Attending Child Welfare Clinics Research Articles

Early growth, stress, and socioeconomic factors as predictors of the rate of multimorbidity accumulation across the life course: a longitudinal birth cohort study

Early growth, stress, and socioeconomic factors are associated with future risk of individual chronic diseases. It is uncertain whether they also affect the rate of multimorbidity accumulation later in life. This study aimed to explore whether early life factors are associated with the rate at which chronic diseases are accumulated across older age. In this national birth cohort study, we studied people born at Helsinki University Central Hospital, Helsinki, Finland between Jan 1, 1934, and Dec 31, 1944, who attended child welfare clinics in the city, and were living in Finland in 1971. Individuals who had died or emigrated from Finland before 1987 were excluded, alongside participants without any registry data and who died before the end of the registry follow-up on Dec 31, 2017. Early anthropometry, growth, wartime parental separation, and socioeconomic factors were recorded from birth, child welfare clinic, or school health-care records, and Finnish National Archives. International Classification of Diseases codes of diagnoses for chronic diseases were obtained from the Care Register for Health Care starting from 1987 (when participants were aged 42-53 years) until 2017. Linear mixed models were used to study the association between early-life factors and the rate of change in the number of chronic diseases over 10-year periods. From Jan 1, 1934, to Dec 31, 2017, 11 689 people (6064 [51·9%] men and 5625 [48·1%] women) were included in the study. Individuals born to mothers younger than 25 years (β 0·09; 95% CI 0·06-0·12), mothers with a BMI of 25-30 kg/m2 (0·08; 0·05-0·10), and mothers with a BMI more than 30 kg/m2 (0·26; 0·21-0·31) in late pregnancy accumulated chronic diseases faster than those born to older mothers (25-30 years) and those with a BMI of less than 25 kg/m2. Individuals with a birthweight less than 2·5 kg (0·17; 0·10-0·25) and those with a rapid growth in height and weight from birth until age 11 years accumulated chronic diseases faster during their life course. Additionally, paternal occupational class (manual workers vs upper-middle class 0·27; 0·23-0·30) and wartime parental separation (0·24; 0·19-0·29 for boys; 0·31; 0·25-0·36 for girls) were associated with a faster rate of chronic disease accumulation. Our findings suggest that the foundation for accumulating chronic diseases is established early in life. Early interventions might be needed for vulnerable populations, including war evacuee children and children with lower socioeconomic status. Finska Läkaresällskapet, Liv och Hälsa rf, the Finnish Pediatric Research Foundation, and Folkhälsan Research Center. For the Finnish and Swedish translations of the abstract see Supplementary Materials section.

Utilization of growth monitoring and promotion services and undernutrition of children less than two years of age in Northern Ghana

BackgroundChild undernutrition is a major public health problem and an important indicator of child’s health. Adequate nutrition is critical for a child’s growth and development. Growth monitoring and promotion (GMP) services is a nutrition intervention aimed at improving the nutritional status of children. We assessed the utilization of growth monitoring and promotion services and nutritional status of children less than two years of age in northern Ghana.MethodsThis was a descriptive cross-sectional study that involved face-to-face interviews among 266 mothers with children < 2 years of age attending child welfare clinics (CWC). We also collected anthropometric measurements. Descriptive statistic was performed and data presented as percentage. The nutritional status of children was classified as underweight (weight-for-age z score < -2 standard deviations), stunted (length-for-age Z score < − 2) and wasted (weight-for-length z score < -2) while utilization of GMP services was based on attendance to CWC and ability to interpret different growth curves. Chi square test was used to determine the relationship between utilization of GMP services and nutritional status of children at an alpha of 0.05.ResultsThe prevalence of undernutrition shows that, 18.6% of the children were underweight, 14.7% were stunted and 7.9% were wasted. About 60% of the mothers accessed GMP services regularly. Less than half of the mothers were able to interpret the children’s growth curve correctly: falling growth curve (36.8%), flattening growth curve (35.7%) and rising growth curve (27.4%). In combining children < 6 and 6–23 months of age, only one-third (33.1%) of mothers practiced appropriate infant and young child feeding. Regular GMP services was found to have a statistically significant relationship with underweight (P < 0.001), stunting (P = 0.006) and wasting (P = 0.042).ConclusionThe level of undernutrition remains high and child feeding practices is poor. Maternal utilization of GMP services is also low in the study area. Similarly, ability to interpret the child’s growth curve appropriately persist as a challenge among women. Thus, attention is needed to improve utilization of GMP services to address child undernutrition challenges.

