Maternal perceived self-efficacy, perceived vulnerability and child health outcome in Ibadan, South-West Nigeria

Objective:The problems associated with child health continue to constitute a global concern,and child morbidity and mortality remain problematic in Sub-Sahara Africa(SSA).Utilizing a community-based survey conducted in Ibadan North Local government,Southwest Nigeria the study examined the influences of maternal perceived self-efficacy(MPSE)and maternal perceived vulnerability(MPV)on child health outcomes(CHO).Methods:The study appraised data from 683 nursing mothers aged 15-45 obtained from 20 major primary healthcare centers in the region undergoing routine health checks for their children.Three regression models were fitted to examine the effects of MPV,MPSE,and confounding variables of maternal preventive actions such as insecticide-treated nets(ITN)usage and child immunization,among other maternal and child sociodemographic attributes on CHO.Results:The study finds that MPV has no correlation with CHO and MPSE but positively correlates with maternal age(r=0.123,P<0.05).However,CHO has a negative correlation with MPSE(r=-0.200,P<0.05)while positively correlated with child age(r=0.134,P<0.05).MPSE has a unique effect on CHO(β=-0.203,P<0.05),maternal preventive action of ITN usage show a positive association with CHO in the study Model 2(β=-0.163,P<0.05),while in Model 3,child's age has a positive association with CHO(β=0.180,P<0.05).The net effect of the study models accounted for approximately 10%of the variance in CHO reported among the children.Conclusion:Overall,MPSE and ITN usage are essential factors for understanding and reducing the potential adverse CHO.Global effort must continue to improve maternal education to support child health and preventive carepractices in SSA.

Impact of Antimicrobial Stewardship Programs on Antibiotic Use and Drug Resistance:Analysis of Data from Maternal and Child Health Care Hospitals in Hubei Province,China

ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).

Longitudinal Care Evaluation in Child Healthcare

Objective: To evaluate the essential attribute of Primary Health Care, longitudinal care, care directed at children from birth to two years old. Methods: This is a descriptive and exploratory study of evaluative character and quantitative approach, conducted with parents/caregivers of 186 children, younger than two years old, patients of primary health care services in the city of Santa Cruz/RN, Brazil. For data collection, the instrument Primary Care Assessment Tools (PCA Tools) was used, and the results of the questions dealing with longitudinal attribute were evaluated. The data were stored and processed in Statistical Package for Social Sciences (SPSS). The study was approved by the Research Ethics Committee of the Health Sciences School of Trairí, under number 348896. Results: The mean age of children in months was 8.21;84.4% (n = 157) were assisted by the same doctor/nurse every time;in 81.7% (n = 152) of cases the doctor/nurse know the full medical history of the child;73.7% (n = 137) answered that the professional know their child more as a person than just as someone with a health problem;48.9% (n = 91) stated that the doctor/nurse do not know their family very well;86.6% (n = 161) reported finding the doctor/nurse understands what is saying or questioning;96.2 (n = 179) of respondents said the doctor/nurse answers the questions so that they understand;96.2% (n = 179) of the interviewed said they feel comfortable telling the concerns or problems of their child to the doctor/nurse;66.7% (n = 124) claimed that they would not change the service/doctor/nurse to another health service. Conclusion: It is concluded that the attribute was well rated by the mothers of children seen in primary health care services and that they can establish good communication and relationship with the health professionals who treat their children.

Pediatric Clinical Pharmacology and Child Health:A Canadian Perspective

Introduction Canadian academic centres and children’s hospitals have had a longstanding interest in the improvement of drug therapy for children through research conducted across the four pillars of activity identified as being of

Marked Improvement in China's Maternal and Child Health

ＭａｒｋｅｄＩｍｐｒｏｖｅｍｅｎｔｉｎＣｈｉｎａ′ｓＭａｔｅｒｎａｌａｎｄＣｈｉｌｄＨｅａｌｔｈＭａｔｅｒｎａｌａｎｄｃｈｉｌｄｈｅａｌｔｈｃａｒｅ（ＭＣＨ）ｉｎＣｈｉｎａｈａｓｉｍｐｒｏｖｅｄｃｏｎｓｉｄｅｒａｂｌｙｃｏｍｐａｒｅｄｗｉｔｈｔｅｎｙ...

