, no. 2 (March 1, 2019): 67–71. http://dx.doi.org/10.11603/ijmmr.2413-6077.2018.2.9286.
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Background. Integrated Child Development Services (ICDS) is an Indian community-centric government program organized under Anganwadi centres catering to supplementary nutrition, health and preschool education, primary healthcare, growth monitoring and counselling the children under six years old along with their mothers. It is the world’s largest outreach program in a developing country covering a population of 1.35 billion; the variations in service delivery were analysed involving cross-sectional rural and urban Anganwadi centers in New Delhi.
Methods. Data were collected by assessment of children and mothers, interview of Anganwadi workers and observation of service delivery parameters and conduction of activities. Infrastructural, beneficiaries, services and content were evaluated by a suitable pre-tested questionnaire based on the National Institute of Public Cooperation and Child Development (NIPCCD) evaluation proforma. The data was analysed by a descriptive statistics.
Results. Gaps were found in respect of infrastructure, resources, health and nutrition facilities especially at rural Anganwadi centre which was inadequate in terms of implementation of nutrition and health program, supplementary nutrition, preschool education and nutrition rehabilitation centre for existing beneficiaries. Both Anganwadi centres were not catering for new WHO growth standards and adolescent health.
Conclusions. Gaps found in respect of infrastructure, resources, health and nutrition facilities can affect performance of ICDS program and the services delivered by Anganwadi centres, which need a boost. Both urban and rural centres have a direct opportunity towards delivering adolescent health program focusing on nutrition and education of girls prior to their pregnancy, and adoption of new WHO growth standards.
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Shepherd-Banigan, Megan, Janice F. Bell, Anirban Basu, Cathryn Booth-LaForce, and Jeffrey R. Harris. "Mothers’ Employment Attributes and Use of Preventive Child Health Services." Medical Care Research and Review 74, no. 2 (August 3, 2016): 208–26. http://dx.doi.org/10.1177/1077558716634555.
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This study examines whether paid sick leave and hours worked per week are associated with receipt of recommended well-child visits, preventive dental care, influenza vaccines, obesity screening, and vision screening among U.S. children aged 0 to 17 years whose mothers were employed using data from the Medical Expenditure Panel Survey. Residual inclusion instrumental variables methods were used to address unobserved confounding related to maternal employment and child health care use. Instruments were the industry-specific mean of paid leave and hours worked. Fewer than half of children received the recommended number of well-child visits and dental care; only 14% of children received an influenza vaccine in the past year. Paid sick leave was associated with increased adherence to recommended well-child visits (marginal probability, 0.12; 95% confidence interval [CI] = 0.23, 0.01), preventive dental care (marginal probability, 0.28; 95% CI = 0.34, 0.33), and receipt of the influenza vaccine (marginal probability, 0.09; 95% CI = 0.13, 0.05 ).
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Panngam, Nittaya, and Khanitta Nuntaboot. "Mothers and Children Right and Need for Essential Services Accessibility in Communities." Caring: Indonesian Journal of Nursing Science 2, no. 1 (July 21, 2020): 8–22. http://dx.doi.org/10.32734/ijns.v2i1.3976.
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Community play important role to enhance the accessibility to essential rights and services of mothers and children in community. This study utilizes the rapid ethnographic community assessment process (RECAP) to explore community potential for managing accessibility to rights and services of mothers and children in communities. The study was conducted in 8 sub-districts of 8 provinces in 4 regions nationwide. There are 146 informants recruited from purposive sampling include family members, community leaders, local leaders, health care providers, and social groups. Data were collected by the participated observation, in-depth interview, focus group discussion, as well as consultation using interview and focus group guidelines. Data were analyzed using content analysis and thematic analysis. The results reveal two parts include 1) sociocultural context of mothers and children which demonstrate need and way of life of pregnant women and child rearing; and 2) community managing to enhance essential right and service accessibility of mothers and children includes (1) managing fundamental right and services; (2) health services; (3) social welfare and community funds; (4) development safe and learning-enhanced environment; (5) educational services; (6) managing sources of information; and (7) caring based on cultural and traditional way. Based on this findings, national policy makers and relevant stakeholders could be utilizing for improvement prospective development and national policy to reinforce and strengthen community organizations contributing to health development of mothers and children. Keywords: Rapid Ethnographic Community Assessment Process, Maternal Rights, Child Rights, Services for Mother and Child, Service Accessibility, Community Management
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Mokwena, Kebogile Mokwena. "Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children’s Rights in South Africa." Children 8, no. 7 (July 19, 2021): 609. http://dx.doi.org/10.3390/children8070609.
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The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.
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Zaidi, Shehla, Maryam Huda, Ammarah Ali, Xaher Gul, Rawshan Jabeen, and Mashal Murad Shah. "Pakistan’s Community-based Lady Health Workers (LHWs): Change Agents for Child Health?" Global Journal of Health Science 12, no. 11 (September 29, 2020): 177. http://dx.doi.org/10.5539/gjhs.v12n11p177.
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BACKGROUND: In Pakistan’s high child mortality context, a large-scale Lady Health Worker (LHW) Program raises the need to look at whether LHWs are delivering their key mandate as agents of change for child health. This study examines the quantity and quality of LHW interactions with mothers for child health and their impact on mothers' knowledge and child health practices.
METHODS: 1,968 mothers of children <2 years (n=1,968) were interviewed through a cross-sectional survey in two rural districts of Pakistan focusing on immunization, nutrition, and early child illness. Data on frequency of LHW’s visits; services provided, specific services related to routine immunization (RI), nutrition and child illness, and maternal knowledge and practices were analyzed using median values for continuous variables and counts and percentages for categorical data.
RESULTS: Monthly visits by LHW were reported by only 63% of LHW covered households. During LHW monthly encounters, Oral Polio drops administration was most frequently reported (77%), followed by RI (59%), breastfeeding counseling (20%), child illness management advice (18%), growth monitoring (9.5%), while none reported receiving hygiene counseling. Although LHWs were reported to be the main information source for child health; limited impact of LHW-mother interaction was seen on maternal knowledge and practices: 76% mothers reported receiving ORS packets from LHWs but only 27% knew of correct usage, only 34% washed hands before feeding children, less than a third could correctly recall early signs of pneumonia and awareness of Vaccine Preventable Diseases other than Polio ranged from 42%-9% only.
CONCLUSION: Although LHWs are main information source for child health services but infrequent, poor quality household encounters indicate ineffective delivery on the key mandate of community-based child health. Policy debate instead of focusing on scaling up or downsizing the program, should prioritize quality and supervision to improve value for money of a critical community resource.
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Bhandari, Buna, Baburam Pokhrel, Bimala Bhatta, Rajib Karn, Ava Pokhrel, and Nilambar Jha. "Utilization of maternal health care services in Belbari VDC of Eastern Region of Nepal." Journal of Nobel Medical College 1, no. 1 (December 28, 2012): 53–58. http://dx.doi.org/10.3126/jonmc.v1i1.7288.
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Background: Appropriate utilization of maternal health care services is very important to reduce the maternal morbidity and mortality rate in the country and healthful practices while caring mother is needed to improve the health condition of both mother and child. Objectives: Main objectives of this study is to assess the utilization of Maternal health care services and know the cultural practices about care of mother and children of under one year of children. Methodology: Descriptive cross sectional study was conducted among 248 mothers of less than one year children on Belbari VDC of Morang district. Data was collected by using quantitative (house hold survey) and qualitative (focus group discussions and key informant interview) methods. Results: Among 248 mothers, 84% utilized the antenatal care services, 91% received TT vaccine during pregnancy. Most of them 80% had done delivery in health institutions. Conclusion: Based on proposed objectives of study, Utilization of maternal health care services should be encouraged in Belbari VDC of Morang District and healthful practices should be reinforced in areas where corrections are needed.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7288 Journal of Nobel Medical College Vol.1(1) 2011 53-58
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Nimmagadda, Sneha, Lakshmi Gopalakrishnan, Rasmi Avula, Diva Dhar, Nadia Diamond-Smith, Lia Fernald, Anoop Jain, et al. "Effects of an mHealth intervention for community health workers on maternal and child nutrition and health service delivery in India: protocol for a quasi-experimental mixed-methods evaluation." BMJ Open 9, no. 3 (March 2019): e025774. http://dx.doi.org/10.1136/bmjopen-2018-025774.
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IntroductionMillions of children in India still suffer from poor health and under-nutrition, despite substantial improvement over decades of public health programmes. The Anganwadi centres under the Integrated Child Development Scheme (ICDS) provide a range of health and nutrition services to pregnant women, children <6 years and their mothers. However, major gaps exist in ICDS service delivery. The government is currently strengthening ICDS through an mHealth intervention called Common Application Software (ICDS-CAS) installed on smart phones, with accompanying multilevel data dashboards. This system is intended to be a job aid for frontline workers, supervisors and managers, aims to ensure better service delivery and supervision, and enable real-time monitoring and data-based decision-making. However, there is little to no evidence on the effectiveness of such large-scale mHealth interventions integrated with public health programmes in resource-constrained settings on the service delivery and subsequent health and nutrition outcomes.Methods and analysisThis study uses a village-matched controlled design with repeated cross-sectional surveys to evaluate whether ICDS-CAS can enable more timely and appropriate services to pregnant women, children <12 months and their mothers, compared with the standard ICDS programme. The study will recruit approximately 1500 Anganwadi workers and 6000+ mother-child dyads from 400+ matched-pair villages in Bihar and Madhya Pradesh. The primary outcomes are the proportion of beneficiaries receiving (a) adequate number of home visits and (b) appropriate level of counselling by the Anganwadi workers. Secondary outcomes are related to improvements in other ICDS services, and knowledge and practices of the Anganwadi workers and beneficiaries.Ethics and disseminationEthical oversight is provided by the Committee for the Protection of Human Subjects at the University of California at Berkeley, and the Suraksha Independent Ethics Committee in India. The results will be published in peer-reviewed journals and analysis data will be made public.Trial registration numberISRCTN83902145
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Bhattarai, Saraswoti Kumari Gautam, and Kanchan Gautam. "Quality of Maternity Care and Client Satisfaction." Journal of Karnali Academy of Health Sciences 2, no. 1 (June 11, 2019): 73–76. http://dx.doi.org/10.3126/jkahs.v2i1.24419.