Early initiation of breastfeeding, bottle feeding, and experiencing feeding challenges are associated with malnutrition.

Malnutrition remains a public health concern amidst low proportions of the core infant and young child feeding (IYCF) practices, yet, data on specific child feeding practices that are associated with undernutrition are rare. Hence, this study sought to assess child feeding practices and their association with undernutrition among young children. An analytical cross-sectional design was used among mothers/caregivers with children aged 6-23 months, attending child welfare clinics in Techiman municipality, Ghana. Simple random sampling was used to select 8 health facilities, and 403 participants were selected from those facilities using proportional stratification. A 24-h dietary recall based on seven food groups was used to collect data on children's dietary intake and used to derive WHO child feeding indicators. The length, weight, and age of children were taken and used to compute anthropometric z-scores. The proportions of children who met their minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were 44%, 56%, and 36% respectively. Children 6-8 months [AOR=2.24, CI (1.037-4.841); p = .04] and 9-11 months [AOR=2.47, CI (1.096-5.573); p = .029], those who were not breastfed within the first hour of delivery [AOR = 3.56, CI (1.833-6.912), p < .001], and those who were bottle fed [AOR = 2.87, CI (1.374-5.973); p = .005] were more likely to be wasted. Children 6-8 months [AOR = 0.29, CI (0.126-0.672); p = .004] and 9-11 months [AOR = 0.24, CI (0.104-0.544); p = .001] and those who experienced feeding challenges [AOR = 0.52, CI (0.301-0.905); p = 0.021] were protected against stunting. The percentages of children who met their MDD, MMF, and MAD were low and not associated with undernutrition. Early initiation of breastfeeding and bottle feeding were associated with acute malnutrition and experiencing feeding challenges was associated with chronic malnutrition. Promoting appropriate child feeding practices can reduce the risk of undernutrition.

Mothers' cord care practices in an academic hospital in Kenya.

Nearly 99% of neonatal deaths globally occur in low- and middle-income countries with about three-quarters of the neonatal deaths resulting from sepsis including those arising from cord infections. Thus, good cord care practices have the potential to reduce the neonatal deaths in low and middle-income countries such as Kenya. Describe cord care practices of mothers in an academic hospital in Kenya. A questionnaire was administered to 114 mothers attending child welfare clinic at 6 weeks in an academic hospital in Western Kenya. Descriptive statistics were computed for continuous variables while frequencies were computed for categorical variables. Parametric and non-parametric tests were used to check for association between maternal variables and cord care practices. Most mothers applied chlorhexidine (n =73, 64%) or practiced dry cord care (n = 17, 14.9%). Some mothers (12.9%) applied potentially harmful substances including saliva, ash and soil. Mothers who attended at least three antenatal clinic visits practiced the recommended cord care (χ2 =16.02, p. = 0.03). Although mothers predominantly practiced the recommended cord care, some potentially deleterious practices were reported. There is need to encourage attendance to antenatal clinic in order to optimize umbilical cord care practices.

Magnitude of undernutrition and its associated factors in children attending Child Welfare Clinics in Techiman Municipal, Ghana

PurposeThis study aims to estimate the magnitude of undernutrition and its associated factors [especially child health interventions at Child Welfare Clinics (CWCs)] among children in Techiman Municipality, Ghana.Design/methodology/approachA facility-based analytical cross-sectional design involving 403 mothers/caregivers with children. Simple random sampling was used to sample study sites and participants. Child health interventions were assessed by adapting items used in the Ghana Demographics and Health Survey. Weight and length of children were measured and used to calculate anthropometric z-scores based on World Health Organization guidelines. Test for associations was performed using bivariate analysis and multivariate logistic regression. Statistical significance was considered at p < 0.05.FindingsThe magnitudes of stunting, wasting and underweight were 20.6% [95% confidence interval (CI): 17–25], 11.4% (95% CI: 9–15), and 9.7% (95% CI: 7–13) respectively. Children aged 12–17 months [odds ratio (OR) = 3.1; CI: 1.3–7.5], male children (OR = 5.2; CI: 2.7–10.0) and children attending CWC 19–22 times (OR = 28.8; CI: 6.6–125) had increased odds of stunting. Additionally, belonging to households with one child under 5 (OR = 2.7; CI: 1.4–5.1) and using borehole/well water (OR = 2.7; CI: 1.4–5.3) were associated with increased odds of stunting. Similarly, being a female (OR = 3.5; CI: 1.6–8.0) and using borehole/well water (OR = 2.1; CI: 1.0–4.2) were associated with increased odds of underweight.Originality/valueThe magnitude of malnutrition, specifically stunting and wasting, exceeds the threshold for public health significance. CWC attendance frequency, age and sex of the child, number of children under five years old in households and water source were significantly associated with undernutrition.