Evaluation of Child Health by Basic Indicators of Health:Historical Series 2005-2014

The continuous assessment of child health services generates knowledge about the real needs of health services and actions in order to achieve better results and indicators. Thus, this study proposes to analyze child health indicators, based on the information systems of health services. This is a descriptive, ecological epidemiological study carried out using secondary data from the following information systems: Information System on Live Births and Mortality Information System, in a historical series of ten years (2005-2014) of the state of Rio Grande do Norte and its health micro regions. It was observed a decrease in infant, neonatal, preterm, late neonatal and postnatal mortality coefficients when compared to the first and last year of the observed period, as well as the concentration of these in micro-regions of health. There was also a positive association between the early neonatal component and infant death. In this perspective, it is important to evaluate the quality of prenatal care, childbirth, puerperium, the first week of integral health and follow-up of the child’s growth and development, as well as to relate the socio-demographic conditions that may be associated with infant morbimortality. Therefore, the importance of situational health assessment studies for the effectiveness of care provided is highlighted, identifying weaknesses and monitoring the effectiveness of strategies.

Access to Child Health Care, Medical Treatment of Sick Children and Childhood Mortality Relationships in Kenya

Child health care factors such as medical treatment of sick children have direct and indirect effect on childhood mortality. Through international cooperation, a number of countries including Kenya have gathered information on provision of child health services at facility level from periodic Service Provision Assessment (SPA) surveys. Kenya has also gathered information on medical treatment of sick children at household level from periodic Demographic and Health Surveys (DHS). However, establishing how health care information in the SPA surveys relates to childhood mortality and also how these factors relate to medical treatment of sick children in the DHS has been constrained by differences in sample designs of the surveys. This study deployed a fstrategy of constructing community level variables derived from the SPA survey data and incorporated them into DHS data which served as the main data source. The SPA and DHS sampling designs for Kenya allow computation of stable estimates of regional demographic and health service indicators at provincial level. This study analyzed information gathered from 690 health facilities in 2010 SPA and 6079 births born less than 60 months from 2008/09 DHS. The study found that access to child health services, waiting time before service in facility and time to the nearest referral facility were significant facilitating factors for medical treatment of sick children. The study also established that waiting time before service in facility was the only access to health care factor which had a significant effect on childhood mortality when HIV prevalence was excluded in the analysis. However, the significance of waiting time before service diminished with inclusion of HIV prevalence. Further research is required to refine definition and measurement for child health care variable on female autonomy.

Non-Participation in Child Health Days or Routine Immunization Services among Children under 5 Years of Age—Somaliland 2012

Background: After two decades of conflict, Somalia remains a fragile state where large scale displacement and inadequate access to functioning health services have left children vulnerable to morbidity and mortality from vaccine preventable disease. Children residing in the autonomous zone of Somaliland are similarly vulnerable to poor access to health care services. Following the conduct of a UNICEF-supported Multiple Indicator Cluster Survey in Somaliland during 2011 which captured information on immunization system performance, a survey was conducted to better understand the reasons for non-vaccination among children in Somaliland. Methods: The Somaliland Routine Immunization Non-Participation Survey (RINPS) was conducted in November 2012 to better understand the reasons for non-participation in both Child Health Days (CHDs) and Routine Immunization Services (RIS). RINPS was a cross-sectional household survey which used a two-stage sample design in order to obtain a representative sample of children 0 - 59 months of age residing in Somaliland. Thirty clusters were randomly selected from the 303 clusters for participation in the 2011 Somaliland MICS. A total of 867 children aged 0 - 59 months were identified and included in the analysis (overall response rate, 96%). Findings: Caregivers lacked motivation to take their children to CHDs and for RIS and lacked information about why children need immunization. Routine vaccination or CHD cards were available for few children at the time of the survey. Almost one-fifth of children aged 0 - 59 months in Somaliland had not received at least one dose of vaccine for DTP, polio or measles vaccine from either CHD or RIS. Conclusion: Child Health Days have a role in at least some area of Somaliland to expand the reach of immunization services. The availability and delivery of sustainable routine immunization services need to be strengthened in Somaliland with a strong social mobilization program to raise awareness about the importance of routine immunization.