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Health service provided to pregnant women during antenatal, childbirth and postnatal period is essential for maternal and child health. Proper care during pregnancy, childbirth and postnatal period are important for the health of mother and baby. High maternal, infant and child morbidity and mortality demand improved healthcare which does not concern to coverage of health services alone. The health issues of pregnant women, mothers, infants and children need to be addressed with the attention to the quality of care (QoC). The Nepal Health Sector Strategy (NHSS) also identifies equity and quality of care gaps as areas of concern for achieving the maternal health sustainable development goal (SDG) target. So this review aims to sensitize and draw attention to the quality of maternity care and client satisfaction to improve maternal and child health. For this article, different studies related to the quality of maternity care and satisfaction from care service received on maternity care are reviewed.
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Rao, Krishna D., Shivani Kachwaha, Avril Kaplan, and David Bishai. "Not just money: what mothers value in conditional cash transfer programs in India." BMJ Global Health 5, no. 10 (October 2020): e003033. http://dx.doi.org/10.1136/bmjgh-2020-003033.
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IntroductionConditional cash transfers (CCTs) have become an important policy tool for increasing demand for key maternal and child health services in low/middle-income countries. Yet, these programs have had variable success in increasing service use. Understanding beneficiary preferences for design features of CCTs can increase program effectiveness.MethodsWe conducted a Discrete choice experiment in two districts of Uttar Pradesh, India in 2018 with 405 mothers with young children (<3 years). Respondents were asked to choose between hypothetical CCT programme profiles described in terms of five attribute levels (cash, antenatal care visits, growth-monitoring and immunisation visits, visit duration and health benefit received) and responses were analysed using mixed logit regression.ResultsMothers most valued the cash transfer amount, followed by the health benefit received from services. Mothers did not have a strong preference for conditionalities related to the number of health centre visits or for time spent seeking care; however, service delivery points were in close proximity to households. Mothers were willing to accept lower cash rewards for better perceived health benefits—they were willing to accept 2854 Indian rupees ($41) less for a programme that produced good health, which is about half the amount currently offered by India’s Maternal Benefits Program. Mothers who had low utilisation of health services, and those from poor households, valued the cash transfer and the health benefit significantly more than others.ConclusionBoth cash transfers and the perceived health benefit from services are highly valued, particularly by infrequent service users. In CCTs, this highlights the importance of communicating value of services to beneficiaries by informing about health benefits of services and providing quality care. Conditionalities requiring frequent health centre visits or time taken for seeking care may not have large negative effects on CCT participation in contexts of good service coverage.
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Kahn, Robert S., Kathryn Wilson, and Paul H. Wise. "Intergenerational Health Disparities: Socioeconomic Status, Women's Health Conditions, and Child Behavior Problems." Public Health Reports 120, no. 4 (July 2005): 399–408. http://dx.doi.org/10.1177/003335490512000407.
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Objective. Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior. Methods. Prospective cohort data (1979–1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of Youth. SES, the Child Behavior Problems Index (BPI), and maternal smoking, depressive symptoms, and alcohol use before, during, and after pregnancy were examined. Results. Lower income and lower maternal education were associated with increased child BPI scores. Adjustment for maternal smoking, depressive symptoms, and alcohol use attenuated the associations between SES and child BPI by 26% to 49%. These maternal health conditions often occurred together, persisted over time, and were associated with the mother's own childhood SES and pre-pregnancy health. Conclusions. Social disparities in women's health conditions may help shape the likelihood of behavior problems in the subsequent generation. Improved public health programs and services for disadvantaged women across the lifecourse may not only address their own urgent health needs, but reduce social disparities in the health and well-being of their children.
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Pai, Divya V., Zari Anjum, Ashwini Kumar, Avinash Shetty, Surabhi Mishra, Uttam Kumar, and Ashita Agrawal. "Utilization of maternal and child health services among migratory/slum dwellers in Udupi municipality area, Karnataka, India." International Journal Of Community Medicine And Public Health 5, no. 9 (August 24, 2018): 3835. http://dx.doi.org/10.18203/2394-6040.ijcmph20183393.
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Background: Irrespective of the tremendous efforts made by Government of India the utilization of MCH services continues to be very low among women belonging to lower socio economic status particularly among slum and migratory population. This significantly upsets country’s declining trend of maternal and infant mortality rate. Therefore a study was undertaken to assess the utilization of maternal and child health services among migratory/slum dwellers in a municipality area.Methods: A community based cross- sectional study was conducted for a period of one month among two hundred eligible women of the study population.Results: Study targeted 1200 households in 16 localities and we obtained information from 200 eligible mothers. Amongst them 74% availed antenatal services from government facilities and only 67% were registered in the first trimester. All mothers received antenatal services. Mother and child protection card was not received by 8.5% of women. 86.1% of them had institutional delivery. 13.9% of mothers delivered at home and 10% of the deliveries were unattended or assisted by friends and relatives. JSY benefits were not availed by 55% of the women.41.5% babies delivered had low birth weight. 14.7% of the children were either partially immunized or not immunized at all. Amongst women belonging to target couple 68% were not using any form of contraception.Conclusions: Utilization of Maternal and Child Health services among the migratory and slum dwellers living in the Municipality area is not satisfactory.
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Dharmawan, Yudhy. "Description Data Completeness in Maternal & Child Health (MCH) Handbook in Temanggung Regency." Journal of Public Health for Tropical and Coastal Region 2, no. 1 (April 16, 2019): 35–40. http://dx.doi.org/10.14710/jphtcr.v2i1.4184.
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Background: Maternal mortality rate in Central Java in 2015 was still high, at 111 / 100,000 live births. Therefore developed a method for early detection of the cause of death in “Desa Siaga“ Program. In this program include a community-based surveillance. Sources of primary data recording surveillance activities are MCH handbook. Therefore it needs to know how the completeness of MCH handbook as a basis for the development of surveillance system in the villageMethod: Data collection techniques using observations with the checklist instrument to describe data completeness MCH handbook. Population study is MCH handbook what owned by Mothers who have children under five. Samples were MCH handbook in 31 villages with category Active “ Desa Siaga” in the working area three health centers in the district of Temanggung.Results: The average of data completeness in MCH Handbook was 45.29%. For 13 MCH Handbook section was observed, there are only 3 parts completeness above 50%, Ten other parts percentage is less than 50%. Conclusion: There are many data that useful for screening high risk pregnant woman and nutrition growth are incomplete. Incomplete data in MCH Data shown that data is not be urgent in MCH Services. Data in MCH Handbook couldn’t be database for MCH Surveillance in “Desa Siaga “ Program
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Fleming, Joseph, Andrew King, and Tara Hunt. "Just Call Me Dad: Health and Social Benefits to Fathers and their Children." Children Australia 39, no. 1 (February 11, 2014): 34–41. http://dx.doi.org/10.1017/cha.2013.35.
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In the past 20 years, social change and expectations for both maternal and paternal responsibilities have highlighted the need for services for families to better understand the role of a father in family relationships. In Australia, as well as internationally, there have been many contested understandings about what constitutes ‘good fathering’ in research, social media and in the political sphere. More specifically, there has also been an emerging trend to understand the challenging task of recruiting and maintaining men's involvement in child and family services programmes, particularly those fathers who are deemed a risk to children and mothers, violent or have been separated from their children. That many child and family/welfare services have exercised dedicated effort to work with fathers is still a relatively recent phenomenon, and has only emerged following criticism that services have been too geared towards working only with mothers. Despite this increasing interest, there is still ongoing need for more research to be undertaken in Australia. An important area of focus is the views of professionals about their perception and engagement of fathers, particularly the views of fathers who are described as being absent from family-based services. The purpose of this article is to report briefly on a study undertaken to examine how child and family welfare workers engage fathers in their work. First, this paper will describe some of the social and health benefits to fathers and their children, focusing on the key role of attachment through play. Research into effective service delivery involving fathers will then be presented, concluding with key practice factors necessary for fathers to be involved in family life.
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Avula, Rasmi, Phuong Nguyen, Sattvika Ashok, Sumati Bajaj, Shivani Kachwaha, Anjali Pant, Monika Walia, et al. "India's 2.42 Million Frontline Health Workers Enable Restoration of Health and Nutrition Service Delivery After Early COVID-19 Lockdowns." Current Developments in Nutrition 5, Supplement_2 (June 2021): 206. http://dx.doi.org/10.1093/cdn/nzab029_007.