Predictors of tuberculosis knowledge among mothers of under-fives, seen at Bingham University Teaching Hospital, Jos Nigeria.

Globally, tuberculosis still remains a disease of public health concern and accounts for high morbidity and mortality particularly in developing countries, where it is fuelled by a number of factors. Through a cross-sectional descriptive study, this study aims to determine the predictors of knowledge about TB among 261 mothers of children under 5 years of age attending Child Welfare Clinic, Bingham University Teaching Hospital, Jos, Plateau State, Nigeria. The mean age of the mothers was 31.54 ± 5.28 years, and 249 (98.4%) aware of TB. About two-third having sufficient knowledge and positive attitude regarding TB. Significant statistical association was found between knowledge and attainment of post-secondary education (OR 4.0; 95% CI 12.09, 7.63; p˂ 0.001), monthly income ≤ 25,000 naira (OR 2.18; 95% CI 1.02, 4.65; p = 0.042), monthly income > 51,000 naira (OR 3.24; 95% CI 1.43, 7.31; p = 0.005), women engaged in business (OR 0.43; 95% CI 0.22, 0.83; p = 0.012) and possessing positive attitude (OR 3.87; 95% CI 2.16, 6.93; p ˂ 0.001) in the univariate analysis. However, in the multivariate logistic regression, it was only attitude that was found to be a predictor of TB knowledge of mothers. TB knowledge among the mothers was high, only attitude regarding thoughts and beliefs about TB was found as an independent predictor of TB knowledge. With the positive influence of attitude on knowledge among the mothers, it is recommended that this be strengthened for sustenance to prevent further infection.

Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana

BackgroundDespite the health and economic benefits of exclusive breastfeeding, there is evidence of a decline globally and in Ghana. Previous studies addressing this problem are mostly quantitative with only a few of such studies using qualitative or mixed methods to examine the predictors, benefits, ways of improving and managing exclusive breastfeeding, and the challenges associated with exclusive breastfeeding from the perspective of exclusive and nonexclusive breastfeeding mothers, and health workers. This study employs the health belief model to examine the experiences of mothers and health workers regarding exclusive breastfeeding to fill this gap in the literature.MethodsA cross-sectional qualitative study involving in-depth interviews was conducted among health workers and mothers attending child welfare clinic at two polyclinics in Madina, Accra-Ghana in 2019. Purposive sampling was used to select health facilities and participants for the study. Twenty participants comprising ten exclusive breastfeeding mothers, six non-exclusive breastfeeding mothers and four health workers were interviewed for the study. The data were analyzed based on emerging themes from inductive and deductive coding.ResultsThe decision to practice exclusive breastfeeding was based on mothers’ work, advertisement on exclusive breastfeeding and education on breastfeeding provided by health workers. Insufficient flow of breast milk, pressure from family and friends, and insufficient breast milk for infants were among the reasons for discontinuing exclusive breastfeeding. The factors that help improve exclusive breastfeeding include eating healthy food and breastfeeding on demand, while counselling and monitoring, restricting advertisement on infant formula and granting maternity leave for breastfeeding mothers were identified as factors that can facilitate the practice of exclusive breastfeeding.ConclusionDifferent levels of experience affect and shape exclusive breastfeeding practice in Ghana. The decision to practice exclusive breastfeeding, as well as the challenges and strategies employed in managing exclusive breastfeeding, emanates from mothers’ personal experiences and interactions with institutional factors. In view of this, there should be counselling on the management of challenges associated with exclusive breastfeeding and provision of accurate information on exclusive breastfeeding to enable mothers practice exclusive breastfeeding.