State of Play of the Use of Children’s Health Booklets in Cameroon according to Child Health Professionals

Introduction: The Child health booklet has been shown to be an essential tool for monitoring the implementation of interventions with a high impact on reducing infant and child mortality. Objective: To describe the opinion of child health providers about child health records. Methodology: Cross-sectional survey of health professionals on content, ease of use and recommendations for a health record of the ideal child. Results: About 3/4 (75%) of participants considered medical follow-up useful and 91.5% wanted it to be conducted at all levels of health care. According to 93% of them, all health care providers should be involved. However, almost two-thirds (65.5%) had never been trained to use the child’s health record. About half (54.2%) of them had already seen the national manual and only 43.7% had ever filled it out, 82.2% of whom found it very difficult. With regards to the assessment of the content, 44.4% to 57.7% of respondents were dissatisfied with 12 of the 16 subheadings of the handbook. As for an ideal child health record, the majority recommended that it should contain indicators related to: childbirth, growth, monitoring of preventive activities and advice to parents. Conclusion: Child health booklets available in health facilities in Cameroon are not optimally used to reduce infant and child morbidity and mortality. It is important to review the content of the child’s health booklets in order to adapt it to the Cameroonian context.

Educational Technologies for Child Health Promotion: An Integrative Literature Review

The use of educational technology focused on child health promotion requires theoretical-methodological foundations to support aspects related to the growth and psychomotor development stage, articulating knowledge and healthy habits as early as possible. This article is an integrative review to investigate the educational technologies used in health education actions to promote child health. The databases LILACS, MEDLINE, BDENF, PUBMED, CINAHL, and in the Virtual library Cochrane Library and SciELO were consulted. Thirteen articles were analyzed. The educational technologies have been employed to promote child health promotion actions and have contributed to the achievement of long-lasting results. The actions happen predominantly in the school context and light, light-hard and hard technologies are used. The association between light and hard technology obtained better results.

Mobile health interventions for improving maternal and child health outcomes in South Africa:a systematic review

Background:Maternal and child health(MCH)remains a significant public health concern globally despite previous efforts made to improve MCH services.Initiatives such as antenatal care,postnatal care services exclusive breastfeeding,child vaccination and supplements have been rolled out to improve MCH outcomes.However,inadequate maternal healthcare,socioeconomic factors,obstetric haemorrhaging,complications of hypertension during pregnancy,lack of maternal information,poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates,especially in resource-constrained areas in many sub-Saharan African countries including South Africa.Objective:This study aimed to review mobile health(mHealth)interventions deployed to improve maternal and child health outcomes.Methods:The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable,prominent electronic databases(Google Scholar,Scopus,PubMed,Embase,CINAHL,Web of Science,etc.).A total of 26 papers were selected and analyzed.Results:The findings revealed several mHealth interventions such as MomConnect,Mobile Alliance for Maternal Action,NurseConnect,ChildConnect,CommCare,Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services.However,inadequate digital infrastructure,digital divide,resistance to change,inadequate funding,language barriers,short message service and data costs,lack of digital skills and support,compatibility,scalability and interoperability issues,legislative and policy compliance,lack of mHealth awareness,data security and privacy concerns hinder uptake and utilisation of mHealth interventions.There is a need to scale up and sustain mHealth interventions and update existing regulatory framework,policies and strategies.Conclusion:mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services.Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues.

The Effect of the COVID-19 Pandemic on Health Service Accessibility for Children under 5 in the Mayo-Tsanaga and Logone & Chari Departments, Far North Cameroon

Context/objectives: The COVID-19 pandemic has disrupted all programs, potentially impacting access to health services for children under 5 years old. The Far North of Cameroon is one of the northern regions with a prevalence of malnourished children ranging from 5% to 10%. Due to the barrier measures implemented to combat the pandemic, many parents are reluctant to take their children to healthcare facilities. Some of these children were benefiting from the Ambulatory Care Center (ACC) program prior to the COVID-19 outbreak. The main objective of this research is to assess the impact of COVID-19 on access to health services for children under 5 in the Mayo Tsanaga (MT) and Logone & Chari (LC) departments. The implementation of barrier measures could significantly increase the risk of malnutrition among children under 5 years old. Method: A cross-sectional analytical study was conducted in the MT and LC departments, employing both retrospective and prospective approaches. Data was collected through questionnaire, interview guide and a review of existing data prior to the pandemic (DHIS 2). Kobo Collect software was used for data collection, and R software was used for analysis. Results: Children who benefitted from the ACC program during the COVID-19 period were found to have a lower prevalence of malnutrition compared to those who did not benefit (OR: 0.09, CI {0.0 - 0.44}). Conclusion: COVID-19 has led to a decrease in the utilization of health facilities in both departments of the study, resulting in an increase in health issues such as malnutrition among children under 5 years old. Various policies have been implemented to improve attendance at health facilities.

