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 hos...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).展开更多
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 infor...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.展开更多
Objective: The aim of this study was to provide insight into how the Child Healthcare Clinic (BVC) nurse supports and encourages the child’s bonding to their parents during the regularly scheduled checkups at the hea...Objective: The aim of this study was to provide insight into how the Child Healthcare Clinic (BVC) nurse supports and encourages the child’s bonding to their parents during the regularly scheduled checkups at the healthcare clinics. Method: The study was done using a qualitative approach. The data was collected from the interviews of four focus groups which were comprised of a total of eighteen BVC nurses who work solely for the BVC. The resulting data was analyzed using qualitative content analysis. Results: The following theme emerged from the research material: Empower the parents in order to enable the child to have a healthy connection to the parents. This is accomplished by the BVC nurse building and creating a trusting relationship with the parents and providing support for them in their new roles as parents. The BVC nurses must have comprehensive knowledge about the needs and development of children and they need to have exceptional communication skills as well. It is also mandatory that the BVC nurse have access to cooperation and support from their colleagues and the support of other related professions. Conclusion: Providing support to parents during the bonding period of their infant children is a most important function for BVC nurses because there is much to be determined about children’s development and future possibilities during this formative period.展开更多
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 chara...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.展开更多
Background: Primary health care clinics promote health in addition to treating illness, but are often perceived as unfriendly and frightening places for children. This research aimed to improve child-friendliness in p...Background: Primary health care clinics promote health in addition to treating illness, but are often perceived as unfriendly and frightening places for children. This research aimed to improve child-friendliness in primary health care settings in a rural, high HIV prevalence area in South Africa. Methods: As part of a larger intervention (“Amagugu” Intervention) health staff in nine primary health care clinics were trained in a child-friendliness approach. 281 enrolled mothers were invited to attend clinic with their primary school-aged children and assessed childfriendliness via structured questionnaires administered by independent assessors;a sub-group also participated in in-depth interviews. Post intervention, focus groups were conducted with 87 primary health staff to determine their experiences of providing child-friendly services. Results: Mothers rated 65% of clerks and 70% of nurses as “very friendly”. Qualitative data showed that heavy clinical loads, limited human resources and inadequate infrastructure were perceived as barriers to child-friendliness, while good clinic leadership and appropriate resources facilitated child-friendliness. Post intervention most health workers reported that child-friendly health promotion activities were rewarding. Conclusions: Providing child-friendliness training and support to primary health care facilities in low-resource settings is feasible, acceptable and yielded encouraging results.展开更多
基金supported by the Natural Science Foundation of Hubei Province(No.2021CFB348).
文摘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).
文摘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.
文摘Objective: The aim of this study was to provide insight into how the Child Healthcare Clinic (BVC) nurse supports and encourages the child’s bonding to their parents during the regularly scheduled checkups at the healthcare clinics. Method: The study was done using a qualitative approach. The data was collected from the interviews of four focus groups which were comprised of a total of eighteen BVC nurses who work solely for the BVC. The resulting data was analyzed using qualitative content analysis. Results: The following theme emerged from the research material: Empower the parents in order to enable the child to have a healthy connection to the parents. This is accomplished by the BVC nurse building and creating a trusting relationship with the parents and providing support for them in their new roles as parents. The BVC nurses must have comprehensive knowledge about the needs and development of children and they need to have exceptional communication skills as well. It is also mandatory that the BVC nurse have access to cooperation and support from their colleagues and the support of other related professions. Conclusion: Providing support to parents during the bonding period of their infant children is a most important function for BVC nurses because there is much to be determined about children’s development and future possibilities during this formative period.
文摘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.
文摘Background: Primary health care clinics promote health in addition to treating illness, but are often perceived as unfriendly and frightening places for children. This research aimed to improve child-friendliness in primary health care settings in a rural, high HIV prevalence area in South Africa. Methods: As part of a larger intervention (“Amagugu” Intervention) health staff in nine primary health care clinics were trained in a child-friendliness approach. 281 enrolled mothers were invited to attend clinic with their primary school-aged children and assessed childfriendliness via structured questionnaires administered by independent assessors;a sub-group also participated in in-depth interviews. Post intervention, focus groups were conducted with 87 primary health staff to determine their experiences of providing child-friendly services. Results: Mothers rated 65% of clerks and 70% of nurses as “very friendly”. Qualitative data showed that heavy clinical loads, limited human resources and inadequate infrastructure were perceived as barriers to child-friendliness, while good clinic leadership and appropriate resources facilitated child-friendliness. Post intervention most health workers reported that child-friendly health promotion activities were rewarding. Conclusions: Providing child-friendliness training and support to primary health care facilities in low-resource settings is feasible, acceptable and yielded encouraging results.