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Abstract Objectives Modeling studies have estimated impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes, but little is known about actual delivery status. We studied disruptions and restorations of health and nutrition services by frontline workers (FLWs) in India during COVID-19. Methods We conducted phone surveys with 5500 FLWs in seven states between August–October 2020, asking about service delivery during April 2020 (T1) and in the August-October period (T2) and analyzed changes between T1 and T2. We also analyzed publicly available administrative data (AD) from 704 districts including the pre-pandemic period (T0) to examine disruptions and restoration of services. Results Phone surveys suggest, in T1, opening of village centers, fixed day events, growth monitoring, and immunization services was <50% in several states. In T2, restorations of center-based services were seen, with increases of >33% in >= 3 states. Food supplementation was least disrupted both in T1 and T2. AD highlights geographic variability both in disruptions in T1 compared to T0 and restorations in T2. FLWs’ adaptations to ensure service provision included home delivery (60 to 96%), ensuring physical distancing (33 to 86%), coordinating with other FLWs (7 to 49%), and using phone (∼2 to 65%). Challenges included personal fears, walking long distances, and beneficiaries’ non-cooperation. Conclusions Services to mothers and children were disrupted during lockdown and restored thereafter. Rapid policy guidance and local adaptations by a strong cadre of FLWs likely enabled service resumption. However, gaps remain, and more research is needed on use of services by clients. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.
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G, Sreekanth, Kusuma Nirmala, and Ravinder A. "A comparative study on the role of antenatal care services and child care at various rural and tribal villages, Adilabad, Telangana state." PERSPECTIVES IN MEDICAL RESEARCH 8, no. 2 (November 16, 2020): 88–93. http://dx.doi.org/10.47799//pimr.0802.19.
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Background: Reproductive, maternal, newborn and child health is one of the four categories of the universal health coverage indicators under sustainable development goals target 3.9: family planning, antenatal care (minimum 4 visits), with skilled attendants at birth, full child immunization coverage, and health seeking behavior for suspected child pneumonia1 . Achievement under millennium development goals shows that in developing countries like India, mostly in tribal villages continue to face the greatest challenges in improving the maternal and child health struggling with a combination of poor coverage and quality of health care services and public health interventions. The hard to reach tribal areas face obstacles in ensuring universal access to sexual, reproductive health services2 . The indicators showed lower performance among the tribal communities as seen with most of the health indicators. Poverty, low literacy and poor nutritional status of reproductive age women give rise to poor maternal and child health outcomes along with lack of healthcare delivery facilities lead poor maternal health indicators3 . Methods: A comparative study was conducted on 243 randomly selected mothers who have children less than 7years in rural and tribal villages (150 and 93 respectively). This is community based cross-sectional study and done by using a pre-tested structured questionnaire for data collection at Shanthapur , a rural village and various tribal villages, at an average 25kms away from Adilabad town from Jan-October 2019. Analysis was done using SPSS for windows version 16, Microsoft excel and Open epi website. Result: Out of 243 study subjects, 85% (206) of the study subjects were registered for the antenatal services. The mean age of mother at pregnancy, female literacy, birth order, number of antenatal visits, person conducting delivery, place of delivery, birth weight of child, number of breastfeeding per day, exclusive breastfeeding, total stoppage of breastfeeding ,baby hospitalization due to sickness, weight per age and height per age of the child are statistically significant(p<0.05) between the rural and tribal study subjects . Conclusion and Recommendation: This study revealed that utilization of ANC services and child care services are far better by rural women than the tribal women. The role of antenatal care and child care being influenced by difficulties of accessibility, availability of these services at tribal areas are exposed from this study
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Khatri, Binita, Saraj Grurung, and Anuja Kachapati. "Utilization of Maternal and Child Health Services among Women Admitted In Maternity Ward of A Hospital of Siddharthanagar Municipality." Journal of Universal College of Medical Sciences 9, no. 01 (June 22, 2021): 71–75. http://dx.doi.org/10.3126/jucms.v9i01.37985.
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INTRODUCTION
Maternal and child mortality is a global issue which could be prevented by the utilization of maternal and child health (MCH) services. The main objective of this study was to find out the utilization of MCH services among women admitted in maternity ward of a hospital.
MATERIAL AND METHODS
Cross-sectional descriptive study was conducted to find out the utilization of MCH services among 150 women admitted in maternity ward of a hospital. Non-probability purposive sampling technique was used to select the sample and semi- structured interview schedule was used to collect the data and collected data was analyzed with SPSS version 16.
RESULTS
The study showed that 100% of the women had utilized antenatal services, 98.67% delivered their baby in health centres and utilized postnatal services. During pregnancy, women got health education on danger signs (66.67%), avoidance of sexual intercourse (54%), and birth preparedness (44%). Cent percent of the children utilized at least one child health services, 80% were breastfed within hour of birth, and 93.24% of women were not aware of administration of vitamin K to their newborn. Ethnicity, religion, education, occupation, age at marriage, gravida, parity, history of abortion or child death and number of live children of women, education and occupation of spouses were significantly associated (p<0.05) with utilization of maternal health services.
CONCLUSION
It is recommended that nurses and health personnel should provide health education focusing on birth preparedness, danger signs of mother and baby, and should inform about administration of vitamin K to mother.
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Florentianus, Tat, and Bait M. Maria. "The Effect of Accessibility on Performance of Maternal and Child Health Policy Implementation in East Nusa Tenggara Province, Indonesia." Global Journal of Health Science 11, no. 11 (September 30, 2019): 180. http://dx.doi.org/10.5539/gjhs.v11n11p180.
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BACKGROUND: The fact shows that the performance of health service policy implementation from the output aspect (out put) and the outcome (out comes) policy has not been in line with expectations. This condition will also have a direct influence on the Human Development Index in East Nusa Tenggara Province, where the position of East Nusa Tenggara is still in the order of 32 out of 34 provinces in Indonesia, which ranges from 68.77. The main purpose of this study was to identify the health service accessibility in East Nusa Tenggara. Furthermore, this study also intended to find out the performance of policy implementation and was to identify the effect of accessibility of health sevices on the performance of policy implementation on mothers and children in East Nusa Tenggara.
SUBJECT & METHOD: This research is a quantitative study, conducted in 11 districts, 104 community healths services, and has 235 health workers as respondents in East Nusa Tenggara Province of Indonesia.
RESULT: The results of the study on conditions of accessibility and networking in maternal and child health services in East Nusa Tenggara Province are still lacking (mean 2.7), meaning that conditions of accessibility in East Nusa Tenggara Province do not support the implementation of MCH policies. The performance of MCH policy implementation in East Nusa Tenggara Province is in the 3.36 category, meaning that the targets of MCH services that have been made have not been maximally realized. There is a correlation between accessibility conditions and the performance of MCH policy implementation (p = 0.00), the correlation coefficient of 0.429 shows that this correlation is quite strong, although not very strong. This correlation shows a positive relationship which means that if the accessibility conditions are easier, it will improve the performance of MCH policy implementation. The effect of accessibility on policy performance has been carried out partial linear regression test (t test), found t count = 19.0115 > t table 1.97 means that there is a significant influence on the condition of accessibility to the performance of MCH policies in East Nusa Tenggara Province.
CONCLUSION: Accessibility to health services in East Nusa Tenggara Province is still lacking, the policy implementation performance is good and there is a significant and positive influence between service accessibility and policy implementation performance.
RECOMENDATION: The government is expected to be more serious in efforts to open the accessibility of health services and set more realistic targets that could be achieved.
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Bhandari, Buna, and S. Shrestha. "Utilization of Maternal and Child Health Care Services and Nutritional Status of Under Five Children in Bungmati Village Development Committee, Lalitpur, Nepal." Birat Journal of Health Sciences 2, no. 1 (May 9, 2017): 93–97. http://dx.doi.org/10.3126/bjhs.v2i1.17282.
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IntroductionMaternal and child health care services is essential component to promote family health. Despite of being provided free of cost, adequate utilization on of services is still the issue affecting health of both mother and child in Nepal.Objective The objective of this study was to assess the utilization of Maternal and child health care services and nutritional status of under five children in Bungmati Village Development Committee Lalitpur, NepalMethodologyDescriptive cross sectional study was conducted in Bungmati VDC of Lalitpur district, Nepal among one hundred and fifty households having either under five children, postnatal mothers or pregnant women which was selected purposively based on the objectives of the study. Data was collected by using interview guidelines and anthropometric measurement of children under five was taken. Collected data were analyzed in SPSS.ResultsRegarding utilization of maternal health care services, 90.9% had done their four-time antenatal checkup, 94.2% had delivered their baby at hospital and 65% married women of reproductive age were using one of the family planning methods. Likewise, immunization of under five children showed 100% BCG coverage, 88% pentavalent DPT and Polio, 77% Measles and low coverage of inject able Polio vaccine. About Nutritional status of under five children, more than half (57%) of the child were underweight, 41% were stunted and 20% of them were wasted.ConclusionUtilization of maternal health care services is good though Coverage of family planning needs to be improved and Immunization program should be strengthened. Awareness program for improvement of nutritional status of the under five children should be planned to address nutritional problem of children.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, page: 93-97
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Camerini, Adriana Vieira, Alexandre Emidio Ribeiro Silva, Silvio Omar Macedo Prietsch, Rodrigo Dalke Meucci, Mariane Pergher Soares, Vanusa Belarmino, and Fabiana Da Silva Fernandes. "Regular dental care in preschoolers in rural Southern Brazil." Revista de Saúde Pública 54 (April 24, 2020): 37. http://dx.doi.org/10.11606/s1518-8787.2020054001686.