Knowledge and perception of mothers toward donor milk and human milk banking: Experience from two centers in Southwest, Nigeria

Background: Breast milk is essential for the optimal growth and development of every child. When the mothers' milk is unavailable, the World Health Organization recommends donated human milk as the best alternative. However, the use of donated human milk has not been introduced in any part of this country. Therefore, this study aimed to assess the knowledge and perception of mothers on breast milk donation and human milk banking in Nigeria. Methodology: A structured, pretested self-administered questionnaire was used for data collection. Mothers attending child welfare clinics and the mothers in the newborn unit of two hospitals in Southwest Nigeria were recruited into the study. Data were analyzed using the SPSS version 22.0. Result: A total of 402 mothers were included in the study. The mean age was 29.8 ± 5.6 years. Forty-ix percent of the women were aware of human milk banking, and the majority (56.8%) heard about this from a health professional. 39.8% were willing to feed their babies with milk from human milk bank (HMB), and 62.1% were ready to donate their milk. Most of the mothers who were unwilling to feed their babies with milk from HMB reported personal reasons as responsible (40.3%). Factors associated with willingness to feed babies with milk from HMB include occupation (P < 0.001), education (P < 0.001), marital status (P < 0.001), and religion of the mothers (P < 0.005). Conclusion: The knowledge of women in Southwest Nigeria on breast milk donation and HMB is suboptimal. There is a need to educate the populace for effective implementation

Factors associated with knowledge and practice of optimal breastfeeding among mothers in Dubai.

Although breastfeeding has been the primary source of nutrition for infants, many women do not choose to practise breastfeeding due to lack of knowledge, inability to do so or personal choices. This study aimed at determining the breastfeeding practices and examining the sociodemographic factors associated with optimal breastfeeding among mothers attending child welfare clinic at Dubai Health Authority. A structured questionnaire was designed consisting of sociodemographic data, knowledge, attitude and practice towards breastfeeding. The main reasons for not breastfeeding the baby within 30 min after delivery were having had a caesarean section, followed by separation of the baby from the mother. We found better practice among homemakers, non-United Arab Emirates (UAE) and married women, those with less monthly income, and those with standard delivery. There is a need for better education on optimal breastfeeding, especially in UAE national pregnant women, who have had caesarean sections, or having babies admitted in the intensive care unit.

Effect of Socio-demographic Status, Knowledge, and Attitude on Utilisation of Safe Delivery Practices among Mothers of Children attending Child Welfare Clinics in Osogbo, Nigeria

Background: Previous studies on attendance at delivery by skilled personnel have neglected childbearing women’s knowledge and attitude towards safe delivery practices. This study assessed factors influencing utilisation of safe delivery services among mothers of under-five children attending child welfare clinics in Osogbo.&#x0D; Methods: This was a cross-sectional study conducted at child welfare clinics in Osogbo, Nigeria. Respondents were selected using a multistage sampling technique. Data was collected using a semi-structured, interviewer-administered questionnaire and analysed using Statistical Package for Social Sciences version 23. Statistical association between safe delivery practices and socio-demographic factors, knowledge of and attitude towards safe delivery practices were determined using logistic regression and p-value &lt;0.05 was considered statistically significant.&#x0D; Results: Four hundred out of the 420 eligible respondents completed the questionnaire giving a response rate of 95.2%. More than half of the respondents; 223 (55.8%) were &lt; 30 years old. Many respondents; 193 (48.3%) and their spouses; 229 (57.2%) had attained tertiary education. Almost all respondents; 389 (97.3%) attended antenatal care during their last pregnancies. Utilisation of skilled birth attendants was associated with antenatal clinic attendance in last pregnancy (p&lt;0.001).&#x0D; Conclusion: The factors associated with utilisation of safe delivery services were respondent’s ages, educational attainment of the respondents and their spouses, and respondents’ attendance at antenatal clinic in last pregnancy. Implementation research on measures to promote antenatal and delivery services by skilled birth attendants is needed in order to increase utilisation of safe delivery practices by mothers.

