Child Health Care Program Research Articles

Health Beliefs Related to Diarrhea in Haitian Children: Building Transcultural Nursing Knowledge

Regardless of where they live or under what circumstances, mothers throughout the world seem to have a compelling desire to provide the best possible health care for their children (Huston, 1979). Haitian mothers living in the Dominican Republic were no exception. The health beliefs and practices of these mothers related primarily to diarrhea among their children which demonstrated a concern and resourcefulness that is commendable. The results of this study clearly indicate the importance of transcultural nurses conducting culturally relevant research as a basis to develop sound health programs in developing countries. Diarrhea was identified as the single most important threat to a child's health in these communities. That mothers did not know about the correct ingredients and/or proportions for oral rehydration solutions (Western views) was of interest. Although the Dominican government makes some commercial packets of ORS, most of the women interviewed did not have ready access to this product. This finding reflected the need for transcultural nurses to offer to teach mothers how to make ORS using the sugar, salt, and water they had available. Since the mothers' perception that diarrhea was a dangerous threat to their children's health, was verified by childhood mortality statistics in the bateys, it would seem that ORS could make a significant impact on the health status of the children. Breastfeeding also was a major health belief factor associated with the treatment of diarrhea. Even though the majority of mothers believed breast feeding should be continued if a child had diarrhea, a number believed it should be discontinued. Nurses working with CHWs will need to emphasize the importance of breastfeeding and help them to develop creative ways of communicating this information to the mothers. The second most dangerous threat to the child identified by the mothers was respiratory ailments. This suggests a new area of concentration for future research and training of CHWs. A host of new questions related to respiratory problems such as health beliefs, causative factors, course of disease, traditional treatments, mortality rate, etc. need to be investigated. When transcultural nurses plan health care programs for women and children in other cultures, it is important to recognize the concerns mothers have for their children, and their intense desire to nature and care for them. In this study, mothers willingly participated and demonstrated active interest in learning to use methods to improve the health and well being of their children. It is well documented (Lieban, 1977) that established health beliefs are not automatically discarded when new knowledge is made available, but that exploration and incorporation of new information when presented in a culturally relevant framework does occur. An understanding of local beliefs surrounding health is fundamental to the development of appropriate transcultural nursing interventions.

Detecting bacteriuria in a primary maternal and child health care programme.

Urinary tract infection in pregnancy has not been adequately dealt with in developing countries, though its consequences are well recognised. This is primarily because of constraints on resources coupled with a lack of technological infrastructure. An evaluation of the Griess test for the mass screening of urinary tract infection among antenatal women was carried out prospectively using a case-control method. The Griess test was found to be a valid, reliable, and economical screening test for urinary tract infection which can be integrated into a primary maternal and child health care programme.

Public policy and the socioeconomic mortality differential in infancy

This paper discusses some of the findings and policy implications of a recently completed study of socioeconomic differences in infant mortality in eight metropolitan areas of Ohio at three points in time. The study revealed that, in spite of a considerable decline in the overall rate of infant mortality since 1960, the inverse socioeconomic differential remains as wide as ever. This clearly suggests that, although maternal and child health has improved overall, the lower economic groups in our society still do not have equal access either to health care or to other amenities essential to the maintenance of good health. Moreover, consideration of recent and current policy proposals with respect to welfare programs in general, and maternal and child health care programs in particular, leads to the conclusion that this situation is not likely to change in the near future. Finally, some policy recommendations for enhancing the health status of low-income families are offered.

Health status of children in rural areas of the Dominican Republic: policy implications for nursing practice and nursing education in Third World countries.

The major purposes of this study were to determine: the health problems of children in rural areas of the Dominican Republic; differences in types of child health problems in specific villages; and major areas nurses should emphasize in rural health programs for children. The sample consisted of 466 children, 5 years and younger, who were seen in clinics held in eight rural villages. The major health problems were protein-calorie malnutrition (66%), upper respiratory infections (58%), and otitis media (25%). There was a significant difference (p < .01) in the types of child health problems found in specific villages. The following areas should have high priority in health care programs for rural children: the nutritional needs of the child; the importance of breast-feeding; the use of available foods to achieve adequate protein; immunizations; and recognition of when to seek health care for the child. Policy recommendations for nursing practice and nursing education in Third World Countries focus on the provision of preventive health care programs for children in rural villages; reduction of malnutrition through educational programs; and the development of nursing education programs which are congruent with the health care needs of individuals in Third World Countries.