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OBJECTIVE: To evaluate if factors related to the mother’s previous guidance on her children’s dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS: A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children’s care in daycare centers or schools and maternal guidance on the child’s dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS: The prevalence of regular use was 11.4% (95%CI 7.5–15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38–4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77–9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION: When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.
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Vosler, Nancy R., and John G. Robertson. "Nonmarital Co-parenting: Knowledge Building for Practice." Families in Society: The Journal of Contemporary Social Services 79, no. 2 (April 1998): 149–59. http://dx.doi.org/10.1606/1044-3894.1812.
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The number of children born in the U.S. to nonmarried parents is increasing, and these children are at risk of deleterious outcomes. However, little is known about relationships between unmarried fathers and mothers. Based on a review of extant empirical research and on a multilevel social systems theoretical framework, a practice model is proposed that identifies 12 key factors for further knowledge-development: child well-being, mother's well-being, father's well-being, mother–child relationship, father–child relationship, mother–father relationship, maternal extended family relationships, paternal extended family relationships, neighborhood characteristics, mother's family background, father's family background, and public services and institutional structures. Implications for multilevel approaches to social work practice include needed interventions at both macro and micro levels that address poverty, housing and neighborhood stabilization, employment, child care, human capital development, health and mental health services, family and individual counseling, and parenting skills. Further research must focus on this specific population of “fragile families,” including development and evaluation of effective policies, programs, and services.
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Wieck, A. "Risks and Challenges in Perinatal Mental Health." European Psychiatry 41, S1 (April 2017): S64. http://dx.doi.org/10.1016/j.eurpsy.2017.01.060.
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Mental illness affects 1 in 5 women during pregnancy and the first year postnatal and in about 1 in 20 women the condition is serious. When a woman with major mental illness becomes pregnant she and her child face a number of risks. These include poor pregnancy and neonatal outcomes and a sharp rise of psychiatric admissions after childbirth. Mental illness is also one of the leading causes of maternal death. Risks to children are impaired parenting and developmental disadvantage in emotional, behavioral and cognitive domains. Parental mental illness also has a significant role in infanticide and abuse-related serious harm to children, with infants <1 year old being most at risk.A recent analysis has shown that the resulting economic costs to public services and the wider society are extremely high. In view of the wide-ranging consequences, a number of European countries have set up specialized perinatal mental health services. These consist of specialized inpatient units and community teams. The essential components of their service are preconception counselling, expert advice on the use of medication during pregnancy and breastfeeding, joint inpatient admissions of mothers and babies, interventions to improve parenting, and advice to children's social services. None of these countries, however, are yet offering universal access.In order to improve service provision and outcomes it is important that perinatal mental health is acknowledged more widely as a public health priority. The workshop will provide an opportunity for participants to discuss approaches to raise awareness and promote perinatal service developments.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Sabo, Samantha, Matthew Butler, Kelly McCue, Patrick Wightman, Vern Pilling, Martín Celaya, and Sara Rumann. "Evaluation protocol to assess maternal and child health outcomes using administrative data: a community health worker home visiting programme." BMJ Open 9, no. 12 (December 2019): e031780. http://dx.doi.org/10.1136/bmjopen-2019-031780.
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IntroductionEmerging evidence suggests community health workers (CHWs) delivering preventive maternal and child health (MCH) interventions through home visiting improve several important health outcomes, including initiation of prenatal care, healthy birth weight and uptake of childhood immunisations.Methods and analysisThe Arizona Health Start Program is a behavioral-based home visiting intervention, which uses CHWs to improve MCH outcomes through health education, referral support, and advocacy services for at-risk pregnant and postpartum women with children up to 2 years of age. We aim to test our central hypothesis that mothers and children exposed to this intervention will experience positive health outcomes in the areas of (1) newborn health; (2) maternal health and healthcare utilisation; and (3) child health and development. This paper outlines our protocol to retrospectively evaluate Health Start Program administrative data from 2006 to 2015, equaling 15 576 enrollees. We will use propensity score matching to generate a statistically similar control group. Our analytic sample size is sufficient to detect meaningful programme effects from low-frequency events, including preterm births, low and very low birth weights, maternal morbidity, and differences in immunisation and hospitalisation rates.Ethics and disseminationThis work is supported through an inter-agency contract from the Arizona Department of Health Services and is approved by the University of Arizona Research Institutional Review Board (Protocol 1701128802, approved 25 January 2017). Evaluation of the three proposed outcome areas will be completed by June 2020.
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Golenko, Xanthe A., Rania Shibl, Paul A. Scuffham, and Cate M. Cameron. "Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study." Australian Health Review 39, no. 2 (2015): 136. http://dx.doi.org/10.1071/ah14108.
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Objective The aim of the present study was to examine the relationship between socioeconomic status (SES) and child general practitioner (GP) visits in the first 12 months of life. Methods A longitudinal analysis of 1202 mother and child dyads was conducted as part of the Environments for Healthy Living study from south-east Queensland, Australia, for participants enrolled between 2006 and 2009. Maternally reported survey data (sociodemographic and child health information) were linked with individual Medical Benefits Scheme data from birth to 12 months, identifying GP service use. Results On average, children visited the GP 10.2 times in the first 12 months of life. An inverse relationship was found for SES and child GP visits, with maternal education and child gender the strongest predictors of the total number of GP visits. Almost 70% of participants had all GP consultations bulk billed and only 3.5% paid more than A$100 in total. Conclusions Children from lower SES families may have a greater need for health services due to higher rates of illness and injury. Bulk billing and low-cost access to GP services, regardless of length of consultation, improve equity of access; however, indirect costs may prevent low-income mothers from accessing care for their child when needed. What is known about the topic? The relationship between health and SES, and the influence that health service use can have on this relationship, are well recognised. Previous studies on adult populations in Australia suggest that people of lower SES have more frequent GP consultations due to greater exposure to health risk. However, consultation times are often shorter because short consultations are more likely to be bulk billed, which is resulting in ongoing unmet need. Early childhood visits to the GP can strongly influence long-term health outcomes; however, relatively few studies have examined GP service use among children in Australia. What does this paper add? This paper builds on current knowledge by providing valuable insights into GP service use in the first 12 months of life. It provides evidence to suggest that the relationship between SES and health risk already exists in the first 12 months of life and that bulk billing and low-cost access to GP services improves equity of access. It also highlights the importance of health policy and practice that enables GP service utilisation based on need rather than ability to pay. What are the implications for practitioners? Policies and practice that promote equity of access, such as bulk billing for lower SES families, can assist in improving long-term health outcomes for disadvantaged populations. Greater equity with regard to length of consultation and bulk billing for adults may assist in reducing the disparities in health outcomes between the higher and lower SES populations. Furthermore, indirect costs and the availability of appropriate services for specific groups, such as low income, rural and remote and linguistically and culturally diverse populations, may also be important barriers to access.
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Magwaja, Elia, Jacqueline Minja, Majige Selemani Budeba, and Rocky R. J. Akarro. "Investigation of some factors associated with utilization of maternal health care services by adolescent mothers in Tanzania." Tanzania Journal of Science 47, no. 2 (June 26, 2021): 847–61. http://dx.doi.org/10.4314/tjs.v47i2.39.
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This study examined some factors associated with the utilization of maternal health care servicesby adolescent mothers (15-19 years) in Tanzania in order to provide advice accordingly. The studyused cross-sectional study of adolescent mothers aged 15-19 years using Demographic HealthSurvey and Malaria indicator Survey 2015/16 data. The dependent variables were number ofantenatal care visits, the place where an adolescent mother delivered and post-natal checkup(adolescent mother’s health checking after being discharged or after a home delivery). Theindependent variables were birth order, education level of a mother, marital status of a mother,media exposure, wealth index, distance to health facility. Multiple binary logistic regression wasused to examine an association between each dependent variable and their respective independentvariables. Data was analyzed using IBM SPSS statistics and STATA. This study used 550adolescent mothers in the analysis. Majority of the adolescent mothers had less than four AntenatalCare (ANC) visits (53.5%), while 68.5% of adolescent mothers delivered at a health facility.Adolescent mothers with two or more children had less odds of having at least four ANCscompared to those with one child, whereas adolescent mothers with at least secondary educationhad greater odds of delivering at a health facility compared to those who had no education.Adolescent mothers who had at least four antenatal care visits and those who are married hadgreater odds of checking their health after being discharged compared to adolescent mothers whohad less than 4 ANCs and single adolescent mothers. It was advised that provision of maternaleducation to young girls on the importance of safe delivery and health checking after delivery isvery important to reduce adolescent maternal morbidity and mortality in the country.
Keywords: Adolescent; Maternal Health; Logistic regression; Chi-square
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Allin, Sara, and Mark Stabile. "Socioeconomic status and child health: what is the role of health care, health conditions, injuries and maternal health?" Health Economics, Policy and Law 7, no. 2 (January 26, 2012): 227–42. http://dx.doi.org/10.1017/s174413311100034x.