Utilization of health facility delivery services in the Jomoro District of the Western Region of Ghana

Background: In the year 2000, member states of the United Nations pledged to work towards a three-quarters reduction in the 1990 maternal mortality ratio by 2015 in line with Millenium. Development Goal 5, but this could not be achieved. This pledge became imperative given the high maternal mortality being recorded, especially among developing countries. The high maternal deaths in developing countries have been attributed partly to the lack of access to skilled birth attendants during delivery. Objective: This study aimed to investigate factors that influence the utilization of health facility delivery services among pregnant women in the Jomoro District of the Western Region of Ghana. Methods: The study used data from a cross-sectional survey among women aged 18 - 49 yr. living in the Jomoro District of Ghana and had given birth between 2012 and 2016 (n = 374). The study participants were randomly selected from women who attended child welfare clinics on clinic days with their babies in eighteen communities. The study used a structured questionnaire to solicit for information about the women’s demographic and socio-economic characteristics, community characteristics and health systems factors likely to influence their decision to seek skilled delivery care as well as their experiences relating to their last delivery. Bivariate analyses were performed between the primary dependent variable and background characteristics of the respondents. Factors influencing the choice of place of delivery were estimated by multiple logistic regression analysis. Data analysis was performed using STATA Statistical Software, Release 14. Results: About 61.0% (n= 228/374) of the women had their last delivery at a health facility while the remaining 38.8% (n= 145/374) delivered at home without skilled assistance. In multivariate analysis, women aged 25 – 29 yr. were less likely to have a skilled delivery (aOR, 0.40; 95% CI: 0.17 - 0.93). Also, professional women had 4.77 odds of having skilled delivery (aOR, 4.77; 95% CI: 1.53 - 14.93). Distance to the nearest health facility also had a statistically significant association with skilled delivery. Women living at 10 – 19 km to a health facility were less likely to have a skilled delivery (aOR, 0.56; 95% CI: 0.32 - 0.97). In addition, the presence of a midwife at a health facility increased the odds of skilled delivery among women (aOR, 4.59; 95% CI: 2.47 - 8.55). Conclusion: Interventions aimed at increasing the uptake of delivery care services to achieve the SDG’s target on maternal mortality must consider improving the socio-economic wellbeing of women in addition to removing the physical and health system barriers impeding access and utilisation of delivery care services.

The relationship between time spent during the first ANC contact, home visits and adherence to ANC contacts in Ghana

ABSTRACT Background The World Health Organization in 2016 recommended eight or more antenatal care (ANC) contacts for a positive pregnancy experience, however, it is unclear what impact the time spent during the first ANC contact and home visits can have on eight or more ANC contacts. Objectives Our study investigated the relationship between time spent during the first ANC contact and eight or more ANC contacts, and between home visits and eight or more ANC contacts. We also assessed the prevalence of eight or more ANC contacts. Methods A cross-sectional study was conducted among 519 mothers with children 12 months old and below attending child welfare clinics in the Nabdam district in the Upper East Region, Ghana. Multivariable logistic regression analysis was used to assess the relationship between time spent during the first ANC contact, home visits, and eight or more ANC contacts, while controlling for potential confounders. Results The proportion of mothers who attained eight or more ANC contacts during pregnancy was 31.2%. Spending 20 minutes or more during the first ANC contact was associated with 2.07 times the odds of having eight or more ANC contacts compared to spending less than 20 minutes [adjusted odds ratio (aOR): 2.07, 95% CI: 1.18,3.63]. Mothers who received at least a home visit from skilled health professionals during pregnancy were 2.44 times more likely to have eight or more ANC contacts compared to mothers who were not visited (aOR: 2.44, 95% CI: 1.51,3.94). Conclusion Spending at least 20 minutes during the first ANC contact and home visits were positively associated with eight or more ANC contacts. We recommend that skilled health professionals should spend at least 20 minutes during the first ANC contact as well as encourage home visits in order to increase the coverage of eight or more ANC contacts.

Fear of infertility limits contraceptive usage among first-time mothers in Ghana: A cross-sectional study.