The trend of breast‐feeding in a primary child care program

The tendency toward the practice of breastfeeding during 1969-81 was evaluated in the Brazilian population served by the Primary Child Health Care Program developed by the Communitary Social Medical Center of Vila Lobato (CSMCVL). The purpose was to evaluate the influence of several measures taken to encourage the breastfeeding practice in the assisted population whether these be internal administrative measures of the CSMCVL or part of the official federal or state policies. The study of children matriculated in 1977 permits the evaluation of 2 additional supporting measures added to the original program: 1) the provision of a nutritional supplement called Gestal to the mothers consisting of a mixture of soya beans and dehydrated cow milk; and 2) the provision of integral dehydrated cow milk as powder during 18 months as a reward for the children who were fed exclusively with breast milk and who had not missed any routine followup appointment in the 1st 6 months of life. In 1980 there was a massive campaign through the social communication systems about the advantages of breastfeeding. The population assisted by CSMCVL is a low income population with low maternal educational level. Overall there was great increase in lactation frequencies over the 1st months. The greatest increase occurred after 1977 when Gestal was supplied to the nursing mothers as a reward. The official campaigns also helped to raise the frequency of breastfeeding in the 1st 6 months of life. Hypogalactia weak milk or little milk were the most frequent reasons cited for early weaning. Orientation and followup of the nursing mothers are important to avoid situations that may lead to premature weaning. The main objective of the program to increase breastfeeding was reached. Maintenance of the increased level of breastfeeding should be supported by incorporating the practice into the cultural values of the population. Legal and social protection of nursing mothers is also needed without the authoritarian and paternalistic measures used as incentives.

A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System

A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System

Policies regarding health and social care of mothers and children in the United States.

Modifications in federal planning and budgeting for health care programs for mothers and children are reviewed. The potential effects on the affected populations are evaluated, and recommendations for response by the health care professions are presented.

THE STATES' ROLE IN HEALTH CARE COST CONTAINMENT*

Under the Social Security Act of 1935, the federal government expanded its involvement in maternal and child health care programs through grants‐in‐aid to state and local health departments. The Medicaid legislation of 1965 vastly enlarged federal expenditures, and state responsibilities. State performance was frequently criticized, especially in health care cost containment. Recently, the states have initiated several efforts to link cost containment and the quality of health care.

The impact of a maternal and child health care program on the quality of prenatal care: an analysis by risk group.

A typical maternal and child health care program was implemented in an American Indian reservation community, and its impact on the effectiveness of prenatal care was assessed. Evaluation included examination from both the provider perspective (care provided to program users) and the population perspective (care received by a sample of all prenatal patients in the community), as well as examination of outcomes of prenatal care. The study cohorts were sorted into relatively high and average risk as a function of age, gravidity, and history of abortion or miscarriage. The study results suggest that such a program will improve the quality of prenatal care, although the program has a greater impact on the average risk group. Standard methods of assessing program effectiveness, which examine the care provided by the program as opposed to the care received by the community, will not detect this phenomenon.

Nutrition: An integral component in the health care of children. The interdisciplinary team in action

The purpose of this paper is not to disseminate new findings or to review past research, but simply to state a progressive clinical philosophy in practical terms. Current emphasis on specialization and the simultaneous need for comprehensive health care seriously challenge the health professional's ability to provide adequate services without a well integrated interdisciplinary approach. In addition, clinical experience strongly points toward the need for individualization of treatment within this broad spectrum of interdisciplinary management. The problems of childhood allergies, epilepsy, and feeding problems are used to illustrate this concept, and the interplay between psychic and somatic factors has been highlighted as rationale for integration of nutrition in an interdisciplinary health care program for children.

Role of voluntary organisations in comprehensive child health care programme.

Role of voluntary organisations in comprehensive child health care programme.

Dental health care programs for children

Dental health care programs for children

International Longshoremen’s and Warehousemen’s Union—Pacific Maritime Association Health and Welfare Fund Dental Health Care Programs for Children: a Progress Report of the First Year’s Activity

International Longshoremen’s and Warehousemen’s Union—Pacific Maritime Association Health and Welfare Fund Dental Health Care Programs for Children: a Progress Report of the First Year’s Activity