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AbstractThere is a persistent relationship between socioeconomic status and health that appears to have its roots in childhood. Not only do children in families with lower income and with mothers with lower levels of education have worse health on average than those with greater socioeconomic advantage, but also the gradient appears to steepen with age. This study contributes to the literature on the relationship between socioeconomic status and child health by testing the hypothesis that the increasing effect of family income on children's health with age relates to the children's use of health care services. It also investigates the role of specific health conditions, injuries or maternal health in explaining the steepening gradient. Drawing on a nationally representative survey from Canada, the National Longitudinal Survey of Children and Youth from the period 1994/95–2008/09, this study provides further evidence of a steepening socioeconomic gradient in child health with age. It finds that accounting for health care use does not explain the steepening gradient and that the protective effect of income appears to be greater for those who had contact with the health system, in particular with regard to physician care and prescription drug use.
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Achalu, Priyanka, Neha Zahid, Dominique N. Sherry, Andrew Chang, and Karen Sokal-Gutierrez. "A Qualitative Study of Child Nutrition and Oral Health in El Salvador." International Journal of Environmental Research and Public Health 16, no. 14 (July 14, 2019): 2508. http://dx.doi.org/10.3390/ijerph16142508.
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The nutrition transition from traditional diets to processed snacks and sugary beverages has contributed to a higher burden of child malnutrition, obesity, and tooth decay. While child health interventions typically promote nutritious eating, they rarely promote oral health. Mothers’ motivations for child nutrition and oral health practices need to be better understood. A convenience sample of 102 mothers in eight rural Salvadoran communities participated in focus groups addressing child nutrition and oral health. Focus groups were transcribed and coded using qualitative content analysis. Primary themes included generational changes in health environments; health knowledge, attitudes, and practices; and access and barriers to health services. Mothers noted general improvements in awareness of oral hygiene but poorer child oral health, which they attributed to widespread sales of unhealthy snacks and beverages near schools. Distance and cost limited families’ access to dental services. Knowledge gaps included the belief that oral iron supplements cause tooth decay, uncertainty regarding when to start tooth brushing, and until when parents should help children brush. Maternal-child health programs should emphasize the adverse health consequences of feeding young children processed snacks and sugary drinks, and promote dental care access and regulations to ensure health-promoting environments surrounding schools.
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Burt, Jessica Florence, Joseph Ouma, Lawrence Lubyayi, Alexander Amone, Lorna Aol, Musa Sekikubo, Annettee Nakimuli, et al. "Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda." BMJ Global Health 6, no. 8 (August 2021): e006102. http://dx.doi.org/10.1136/bmjgh-2021-006102.
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BackgroundCOVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services.MethodsAn observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on maternal, neonatal, child, sexual and reproductive health services from July 2019 to December 2020. Descriptive statistics summarised the main outcomes before (July 2019–March 2020), during (April 2020–June 2020) and after the national lockdown (July 2020–December 2020).ResultsBetween 1 July 2019 and 31 December 2020, there were 14 401 antenatal clinic, 33 499 deliveries, 111 658 childhood service and 57 174 sexual health attendances. All antenatal and vaccination services ceased in lockdown for 4 weeks.During the 3-month lockdown, the number of antenatal attendances significantly decreased and remain below pre-COVID levels (370 fewer/month). Attendances for prevention of mother-to-child transmission of HIV dropped then stabilised. Increases during lockdown and immediately postlockdown included the number of women treated for high blood pressure, eclampsia and pre-eclampsia (218 more/month), adverse pregnancy outcomes (stillbirths, low-birth-weight and premature infant births), the rate of neonatal unit admissions, neonatal deaths and abortions. Maternal mortality remained stable. Immunisation clinic attendance declined while neonatal death rate rose (from 39 to 49/1000 livebirths). The number of children treated for pneumonia, diarrhoea and malaria decreased during lockdown.ConclusionThe Ugandan response to COVID-19 negatively impacted maternal, child and neonatal health, with an increase seen in pregnancy complications and fetal and infant outcomes, likely due to delayed care-seeking behaviour. Decreased vaccination clinic attendance leaves a cohort of infants unprotected, affecting all vaccine-preventable diseases. Future pandemic responses must consider impacts of movement restrictions and access to preventative services to protect maternal and child health.
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Karel, Harumi Sasaki. "Knowledge and Use of Maternal and Child Health Services by Mothers in Papua New Guinea." Asia Pacific Journal of Public Health 7, no. 3 (July 1994): 191–93. http://dx.doi.org/10.1177/101053959400700308.
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A survey was conducted in the coastal area of Morobe Province in Papua New Guinea between March to April 1992 in order to obtain and examine the current health knowledge and practices of mothers with children under two years of age. The purpose of the survey was to gather data for the detailed planning and implementation of a Child Survival Intervention Project funded by USAID. A total of 30 villages in the area were selected utilizing the WHO 30-cluster sampling technique. The results indicated that breastfeeding was a very common practice. However, because nutritional intake was not increased during pregnancy and lactation for many of the women, it is likely that their nutritional intake was insufficient. Although many mothers knew the importance of immunization, they were unclear about the importance of completing immunization series. The utilization of contraceptive methods was very low among women who did not want to have another child within the subsequent two years. The most common methods were injections and pills. The dissemination of health education to isolated rural villages is one of the most important interventions in reducing maternal and infant mortality. As there currently is no health education unit at the Morobe Provincial Department of Health. It is crucial to establish the unit and to emphasize the importance of health education as the tool for disease prevention and health promotion. Asia Pac J Public Health1994;7(3):191-3.
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Gautam, Laxmi, and Jwala Subedi. "Barriers in utilization of maternal and child health services among Musahar in Dudhauli Municipality of Sindhuli district, Nepal." International Journal Of Community Medicine And Public Health 8, no. 1 (December 25, 2020): 1. http://dx.doi.org/10.18203/2394-6040.ijcmph20205670.
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Background: Maternal and Child Health remains a public health challenge in Nepal. This study explored information regarding barriers in the utilization of Maternal and Child Health services among women of Musahar community.Methods: A cross-sectional study was carried out in Dudhauli Municipality, Sindhuli using qualitative and quantitative methods. Qualitative data were obtained from, In Depth Interview among health workers and a Focus Group Discussion among FCHVs of Musahar community. Interview was carried out using questionnaire for quantitative study among 121 mothers of under 5 children. The data was analyzed using SPSS software version 21. Chi Square test was applied to test the associations while p value <0.05 was considered significant.Results: The average age and age at marriage of respondents were 24.6±5.7 years and 16.22±2.8 respectively, 76% were illiterate, 93.2% lies below poverty line and 73.6% were home maker. Among them, 29.8 did not have ANC while 47.1 had 4 or more ANC visits, 64.5% institutional delivery and 29.8% PNC visit. Social barriers and lack of information are major barriers contributing to more than half of no ANC visit and which contribute to >60% in case of PNC. Home delivery for first child was 56.2% while for last child was 33.9%. Almost 1/5th of the children were not vaccinated. Qualitative study identified social factors like negligence, family pressure, shyness, and unhealthy financial decisions as important barriers.Conclusions: Utilization of maternal and child health services was poor among Musahar mothers and children which indicates a serious public health concern.
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Borglin, Gunilla, Johanna Hentzel, and Doris M. Bohman. "Public health care nurses’ views of mothers’ mental health in paediatric healthcare services: a qualitative study." Primary Health Care Research & Development 16, no. 05 (February 16, 2015): 470–80. http://dx.doi.org/10.1017/s1463423615000055.
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AimTo investigate public health nurses’ perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services.BackgroundAlthough maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses.MethodsFor this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard’s description of the four-step qualitative content analysis.FindingsThree categories – external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support – were interpreted to reflect the nurses’ perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum.ConclusionWe found that public health nurses can have an important role in supporting mothers’ mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers’ transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.
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Tangcharoensathien, Viroj, Kunihiko Chris Hirabayashi, Chompoonut Topothai, Shaheda Viriyathorn, Orana Chandrasiri, and Walaiporn Patcharanarumol. "Children and Women’s Health in South East Asia: Gap Analysis and Solutions." International Journal of Environmental Research and Public Health 17, no. 10 (May 12, 2020): 3366. http://dx.doi.org/10.3390/ijerph17103366.
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In response to the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) commitment, eight selected countries in the South East Asia region have made a remarkable reduction in infant and child mortality, while a few have achieved an SDG 3.2 target of 25 and 12 for child and neonatal mortality rate, respectively, well before 2030. Across these eight countries, there is a large variation in the achievement of the nine dimensions of maternal, neonatal, and child health service coverage. The poorest wealth quintiles who reside in rural areas are the most vulnerable and left behind from access to service. The rich rural residents are better off than the poor counterparts as they have financial means for travel and access to health services in urban town. The recent 2019 global Universal Health Coverage (UHC) monitoring produced a UHC service coverage index and an incidence of catastrophic health spending, which classified countries into four quadrants using global average. Countries belonging to a high coverage index and a low incidence of catastrophic spending are good performers. Countries having high coverage but also a high incidence of catastrophic spending need to improve their financial risk protection. Countries having low coverage and a high incidence of catastrophic spending need to boost service provision capacity, as well as expand financial protection. Countries having low coverage and a low incidence of catastrophic spending are the poor performers where both coverage and financial protection need significant improvement. In these countries, poor households who cannot afford to pay for health services may forego required care and instead choose to die at home. This paper recommended countries to spend adequately in the health sector, strengthen primary health care (PHC) and safeguard the poor, mothers and children as a priority in pathways towards UHC.