Objectives:This study aimed to determine postpartum modern contraceptive use among first-time young mothers attending child welfare clinics in the Eastern Region of Ghana and explore factors that influence family planning uptake after the first delivery, including fear of infertility.Methods:This facility-based, cross-sectional study used interviewer-administered structured questionnaires. The study recruited 422 first-time young mothers aged 15–24 years, with 6- to 18-month-old babies attending child welfare clinics.Results:Overall, less than half (44%) of first-time mothers used modern contraceptives within 18 months after delivery. Fear of infertility after contraceptive use (56%) is the main barrier reported as the reason for women’s non-use of modern contraceptives. Mothers with tertiary education have higher odds of using postpartum contraceptives (adjusted odds ratio =1.6, 95% confidence interval: 0.4–2.0). Compared to mothers with younger children, those with children older than 6 months have higher odds of postpartum contraceptive use (adjusted odds ratio = 1.3, 95% confidence interval: 0.3–1.7). Nonspousal communication (adjusted odds ratio = 0.1, 95% confidence interval: 0.1–0.3) as compared to communication among partners about contraception and those in formal employment (adjusted odds ratio = 0.3, 95% confidence interval: 0.1–0.7), were less likely to use postpartum contraceptives.Conclusion:Considering that there is low postpartum contraceptive utilization, mostly due to concerns about fear of infertility after use, it is paramount to intensify education on actual side effects and reformulate policies that address specific concerns of infertility among mothers and contraceptive use.

Risk Factors of Anaemia among Children under Five Years in the Hohoe Municipality, Ghana: A Case Control Study.

Background Anaemia is one of the major causes of death among children under five years in Ghana. We examined the risk factors of anaemia among children under five years in the Hohoe Municipality, Ghana. Methods This facility-based matched case control study recruited 210 children (70 cases and 140 controls) aged 6 to 59 months. Stratified and simple random sampling techniques were used to select mothers attending Child Welfare Clinic (CWC) for the screening of their children. Data were collected using a semistructured questionnaire. Finger prick blood was collected to estimate the haemoglobin (Hb) level and thick film was prepared to determine malaria parasitaemia. Axillary temperature was measured using an +electronic thermometer and anthropometric measurements were done using a weighing scale and inelastic tape measure. Continuous variables were presented as means and standard deviations and categorical variables as frequencies and proportions. Conditional logistic regression was used to determine the strength of association between the dependent and the independent variables. Statistical significance was considered at p value of <0.05. Results The prevalence of anaemia was high (53.8%), while children whose mothers received iron supplementation during pregnancy were 7.64 times more likely to be anaemic compared with those who did not [AOR=7.64 (95% CI:1.41-41.20.93); p=0.018]. Children with poor dietary diversity were 9.15 times more likely to have anaemia [AOR=9.15 (95% CI: 3.13-26.82); p< 0.001]; and children whose mothers were farmers and traders were 83% [AOR = 0.17 (95% CI: 0.05-0.60); p=0.006] and 79% [AOR=0.21 (95% CI: 0.06-0.74); p=0.014], respectively, less likely to have anaemia. Conclusion The biologic, intermediate, and underlying factors that were significantly associated with anaemia comprised maternal iron supplementation, poor dietary diversity, farmers, and traders. Given that iron supplementation during pregnancy did not protect children against anaemia, we recommend the child's nutritional dietary diversity is encouraged.

Growth monitoring and promotion practices among health workers may be suboptimal despite high knowledge scores

BackgroundThe child health record booklet (CHRB) is a powerful tool for screening children under five and for education of caregivers by health workers. The objective of the present study was to assess the knowledge and utilization of CHRB by mothers and health workers in child growth monitoring and promotion (GMP) in the East Mamprusi Municipal, Northern region, Ghana.MethodsA descriptive cross-sectional study was conducted among mothers attending child welfare clinics (CWC) and health workers providing GMP at CWC. Observational checklists were used to assess 73 CHRB on the completeness and correctness of growth charts. Mothers and health workers’ knowledge on essential components of CHRB were assessed with a questionnaire.ResultsWeight measurements were correctly recorded in all booklets analyzed. Even though a greater proportion (70.7%) of health workers exhibited high knowledge scores on the interpretation of the essential components of the CHRB,most of the charts analyzed were not completely filled (72.6%) but rather correctly filled (74.0%). Mean knowedge score (3.4 ± 1.3) on growth charting was low among mothers who attend GMP. Work overload (26.1%), inadequate supply of CHRB (26.1%) and vaccine shortages (18.7%) were concerns raised by health workers on the effective usage of the CHRB.ConclusionKnowledge scores on the child health record booklets among health workers and mothers in this part of northern Ghana were high but charting of growth of children was sub-optimal among health workers.

