Child Health Care Services Research Articles

Health care providers\u2019 responses to sexually abused children and adolescents: a systematic review

BackgroundSexual abuse of children and adolescents is a significant health concern worldwide. Appropriate and timely health services for victims can prevent severe and long-term consequences. This study identified and categorized diagnostic and treatment services needed for sexually abused children and adolescents.MethodsSeveral databases, including MEDLINE, Web of Science, Scopus, Science Direct, ProQuest, and Google Scholar, were searched to retrieve studies on the topic and clinical guidelines in English covering the literature from 2010 to 2020 using search terms. Primary studies and guidelines were reviewed to identify treatment strategies and medical interventions related to sexually abused children and adolescents.ResultsTwenty-one studies and guidelines were selected and analyzed narratively. The quality of evidence was relatively good. We identified that effective health care systems for sexually abused children include the following: interview and obtain medical history, physical and anogenital examination, collecting forensic and DNA evidence, documenting all the findings, prevention and termination of pregnancy, diagnostic tests, prophylaxis for HIV and other STIs, vaccinations, and psychological intervention.ConclusionsThis review provides up-to-date evidence about adequate health care services for children and adolescent victims of sexual abuse. We conclude that recent studies have focused more on prophylaxis against HIV and other STIs, studies on vaccinating against HPV for victims are still limited, and future research in this area is needed.

Health Care Delivery System and the Reduction of Maternal and Child Mortality in Hospitals of Makurdi Benue State Nigeria

The objectives of this publication are to find the historical background of maternal and child health care delivery, the incidence of maternal and child mortality, causes of maternal and child mortality, challenges in accessing maternal health care services of Nigeria. Data for the study were sourced from both primary and secondary means. Primary data was drawn through questionnaire and hospital records. Questionnaire was distributed to a sample of 369 respondents out of 4,740 population of staff of four purposely selected largest hospitals in Makurdi, Benue State. The sample size was determined through Taro Yamane’s formula, while the Bourley’s proportional allocation formula was used to determine the sample size per each hospital. Data were analyzed using descriptive statistics like tables, percentages, mean and standard deviation, while the test of hypotheses were done through Chi-square. The analyzed result shows that; the availability of maternal and child health care services in the hospitals were poor; accessibility of maternal and child health care services was also poor; Furthermore, Maternal and infant mortality is essentially high and increasing in hospitals of Makurdi, Benue State Nigeria. Several challenges are militating against effective healthcare delivery, therefore, the study recommended, among others, that government and other stakeholders should make conscious efforts to ensure that adequate facilities, tools, and equipment are provided for the hospitals to enhance the quality of maternal and child healthcare services in the Benue State of Nigeria.

The future of child welfare will look toward children’s health: the case of the Kentucky Health Information Data Sharing (KHIDS) project

ABSTRACT The child welfare field in the United States aspires to encompass more than child protection and to move toward the promotion of child and family wellness. Scholars and practitioners have long observed that child wellbeing has been the most elusive of the three-part mandate of the Adoption and Safe Families Act. In response, child welfare agencies have increasingly been asking themselves hard questions and testing new approaches to meet the needs of families. This commentary argues that current developments suggest a future where child welfare workers’ activity in the field actively promotes the health of children and is recognized as an asset to pediatricians and healthcare systems. An example is offered to support this prediction in the form of the Kentucky Health Information Data Sharing (KHIDS) project. KHIDS involved an operational linkage between Kentucky’s child welfare information system and its health information exchange to allow child welfare professionals access to information that allows them to more efficiently perform their duties – especially those related to monitoring health care services for children in out of home care. The KHIDS project is a positive sign of things to come for the future of the field.

Socio-cultural barriers to the delivery and utilisation of child healthcare services in rural Ghana: a qualitative study

BackgroundOver half of global deaths among children under five years of age occur in sub-Saharan Africa. Prompt and consistent access to and utilisation of child healthcare services improves child health outcomes. However, socio-cultural barriers impede the utilisation of child healthcare services among rural dwellers in Ghana. There is a paucity of studies that explore the experiences of nurses and caregivers regarding the socio-cultural barriers to the delivery and utilisation of child healthcare services in rural areas in Ghana such as the Nkwanta South Municipality.PurposeThe purpose of this study was to explore the experiences of nurses and caregivers regarding the socio-cultural barriers that impede the delivery and utilisation of child healthcare services by caregivers for their children in the Nkwanta South Municipality, Ghana. MethodsData were collected through semi-structured interviews conducted with a purposive sample of ten nurses and nine caregivers of children under five years of age who utilised the available child healthcare services in a rural setting. The consent of all participants was sought and given before interviews were conducted. Data analysis entailed coding and the generation of themes the codes.ResultsThe exploration of experiences of nurses and caregivers of children under-five years of age revealed that certain socio-cultural beliefs and practices, language barriers and reliance of caregivers on self-medication were the main socio-cultural barriers that impeded the delivery and utilisation of child healthcare services in the Nkwanta South Municipality. Conclusion Nurses and caregivers experienced several socio-cultural barriers which either delayed care seeking by caregivers for their sick children or interfered with the smooth and prompt delivery of needed child healthcare services by nurses. Some of the barriers negatively affected the interaction between nurses and caregivers with the tendency to affect subsequent child healthcare service utilisation. It is recommended that healthcare managers and nurses should foster close collaboration with caregivers and community leaders to address these socio-cultural barriers and facilitate prompt and consistent utilisation of child healthcare service in rural areas.