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Nabudere, Harriet, Delius Asiimwe, and Rhona Mijumbi. "Task shifting in maternal and child health care: An evidence brief for Uganda." International Journal of Technology Assessment in Health Care 27, no. 2 (March 30, 2011): 173–79. http://dx.doi.org/10.1017/s0266462311000055.
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The Problem: There is a shortage and maldistribution of medically trained health professionals to deliver cost-effective maternal and child health (MCH) services. Hence, cost-effective MCH services are not available to over half the population of Uganda and progress toward the Millennium Development Goals for MCH is slow. Optimizing the roles of less specialized health workers (“task shifting”) is one strategy to address the shortage and maldistribution of more specialized health professionals.Policy Options: (i) Lay health workers (community health workers) may reduce morbidity and mortality in children under five and neonates; and training for traditional birth attendants may improve perinatal outcomes and appropriate referrals. (ii) Nursing assistants in facilities might increase the time available from nurses, midwives, and doctors to provide care that requires more training. (iii) Nurses and midwives to deliver cost-effective MCH interventions in areas where there is a shortage of doctors. (iv) Drug dispensers to promote and deliver cost-effective MCH interventions and improve the quality of the services they provide. The costs and cost-effectiveness of all four options are uncertain. Given the limitations of the currently available evidence, rigorous evaluation and monitoring of resource use and activities is warranted for all four options.Implementation Strategies: A clear policy on optimizing health worker roles. Community mobilization and reduction of out-of-pocket costs to improve mothers’ knowledge and care-seeking behaviors, continuing education, and incentives to ensure health workers are competent and motivated, and community referral and transport schemes for MCH care are needed.
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Edmond, Karen, Khaksar Yousufi, Malalai Naziri, Ariel Higgins-Steele, Abdul Qadir Qadir, Sayed Masoud Sadat, Alexandra L. Bellows, and Emily Smith. "Mobile outreach health services for mothers and children in conflict-affected and remote areas: a population-based study from Afghanistan." Archives of Disease in Childhood 105, no. 1 (July 3, 2019): 18–25. http://dx.doi.org/10.1136/archdischild-2019-316802.
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ObjectiveTo assess whether sustained, scheduled mobile health team (MHT) services increase antenatal care (ANC), postnatal care (PNC) and childhood immunisation in conflict-affected and remote regions of Afghanistan.DesignCross-sectional, population-based study from 2013 to 2017. Proportions were compared using multivariable linear regression adjusted for clustering and socio-demographic variables.Setting54 intervention and 56 control districts in eight Afghanistan provinces.Participants338 796 pregnant women and 1 693 872 children aged under 5 years.Interventions‘Intervention districts’ that received MHT services for 3 years compared with ‘control districts’ in the same province without any MHT services over the same period.Main outcome measuresDistrict-level and clinic-level ANC, PNC, childhood immunisation (pentavalent 3, measles 1), integrated management of childhood immunisation services.ResultsProportion of pregnant women receiving at least one ANC visit was higher in intervention districts (83.6%, 161 750/193 482) than control districts (61.3%, 89 077/145 314) (adjusted mean difference (AMD) 14.8%;95% CI: 1.6% to 28.0%). Proportion of children under 1 year receiving their first dose of measles vaccine was higher in intervention (73.8%, 142 738/193 412) than control districts (57.3%, 83 253/145 293) (AMD 12.8;95% CI: 2.1% to 23.5%). There was no association with PNC (AMD 2.8%;95% CI: −5.1% to 10.7%). MHTs did not increase clinic-level service provision for ANC (AMD 41.32;95% CI: -52.46 to 135.11) or any other outcomes.ConclusionsSustained, scheduled MHT services to conflict-affected and remote regions were associated with improved coverage of important maternal and child health interventions. Outreach is an essential service and not just an ‘optional extra’ for the most deprived mothers and children.
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Symes, Lene, Judith McFarlane, John Maddoux, and Nina Fredland. "Evaluating an Intergenerational Model to Explain the Path From Violence Against Mothers to Child Behavior and Academic Outcomes." Violence Against Women 26, no. 6-7 (April 29, 2019): 730–49. http://dx.doi.org/10.1177/1077801219841444.
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An intergenerational model to explain the long-term effect of partner violence against mothers on child behavior was evaluated 48 months after 278 mothers first sought safe shelter or justice services. Twelve percent reported recent abuse, and six mothers reported severe or extreme danger. Self-efficacy (−.58, p < .05), social support (−28, p < .05), and financial support (−.25) were inversely associated with mental health concerns. Higher maternal mental health concerns (.55, p < .05) and child witnessing abuse (.70, p < .05) were associated with child behavioral problems. Child behavioral problems were inversely associated with child academic functioning (−.22, p < .05). To improve child outcomes, interventions that establish safety for mothers and children and promote maternal mental health are needed.
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Agustina, Agustina, and Mariana Oni Betan. "Pengaruh Pendidikan Kesehatan Tentang Deteksi Dini Perkembangan Anak Usia Balita Terhadap Peningkatan Pengetahuan dan Ketrampilan Ibu Dalam Melakukan Deteksi Dini Perkembangan Anak di Pusat Kesehatan Masyarakat Sikumana, Kota Kupang." JURNAL INFO KESEHATAN 15, no. 1 (June 3, 2017): 1–13. http://dx.doi.org/10.31965/infokes.vol15.iss1.123.
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Early childhood is the "golden period" of child development, the window of opportunity and the critical period. This period is a sensitive period, a period of rapid and important growth and development. If there is a drift of growth and not detected early then it will affect the growth of the next flower (Siswanto, 2010). Based on data from East Nusa Tenggara Health Profile (2010), early detection in children under five in Kupang City was 1,506 children (9.3%) of 16,121 children under five. Research Ina A., 2014, in Kota Kupang, found 19 respondents experiencing development deviations. Existing phenomenon in the field rarely found early detection activities of child development in Maternal and Child Health Services. Assessment of progress with KPSP is easy to do as long as you know how. This study aims to analyze the influence of health education on early detection of the child under five development of children towards improving mother's knowledge and skill in early detection of child development, at Maternal and Child Health Services, health center of Sikumana, Kupang City ". This type of research is experimental with one group design pre-test and post-test design. The sample size was 44 people, ie 22 treatment and 22 no treatment. Random sampling. The results of this study indicate that there is an effect of health education on early detection of the development of children under five on improving mother's knowledge and skills in early detection of child development, in Maternal and Child Health Services Sikumana Health Center, Kupang City "with p = 0,000, for knowledge and p = 0,000 for skills.
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Kremer, Kristen P., Jamie S. Kondis, and Theodore R. Kremer. "Discordance in Reporting of Maternal Aggression: Exploring Differences by Characteristics of Children, Mothers, and Their Environments." Child Maltreatment 25, no. 3 (September 17, 2019): 339–51. http://dx.doi.org/10.1177/1077559519876033.
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This study investigated discordant reports of maternal aggression using the Fragile Families and Child Wellbeing Study ( N = 1,606). Multinomial logistic regression models predicted discordant reports of hitting and shouting from child, mother, and environmental characteristics. Compared to dyads in which both mothers and children reported aggression, mothers with a college degree had higher child-only and mother-only reports of both hitting and shouting versus mothers with less than a high school diploma. High-income mothers had higher child-only reports of hitting, while families with past Child Protective Services involvement had higher child-only and mother-only reports of hitting. Additionally, children with lower reading test scores and whose fathers had history of incarceration had higher child-only reports of hitting. Families residing in neighborhoods for which mothers were scared to let children play outside also had higher child-only and mother-only reports of hitting and shouting.
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Carson, Lauren E., Borscha Azmi, Amelia Jewell, Clare L. Taylor, Angela Flynn, Carolyn Gill, Matthew Broadbent, Louise Howard, Robert Stewart, and Lucilla Poston. "Cohort profile: the eLIXIR Partnership—a maternity–child data linkage for life course research in South London, UK." BMJ Open 10, no. 10 (October 2020): e039583. http://dx.doi.org/10.1136/bmjopen-2020-039583.
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PurposeLinked maternity, neonatal and maternal mental health records were created to support research into the early life origins of physical and mental health, in mothers and children. The Early Life Cross Linkage in Research (eLIXIR) Partnership was developed in 2018, generating a repository of real-time, pseudonymised, structured data derived from the electronic health record systems of two acute and one Mental Health Care National Health Service (NHS) Provider in South London. We present early descriptive data for the linkage database and the robust data security and governance structures, and describe the intended expansion of the database from its original development. Additionally, we report details of the accompanying eLIXIR Research Tissue Bank of maternal and neonatal blood samples.ParticipantsDescriptive data were generated from the eLIXIR database from 1 October 2018 to 30 June 2019. Over 17 000 electronic patient records were included.Findings to date10 207 women accessed antenatal care from the 2 NHS maternity services, with 8405 deliveries (8772 infants). This diverse, inner-city maternity service population was born in over 170 countries with an ethnic profile of 46.1% white, 19.1% black, 7.0% Asian, 4.1% mixed and 4.1% other. Of the 10 207 women, 11.6% had a clinical record in mental health services with 3.0% being treated during their pregnancy. This first data extract included 947 infants treated in the neonatal intensive care unit, of whom 19.1% were postnatal transfers from external healthcare providers.Future plansElectronic health records provide potentially transformative information for life course research, integrating physical and mental health disorders and outcomes in routine clinical care. The eLIXIR database will grow by ~14 000 new maternity cases annually, in addition to providing child follow-up data. Additional datasets will supplement the current linkage from other local and national resources, including primary care and hospital inpatient data for mothers and their children.