Awareness and Determinants of Exclusive Breastfeeding Practices among Nursing Mothers Attending Primary Health Care Facilities in Uyo, Nigeria

Introduction: Exclusive breastfeeding (EBF) is a nutrition specific intervention that is crucial to growth and development of a young child and contributes to the attainment of sustainable development goals.&#x0D; Aim: To determine the level of awareness, prevalence and determinants of EBF among nursing mothers attending Primary Health Care (PHC) facilities in Uyo Local Government, Nigeria&#x0D; Place and Duration of Study: three selected Primary Health care facilities in Uyo Local Government (LG) of Akwa Ibom state Nigeria. June-July 2017.&#x0D; Methods: The study used a descriptive cross sectional design involving 331 mothers attending child welfare clinics in three (PHC) facilities that were selected using simple random sampling techniques. A structured interviewer administered questionnaire was used to collect data on socio- demographic characteristics, awareness and practice of EBF. Categorical variables were summarized using percentages, and continuous data using mean and standard deviation, chi square was used to assess the relationship between variables. While multivariate logistic regression was used to determine independent predictors of EBF practice .&#x0D; Results: The level of awareness of EBF and early initiation of breastfeeding (EIBF) were 89% and 88.5% respectively and universal awareness was 81.3%. Out of 231 infants below 6 months, 42% of them were currently on EBF and 36.8% (122/331) of the infants 0-12 months had EBF, the EIBF rate was 54.4%, about 45% of the infants had been on infant formula. Mothers who practiced EBF were significantly older than those who did not, the predictors of EBF were; delivery at the health facility (AOR 4.3; 1.84-10.49), normal delivery (AOR 2.3; 1.15-4.4), those with 2 (AOR 1.9; 1.04-3.4) or more than 3 children (AOR 4.7;1.91-9.9), mothers who had opportunity to breastfeed at work place (AOR 4;1.2-12.9) and mothers who were unemployed/self-employed (AOR 7.2; 2.2-23.7).&#x0D; Conclusion: The practice of EBF remains poor despite relatively high level of awareness, measures such as Community-based breastfeeding support groups, one-on-one counselling and establishment of crèches in workplaces should be put in place. The international codes on marketing of breast-milk substitutes should be fully implemented.

Maternal determinants of low birth weight and neonatal asphyxia in the Upper West region of Ghana

BackgroundAdverse birth outcomes continue to be a global public health challenge, particularly in low resource settings. Therefore, the present study aimed at assessing maternal determinants of low birth weight and neonatal asphyxia in the Upper West region of Ghana. MethodsAn analytical cross sectional survey was conducted among mothers who attended child welfare clinics (CWC) in six sub-districts. Pregnancy outcome data and maternal nutritional, health service and socio-demographics were obtained using a pre-tested questionnaire. Determinants of low birth weight (LBW) and neonatal asphyxia were analyzed using chi-square and multivariable logistic regression modelling. ResultsThe results showed that the prevalence of low birth weight and neonatal asphyxia were 8.2% and 9.3% respectively. Multiple logistic regression showed that the risk of giving birth to a LBW baby was high among mothers who consumed alcoholic beverages [AOR = 5.93; 95% CI (1.22–28.84); p = 0.03], those who had food taboos during pregnancy [AOR = 3.31; 95% CI (1.02–10.77); p = 0.047] and not having additional meals [AOR = 3.16; 95% CI (1.0–10.0); p = 0.05] during pregnancy. Neonatal asphyxia was higher among new born babies whose mothers did not receive nutritional counselling in pregnancy [AOR = 5.64; 95% CI (1.48–21.60); p = 0.01] and those who had anaemia at 36 weeks gestation [AOR = 2.69; 95% CI (0.95–7.65); p = 0.06]. ConclusionMaternal dietary practices during pregnancy could positively affect birth outcome in the Upper West Region of Ghana.