Innovations in maternal and child health:case studies from Uganda

Background:Nearly 300 children and 20 mothers die from preventable causes daily,in Uganda.Communities often identify and introduce pragmatic and lasting solutions to such challenging health problems.However,little is known of these solutions beyond their immediate surroundings.If local and pragmatic innovations were scaled-up,they could contribute to better health outcomes for larger populations.In 2017 an open call was made for local examples of community-based solutions that contribute to improving maternal and child health in Uganda.In this article,we describe three top innovative community-based solutions and their contributions to maternal health.Main text:In this study,all innovations were implemented by non-government entities.Two case studies highlight the importance of bringing reproductive health and maternal delivery services closer to populations,through providing accessible shelters and maternity waiting homes in isolated areas.The third case study focuses on bringing obstetric imaging services to lower level rural health facilities,which usually do not provide this service,through task-shifting certain sonography services to midwives.Various health system and policy relevant lessons are highlighted.Conclusions:The described case studies show how delays in access to health care by pregnant women in rural communities can be systematically removed,to improve pregnancy and delivery outcomes.Emphasis should be put on identification,capacity building and research to support the scale up of these community-based health solutions.

Children’s Health, Parent-Child Activities, Using Digital Devices, and Social Competence: Serial Mediation

Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital devices were serial mediators of the relationship between children’s health and social development needs further verification. Purpose: This study explored how parent-child activities and children’s use of digital devices influence the relationship between children’s health and their social competence. Method: This study used data from Kids in Taiwan: National Longitudinal Study of Child Development and Care. A total sample of 2164 participants was used in this study. Serial mediation analyses were performed using model six of Hayes’ PROCESS (2012). Results: This study found that parent-child activities and the use of digital devices can serially mediate the relationship between children’s health and social competence. Children’s health could directly improve their social competence, but it could also serially mediate social competence by increasing parent-child activities and reducing the use of digital devices. Conclusion: Childcare policy planners and parenting educators should not only call on parents to reduce the use of electronic products for their children, but also encourage parents to spend more time interacting with their children, so that children can learn social skills by interacting with others in their daily lives.

An innovation in child health:Globally reaching out to child health professionals

Worldwide deaths of children younger than 5 years reduced from 12.7 million in 1990 to 6.3 million in 2013.Much of this decline is attributed to an increase in the knowledge,skills,and abilities of child health professionals.In turn this increase in knowledge,skills,and abilities has been brought about by increased child-health-focused education available to child health professionals.Therefore child-health-focused education must be part of the strategy to eliminate the remaining 6.3 million deaths and to achieve the United Nations Millennium Development Goals.This article describes a child-health-focused program that was established in 1992 and operates in 20 countries:Australia,Bangladesh,Botswana,Cambodia,China,Ethiopia,Hong Kong,India,Kenya,Malawi,Mongolia,Myanmar,Sierra Leone,the Seychelles,the Solomon Islands,Tanzania,Tonga,Vanuatu,Vietnam,and Zimbabwe.The Diploma in Child Health/International Postgraduate Paediatric Certificate(DCH/IPPC)course provides a comprehensive overview of evidence-based current best practice in pediatrics.This includes all subspecialty areas from infectious diseases and emergency medicine through to endocrinology,respiratory medicine,neurology,nutrition,and dietetics.Content is developed and presented by international medical experts in response to global child health needs.Content is provided to students via a combination of learning outcomes,webcasts,lecture notes,personalized study,tutorials,case studies,and clinical practice.One hundred eleven webcasts are provided,and these are updated annually.This article includes a brief discussion of the value and focus of medical education programs;a description of the DCH/IPPC course content,approaches to teaching and learning,course structure and the funding model;the most recent evaluation of the DCH/IPPC course;and recommendations for overcoming the challenges for implementing a multinational child-health-focused program.