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Paudel, Radha Kumari, Mamata Maharjan, and Sabina Shrestha. "Utilization of Postnatal among Mothers having under Two years Child in Mahalaxmi Municipality, Lalitpur, Nepal." Journal of Advanced Academic Research 4, no. 2 (April 1, 2018): 92–98. http://dx.doi.org/10.3126/jaar.v4i2.19539.
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Postnatal care is a critical phase in the lives of mothers and newborn babies as major changes occur during this period which determines the well-being of mothers and newborns. Adequate utilization of postnatal care can help reduce maternal as well as infant morbidity and mortality. Thus, this study generates the information regarding postnatal care utilization in Lubhu of Mahalaxmi Municipality. This was a descriptive cross-sectional study carried out in a Lubhu of Lalitpur district. The study sample comprised of 130 mothers having unser2 year’s children in year 2017. A pre-tested structured questionnaire was used for data collection. The findings showed that majority of mothers fall under age group 20-29, maximum were from Hindu and Newar ethnicity. This study highlighted more than half (67.7%) mothers utilize the postnatal services. One of the important reasons for not utilizing postnatal services is absence of disease condition in child followed by less knowledge about postnatal services. There was a significant (p=0.018) association between mothers’ education status with utilization of postnatal services. This study concludes that maternal education status affects the maternal utilization of postnatal care services. In order to achieve 100% postnatal care utilization, awareness programs, educational package and other various Postnatal women focused program must be conducted to make them aware about the importance of the utilization of Postnatal services and availability of Postnatal services in different level of health facility.
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Khoirunisa, Esdaniar, Ravik Karsidi, and Munawir Yusuf. "The Role of Posyandu as Primary Health Care Services in Implementing Early Detection and Intervention for Autistic Children in Indonesia." International Journal of Multicultural and Multireligious Understanding 6, no. 1 (February 1, 2019): 101. http://dx.doi.org/10.18415/ijmmu.v6i1.511.
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Autism is one of the most complex developmental disorder in children. In the developing country, Autism is a new paradigm, it causes various problems in autism service especially in early detection. It is caused by several factors that interconnected, such as the low understanding of society about autism, the low public awareness about the importance of early detection of autistic children, and the less prioritized attention from the government. Expanding the accessibility of autism services through primary health care is needed to overcome those problems. One of the primary health care most relatable to mother and children is the Maternal and Child Health Center, or in Indonesia it is called "Posyandu" which is an acronym means Integrated service post. The services in Posyandu is not run by professionals such doctor nor midwife. Posyandu is a service-based community and society handled by "posyandu cadres". The aim of this study is to find out how far the possibility of posyandu could provide services for autistic children. The subjects involved in this study were 120 posyandu cadres and 15 parents of autistic children. The research method used is a survey. The results show the following data: 92% of Posyandu cadres did not know how to do early detection of autistic children, 87% said they did not know how to handle autistic children, and 87% of Posyandu cadres felt they still need additional knowledge about autism. While 87% of parents feel that posyandu cadres are not involved in the early detection of their children. At the same time, 93% of parents still hope Posyandu could provide better services for their autistic children. This indicates that the primary health care has not fully played a role for autistic children yet, and there is a need to increase autism services access through posyandu cadres.
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Phommachanh, Sysavanh, Dirk R. Essink, Pamela E. Wright, Jacqueline E. W. Broerse, and Mayfong Mayxay. "Maternal health literacy on mother and child health care: A community cluster survey in two southern provinces in Laos." PLOS ONE 16, no. 3 (March 29, 2021): e0244181. http://dx.doi.org/10.1371/journal.pone.0244181.
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Rational Increased maternal health literacy (MHL) has contributed considerably to maternal and child health outcomes in many countries. Malnutrition, and low coverage of child vaccination and breastfeeding are major health concerns in Laos, but there is little insight into mothers’ literacy on these issues. The aim of this study was to identify the level of MHL of Lao mothers and to explore factors influencing it, in order to provide evidence that can inform policies and planning of health services. Methods A cross-sectional survey was conducted using a questionnaire on health literacy (ability to access, understand, appraise and apply health-related information) in relation to care during pregnancy, childbirth, and the postpartum period. We interviewed 384 mothers with children aged under five years; 197 from urban and 187 from rural areas. Descriptive and inferential statistics were applied to analyze the data. Results Overall, MHL of Lao mothers was very low in both urban and rural areas; 80% of mothers had either inadequate or problematic MHL, while only 17.4% had sufficient and 3.5% excellent MHL. The MHL scores were significantly higher in urban than in rural areas. One third of mothers found it very difficult to access, understand, appraise and apply information on mother and child (MCH). Health personnel were the main source of MCH information for the mothers. Years of schooling, own income, health status, and number of ANC visits significantly predicted a higher level of MHL (R square = 0.250; adjusted R square = 0.240, P = <0.001). Conclusions MHL of Lao mothers was inadequate in both urban and rural areas. Socio-demographics and key practices of the mothers were significantly associated with a better level of MHL. Health education on MHL to mothers in both urban and rural areas needs attention, and could best be done by improving the quality of health providers’ provision of information.
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Cesar, Juraci A., Alicia Matijasevich, Iná S. Santos, Aluísio J. D. Barros, Juvenal S. Dias-da-Costa, Fernando C. Barros, and Cesar G. Victora. "The use of maternal and child health services in three population-based cohorts in Southern Brazil, 1982-2004." Cadernos de Saúde Pública 24, suppl 3 (2008): s427—s436. http://dx.doi.org/10.1590/s0102-311x2008001500008.
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This study aimed to describe indicators of health care assistance during antenatal care, delivery and in the first year of life in Pelotas, Rio Grande do Sul State, Brazil. In 1982, 1993, and 2004, all hospital newborns from the urban area of Pelotas were enrolled in a cohort study. In this period, the number of pregnant women that did not attend antenatal care fell from 4.9% to 1.9%; the mean number of appointments increased from 6.7 to 8.1; and the number of women who began antenatal care in the third trimester of pregnancy decreased from 14.8% to 7%; caesarean sections increased from 27.7% to 45.2% and the proportion of deliveries assisted by physicians increased from 61.2% to 89.2%. Improvements in immunization rates during the first year of life mainly occurred between 1982 and 1993, while the number of preventive medical appointments improved among those born in 2004. This increase in coverage was greater for low-income mothers and children, which may reflect the implementation of universal coverage in Brazil; however, coverage levels in 1982 were already high for wealthy mothers and children, reducing the scope for further gains.
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Pachori, Ravi, and Jiratithigan Sillapasuwan. "Impact of determinants on nutritional status among children up to five years at tertiary care hospital, HIMS, Sitapur, Uttar Pradesh." International Journal Of Community Medicine And Public Health 8, no. 3 (February 24, 2021): 1391. http://dx.doi.org/10.18203/2394-6040.ijcmph20210487.
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Background: Malnutrition in children occurs as a complex interplay among various factors like maternal health, dietary practices, hand washing and other hygiene practices, low birth weight, episode of diarrhoea and acute respiratory infection within the last 6 months are often associated with undernutrition in most developing nations including India. Objective of the study were to assess the determinants of maternal and child health, hygienic practice, health services for underweight and their association among apparently healthy children. Methods: The present study was hospital based descriptive cross-sectional study conducted from June 2019 to December 2019. The sample size calculated was 410, and accounting for 10% nonresponsive, the sample size calculated was 451. The data obtained were compiled and entered in MS-excel 2010 and analysed by using institutional SPSS (22.0). Results: Mother’s age at marriage <18 years belong to 68 (15.1%) children significantly low proportion as compared to marriage >18 years 383 (84.9%) including underweight 41 (22.5%) and mother’s age at child birth <18 years belong to 46 (10.2%) children significantly very low proportion in comparison to child birth >18 years including underweight 30 (16.6%). Birth weight <2.5 kg belongs to significantly 136 (30.1%) children including underweight 72 (39.8%) and significantly birth order >2 belong to 135 (29.9%) children including underweight 39 (21.6%). Exclusive breast feeding belongs to 149 (33.0%) children including underweight 62 (34.2%)Conclusions: Health education and its reinforcement especially in the area of maternal & child health care services is required.
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Topothai, Chompoonut, Thitikorn Topothai, Rapeepong Suphanchaimat, Walaiporn Patcharanarumol, Weerasak Putthasri, Yupayong Hangchaowanich, and Viroj Tangcharoensathien. "Breastfeeding Practice and Association between Characteristics and Experiences of Mothers Living in Bangkok." International Journal of Environmental Research and Public Health 18, no. 15 (July 26, 2021): 7889. http://dx.doi.org/10.3390/ijerph18157889.