Knowledge and practice of exclusive breastfeeding among mothers in the tamale metropolis of Ghana

BackgroundThe prevalence of exclusive breastfeeding (EBF) for the first six months of life has remained low worldwide and in Ghana, despite strong evidence in support of its practice. This study was aimed at assessing the knowledge and practice of exclusive breastfeeding among mothers in the Tamale metropolis of Ghana.MethodsIn a descriptive cross-sectional study, 393 mother-infant pairs attending child welfare clinics from three health facilities in the Tamale Metropolis were surveyed. A structured item questionnaire was used to collect data on the socio-demographic Characteristics of the participants, their knowledge regarding breastfeeding and level of practice of exclusive breastfeeding (EBF). The results were presented in frequency counts, percentages and inferences were made using a contingency table and chi-square values were computed to check for the relationship between participants demographic characteristics, the Knowledge and the practice of EBF and P value was set at 0.05.ResultsThe Analysis of the data was done with SPSS version 20. The study surveyed a total of 393 mothers from Tamale metropolis, of whom 27.7% reported having exclusively breastfed their infant for the first 6 months of life. The socio-demographic of the participants showed that they all had some level of education. The study revealed that 39.4% initiated breastfeeding within one hour after birth. Majority of participants had heard of EBF 277 (70.5%), about 344 (87.5%) of participants believed that EBF should be practised for 5 months in their locality. Pearson Chi-square test of the association between sociodemographic characteristics associated and EBF showed a significant association between EBF and the sex of the child, X2 = 4.177, P = .041. Whiles, EBF and the Knowledge on child spacing was X2 = 17.769, P < .001 and EBF and knowledge on Breast cancer reduction was also significant X2 = 4.384, P = .036.ConclusionsAlthough all the participants had some level of education background, a majority did not have adequate knowledge on EBF and EBF practice was low in the study community. Thus, we suggest improved education at the child welfare clinics and the media should be used as a platform to educate women adequately about importance of EBF.

Survey of umbilical cord care practices and separation time in healthy new-born in Maiduguri, Nigeria

This study aimed at assessing the umbilical cord care practices and separation time in healthy new-born in Maiduguri, Borno State, Nigeria. A descriptive survey design was adopted for the study. A total of 365 women attending child welfare clinic were selected through systematic random sampling technique from three health care facilities in Maiduguri Metropolis. A self-developed and validated questionnaire was used to collect information from the women on common cord care practices and knowledge of standard umbilical cord care practices. The questionnaire was pretested in State Specialist Hospital Maiduguri, Borno State and the correlation coefficient of 0.87 determined. The result of the study revealed that common cord care practices among women in Maiduguri include the use of methylated spirit, hot compress, charcoal, Vaseline and table salt. Others were mixture of methylated spirit with traditional concoctions, toothpaste and cow dung were also found to be commonly used by the mothers. The mean umbilical cord separation time of 3.5 days (± 0.397) was observed with the unorthodox treatment of the cord. Although there was a good knowledge among the respondents with regards to standard umbilical cord care practice, there was however no commensurate practice. Therefore, there is an urgent need for cultural re-orientation most especially of women with regard and unhygienic traditional cord care practices on the new born.

Prevalence of Exclusive Breastfeeding among Mothers of Infants Aged 0-6 Months in Makurdi, Nigeria: A Cross-Sectional Survey

There is paucity of reports on breastfeeding practices among nursing mothers in Makurdi, Benue state. The study was aimed at determining the prevalence of exclusive breastfeeding and associated factors among mothers of infants aged 0-6months attending Child Welfare Clinics in Makurdi, Benue state. This cross-sectional study was conducted among 300 mothers of children aged 0-6months attending under-five clinics in Makurdi. Data was collected using structured questionnaire and analyzed using SPSS version 20. The mean age of the infants was 3.06 months ± 2.2months. Majority of the mothers 292(97.3%) were currently breastfeeding, but less than half of the mothers 141(47.0%) were exclusively breastfeeding. Among mothers that were not practicing exclusive breastfeeding, 103(64.8%) gave water, 68(42.8%) administered soft drink, 54(34.0%) gave infant formula, 11(6.9%) gave custard, while 17(10.7%) administered yam porridge, tea, fruit juice or liquid milk. Mothers who had one or more previous pregnancies and mothers of babies aged 0-1month were more likely to practice EBF. Even though the exclusive breastfeeding prevalence reported in this study is above the national figure, it is however less than the World Health Organization target for infants that are six months and below. Efforts should be intensified to sustain this giant stride with the hope of improving on it through public awareness on the importance of exclusive breastfeeding.