Classification,prevalence and integrated care for neurodevelopmental and child mental health disorders:A brief overview for paediatricians

‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.

Does health insurance coverage lead to better child health?Evidence from China

Using data from the China Health and Nutrition Survey,this study investigated the impact of health insurance coverage on children’s health in China.To address the potential endogeneity between insurance and health,we adopted the instrumental variable probit model.We found that insurance enrollment significantly improved the health of children,especially urban children,but there was no significant insurance effect across gender.After using the propensity score matching method,an alternative measure of child health,and a sub-sample of children aged above 10,our major finding of the insurance effect on child health is verified and robust.We further conducted the path analysis by identifying three potential paths through which medical insurance improved child health.We found that child health behaviour and nutritional intake are the effective paths between insurance enrollment and health status.These results provided implications for policy makers in constructing and developing the supportive system of child medical insurance in China.

Health of children less than 5 years old in an upper middle income country: parents' views

Health literature in the Caribbean, and in particular Jamaica, has continued to use objective indices such as mortality and morbidity to examine children’s health. The current study uses subjective indices such as parent-reported health conditions and health status to evaluate the health of children instead of traditional objective indices. The study seeks 1) to examine the health and health care-seeking behaviour of the sample from the parents’ viewpoints;and 2) to compute the mean age of the sample with a particular illness and describe whether there is an epidemiological shift in these conditions. Two nationally representative cross-sectional surveys were used for this study (2002 and 2007). The sample for the current study is 3,062 respondents aged less than 5 years. For 2002, the study extracted a sample of 2,448 under 5 year olds from the national survey of 25,018 respondents, and 614 under 5 year olds were extracted from the 2007 survey of 6,728 respondents. Parents-reported information was used to measure issues on children under 5 years old. In 2007, 43.4% of the sample had very good health status;46.7% good health status;2.5% poor health and 0.3% very poor health status. Almost 15% of children had illnesses in 2002, and 6% more had illnesses in 2007 over 2002. In 2002, the percentage of the sample with particular chronic illnesses was: diabetes mellitus (0.6%);hypertension (0.3%) and arthritis (0.3%). However, none was recorded in 2007. The mean age of children less than 5 years old with acute health conditions (i.e. diarrhoea, respiratory diseases and influenza) increased over 2002. In 2007, 43.4% of children less than 5 years old had very good health status;46.7% good health status;7.1% fair health status;2.5% poor and 0.3% very poor health status. The association between health status and parent- reported illness was –x2 (df = 4) = 57.494, P< 0.001-with the relationship being a weak one, correlation coefficient=0.297. A cross-tabulation between health status and parent-reported diagnosed illness found that a significant statistical correlation existed between the two variables –x2 (df = 16) = 26.621, P < 0.05, cc = 0.422, – with the association being a moderate one, correlation coefficient = 0.422. A cross tabulation between health status and health care- seeking behaviour found a significant statistical association between the two variables –x2 (df = 4) = 10.513, P < 0.033-with the correlation being a weak one-correlation coefficient = 0.281. Rural children had the least health status. The health disparity that existed between rural and urban less than 5 year olds showed that this will not be removed simply because of the abolition of health care utilization fees.

Food Insecurity in US Families with Children with Limiting Health Conditions

Food insecurity in US households with children with limiting health conditions was compared to households with children without limiting health conditions, controlling for demographic variables. Multivariable logistic regression was used to calculate the odds ratios. Data from the 2008-2011 Making Connections Survey (N = 1940) of households with children in seven high poverty communities in the US were used. Having a child with a limiting health condition made a household’s odds 1.41 times (95% C.I., 1.110, 1.790) more likely to be food insecure. When there are two or more children with limiting conditions in the household, the odds of food insecurity are 1.67 times (95% CI, 1.16, 2.40), higher than a family with no children with a disabling health condition. Families with children with limiting health conditions in high poverty communities are especially at risk of experiencing food insecurity, which can complicate health conditions. Nutrition assistance programs are vital to keep children and families food secure.

Poverty and Nutritional Health of the Child: Some Evidence from 2005 Demographic and Health Survey of Congo

The objective of this study is to identify the ways in which poverty could affect the nutritional health of the child and to analyze the strength of these links. On the whole, it appears that the relationship between poverty (measured by the wealth index) and health of the child (measured by an anthropometric index) is positive and highly significant.