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Although the benefits of breastfeeding are widely recognized, only 14% of mothers in Thailand exclusively breastfed their children during the first six months of their lives in 2019, which dropped from 23% in 2016. This study aimed to assess the prevalence of exclusive breastfeeding (EBF) up to six months, current breastfeeding patterns, and key determinants that influence six-month EBF among mothers residing in Bangkok, Thailand. A cross-sectional study was conducted using a self-administered questionnaire survey. In total, 676 healthy mothers living in Bangkok, whose most recent child was between 6 and 18 months old, were recruited. Descriptive statistics, univariable analysis by Chi-square test, and multivariable logistic regression were performed to assess the association between six-month EBF and maternal characteristics and experiences of using maternal health services. The prevalence of six-month EBF of infants in Bangkok was 41%. The key determinants that influenced six-month EBF included: maternal age of more than 30 years; higher education level; higher maternal income; multi-parity; exposure to breastfeeding advice during pregnancy; intention to breastfeed for a long duration (≥6 months) during pregnancy; experience of six-month EBF in the previous child. This study draws health professionals’ and policy makers’ attention to further promote breastfeeding in particular types of mothers.
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Félix-Beltrán, Lucía, James Macinko, and Randall Kuhn. "Maternal height and double-burden of malnutrition households in Mexico: stunted children with overweight or obese mothers." Public Health Nutrition 24, no. 1 (September 1, 2020): 106–16. http://dx.doi.org/10.1017/s136898002000292x.
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AbstractObjective:To assess the association between short maternal height and four types of mother–child nutritional status groupings within Mexican households.Design:We classified mother–child dyads into four groups: stunted child and a non-overweight/non-obese mother (stunting-only), non-stunted child and an overweight/obese mother (overweight-only), stunted child with an overweight/obese mother (double-burden) and households with neither child stunting nor overweight/obese mothers (neither-condition). We assessed the association between maternal height and mother–child nutrition status using multinomial logistic regression, controlling for socio-economic covariates.Setting:Nationally representative cross-section of households from the 2012 Mexican National Health and Nutrition Survey.Participants:Children <5 years of age were matched to their mothers, resulting in a sample of 4706 mother–child dyads.Results:We found that among children with stunting, 53·3% have an overweight/obese mother. Double-burden was observed in 8·1% of Mexican households. Maternal short stature increased the probability of stunting-only by 3·5% points (p.p.) and double-burden by 9·7 p.p. (P < 0·05). The inverse association was observed for overweight-only and neither-condition households, where the probability of these outcomes decreased by 7·2 and 6 p.p. in households with short-statured mothers (P < 0·05), respectively.Conclusions:Women with short stature are more likely to develop overweight and simultaneously have a stunted child than those who are not short-statured. Our findings underline the challenges faced by public health systems, which have to balance the provision of services for both an undernourished and increasingly overweight/obese population.
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Coyle, Sabrina, Kiran M. Sarma, Catherine Maguire, and Leora De Flumere. "Building a Predictive Model of Social-Emotional Adjustment: Exploring the Relationship between Parenting Self-Efficacy, Parenting Behaviour and Psychological Distress in Mothers of Young Children in Ireland." International Journal of Environmental Research and Public Health 18, no. 6 (March 11, 2021): 2861. http://dx.doi.org/10.3390/ijerph18062861.
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The purpose of this study was to generate greater understanding of social-emotional difficulties in infants and toddlers in an Irish context. This study compared rates of reported social-emotional difficulties in young children in clinical and non-clinical samples and probed a predictive model of social-emotional adjustment. Data were collected from a cross-sectional sample of 72 mothers of young children aged between 12 and 48 months. Mothers were recruited from waiting lists for child Early Intervention services (clinical sample) and community mother-toddler groups (non-clinical sample). Mothers completed a questionnaire battery which assessed parenting self-efficacy, parenting behaviour, psychological distress and child social-emotional adjustment. The results indicated that 55.5% of young children in the clinical sample and 15% in the non-clinical sample had significant social-emotional problems. Similarly, 55.5% of young children in the clinical sample and 30% in the non-clinical sample had significant delays in the acquisition of social-emotional competencies. Two hierarchical multiple regressions were carried out with social-emotional problems and social-emotional competencies as the respective criterion variables. Clinical or non-clinical group membership, parenting satisfaction and maternal psychological distress were found to be significant predictors of child social-emotional problems in a model which explained 59% of the variance. Task-specific self-efficacy was the only significant predictor of child social-emotional competencies in a model which explained 21% of the variance. The significant rates of social-emotional problems in young children in the current study and the potential negative impact on child health and wellbeing, suggest that the early assessment of social-emotional adjustment should be incorporated into routine clinical assessment for young children. For services to effectively meet the needs of children with social-emotional difficulties and their families, consideration of maternal factors is also necessary.
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Akseer, Nadia, James Wright, Hana Tasic, Karl Everett, Elaine Scudder, Ribka Amsalu, Ties Boerma, et al. "Women, children and adolescents in conflict countries: an assessment of inequalities in intervention coverage and survival." BMJ Global Health 5, no. 1 (January 2020): e002214. http://dx.doi.org/10.1136/bmjgh-2019-002214.
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IntroductionConflict adversely impacts health and health systems, yet its effect on health inequalities, particularly for women and children, has not been systematically studied. We examined wealth, education and urban/rural residence inequalities for child mortality and essential reproductive, maternal, newborn and child health interventions between conflict and non-conflict low-income and middle-income countries (LMICs).MethodsWe carried out a time-series multicountry ecological study using data for 137 LMICs between 1990 and 2017, as defined by the 2019 World Bank classification. The data set covers approximately 3.8 million surveyed mothers (15–49 years) and 1.1 million children under 5 years including newborns (<1 month), young children (1–59 months) and school-aged children and adolescents (5–14 years). Outcomes include annual maternal and child mortality rates and coverage (%) of family planning services, 1+antenatal care visit, skilled attendant at birth (SBA), exclusive breast feeding (0–5 months), early initiation of breast feeding (within 1 hour), neonatal protection against tetanus, newborn postnatal care within 2 days, 3 doses of diphtheria, pertussis and tetanus vaccine, measles vaccination, and careseeking for pneumonia and diarrhoea.ResultsConflict countries had consistently higher maternal and child mortality rates than non-conflict countries since 1990 and these gaps persist despite rates continually declining for both groups. Access to essential reproductive and maternal health services for poorer, less educated and rural-based families was several folds worse in conflict versus non-conflict countries.ConclusionsInequalities in coverage of reproductive/maternal health and child vaccine interventions are significantly worse in conflict-affected countries. Efforts to protect maternal and child health interventions in conflict settings should target the most disadvantaged families including the poorest, least educated and those living in rural areas.
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Atmadja, Sardjana, and Gulam Gumilar. "UPDATE HEALTH POLICY DECISION MAKING IN SAFE MOTHERHOOD REGIONAL ISSUE." ADI Journal on Recent Innovation (AJRI) 1, no. 2 (December 9, 2019): 9–13. http://dx.doi.org/10.34306/ajri.v1i2.38.
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More than a half million women die every year because of complications related to pregnancy and child birth. Nearly all these deaths take place in developing countries. The disparity between maternal death rates in developing and developed countries is greater than for any other common category of death. Poor maternal health during pregnancy is directly linked to poor health in the infant. Therefore, a mother’s health and survival continues to be critically important throughout a child’s life. Pregnant women and children suffer first and most under poor socioeconomic conditions. To reduce maternal and morbidity in half by the 2000, the safe motherhood initiative was launched. The success of safe motherhood initiative depends on the active participation of a wide range of individuals and organizations who can contribute ideas, skills, and funds, because the problem stems not only from inadequate health services, but mostly also from the social, cultural, and economic environment in which women live. Health policy decision making in safe mother-hood at least should be based on the assessment of Maternal Health situation and health services and the assessment of socio- cultural aspects of safe motherhood of each region.
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Tran, Lan Mai, Phuong Hong Nguyen, Ruchira Tabassum Naved, and Purnima Menon. "Intimate partner violence is associated with poorer maternal mental health and breastfeeding practices in Bangladesh." Health Policy and Planning 35, Supplement_1 (November 1, 2020): i19—i29. http://dx.doi.org/10.1093/heapol/czaa106.
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Abstract Exposure to intimate partner violence (IPV) can have profound adverse consequences on maternal and child health. This study aimed to: (1) identify factors associated with IPV during pregnancy and postpartum in Bangladesh; and (2) assess the associations between IPV and maternal mental health and breastfeeding practices. We used data from a cross-sectional survey of 2000 mothers with children <6 months in four districts in Bangladesh. We applied multivariable logistic regression models to examine factors associated with IPV and structural equation modelling to assess the inter-relationships between IPV, maternal common mental disorders (CMD, measured by Self-reporting Questionnaire ≥7) and breastfeeding practices. Overall, 49.7% of mothers experienced violence during the last 12 months and 28% of mothers had high levels of CMD. Only 54% of women reported early initiation of breastfeeding and 64% reported exclusive breastfeeding. Women were more likely to experience IPV if living in food-insecure households, being of low socio-economic status, having low autonomy or experiencing inequality in education compared with husbands (OR ranged from 1.6 to 2.8). Women exposed to IPV were 2–2.3 times more likely to suffer from high levels of CMD and 28–34% less likely to breastfeed their babies exclusively. The indirect path (the indirect effects of IPV on breastfeeding through CMD) through maternal CMD accounted for 14% of the relationship between IPV on breastfeeding practice. In conclusion, IPV is pervasive in Bangladesh and is linked to increased risks of CMD and poor breastfeeding practices. Integrating effective interventions to mitigate IPV, along with routine maternal and child health services and involving men in counselling services, could help both to reduce exposure to IPV among women and to contribute to better health outcomes for women and children.