Complementary feeding practices and associated factors among children aged 6-23 months in rural Haramaya district, Eastern Ethiopia: A community-based cross-sectional study.

Background: The age of children up to 59 months is a critical period for children's growth and development and the age when optimal complementary feeding is crucial. Aim: To assess optimal complementary feeding practices and associated factors among children aged 6-23 months in rural Haramaya district, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted. Statistical Package for Social Science (SPSS) version 24 was used for the analyses. Bivariable and multivariable logistic regression analysis were conducted at p-value < 0.05 and an Adjusted Odd Ratio (AOR) with a 95% Confidence Interval (CI). Results: The percentage of mothers that practiced optimal complementary feeding practices was 53.5% (95% CI: 49.2%, 57.6%). Average monthly income of the family, $37.5 to $75 (AOR = 0.52, 95% CI: 0.28, 0.98), institutional delivery (AOR = 1.61, 95% CI: 1.06, 2.46), postnatal care follow-up (AOR = 2.53, 95% CI: 1.67, 3.82), having an awareness about IYCF (AOR = 3.05, 95% CI: 1.85, 5.02), less than 30 min foot-walking to reach health facility (AOR = 2.61,95% CI: 1.65, 4.09), separate child's feeding plate (AOR = 1.75, 95% CI: 1.16, 2.64), and attendance of Infant and Young Child Feeding demonstration (AOR = 2.02, 95% CI: 1.33, 3.07) were significantly associated with optimal complementary feeding practices. Conclusion: The magnitude of optimal complementary feeding practices was below the minimum recommended level for the growth and development of children in the study area. Lack of access to and underutilization of maternal and child healthcare services were significant risk factors for suboptimal complementary feeding practices. Maternal and child health services would be essential to mitigate suboptimal feeding practices for children aged 6-23 months.

Development and feasibility testing of a physical activity intervention for youth with anxiety and depression: a study protocol

BackgroundAnxiety and depressive disorders in children and adolescents are highly prevalent and account for more than half of all youth psychiatric disorders. Left untreated, anxiety, and depression lead to numerous detrimental outcomes, including reduced quality of life, psychiatric, and somatic comorbidity and even reduced lifespan. This puts a large strain on child and adolescent mental healthcare services (CAMHS) to provide effective treatments. However, even when provided the best evidence-based treatment, between 40–50% of patients continue to report significant symptom burdens. Thus, there is an immediate need for supplemental and/or new treatment approaches. Physical activity as a supplementary treatment may be such an approach. However, research investigating this approach within this population is scant. This protocol paper describes the development and feasibility trial of a physical activity-based intervention targeting anxiety and depressive symptoms in youth treated in CAMHS.Methods/designThe study is based on the UK Medical Council Research Framework (MRC) for developing and evaluating complex interventions. Feasibility and acceptability of the physical activity intervention (confident, active, and happy youth) will be evaluated in an uncontrolled open-label trial using qualitative and quantitative data. Twenty youths with anxiety and/or depressive symptoms will be recruited. Acceptability of assessment procedures, the intervention, and perceived benefits and barriers to participation will be assessed, and qualitative interviews with participants, caregivers, and referring specialists will explore contextual and practical factors associated with intervention delivery. Physical activity will be measured using the Actigraph GT3X+ monitor at baseline, and post-intervention and change in anxiety and depression will be assessed.DiscussionThis study will contribute to the development of supplementary physical treatment interventions for youth with anxiety and depression in contact with CAMHS. The goal is to examine new avenues of treatment that ultimately may improve upon current treatment outcomes of anxiety and depression. This work will be in preparation for a future definitive randomized controlled trial (RCT) of this approach, in line with the MRC Framework.Trial registrationClnicalTrials.gov, NCT05049759. Registered on August 19, 2021. Retrospectively registered.

493 Increased Utilization of Healthcare Services in Children with Craniosynostosis

INTRODUCTION: Craniosynostosis is a condition characterized by the premature fusion of at least one cranial suture. While evidence suggests that both syndromic and nonsyndromic patients may benefit from developmental, behavioral, and mental health support, data on utilization of healthcare services is lacking. METHODS: The Optum Clinformatics® DataMart database was queried to identify 1340 patients with craniosynostosis. Long-term utilization of mental health care, rehabilitation therapies, and other medical services up to age six was calculated. Rates of utilization were compared to healthy controls (n = 1577) and children with plagiocephaly (n = 1249). RESULTS: Mental health care was utilized more frequently in craniosynostosis patients (8.1%) compared to plagiocephaly (5.0%, p=0.0020) and healthy controls (2.9%, p&lt;0.0001) . Physical, occupational and speech therapy were more frequently used by plagiocephaly than craniosynostosis patients (14.1% vs. 11.2%, p = 0.0283), which was significantly higher than use by controls (11.2% vs. 3.9%, p&lt;0.0001). Other medical subspecialty services (developmental pediatrics, ophthalmology, optometry and audiology) were utilized by 37.0% of craniosynostosis patients, compared with 20.9% (p&lt;0.0001) and 15.1% (p&lt;0.0001) of plagiocephaly and healthy controls, respectively. Among craniosynostosis patients, utilization was not uniform by age; while ophthalmology utilization did not differ by age (p = 0.1003), mental health care was most commonly used among older children (p = 0.0107). CONCLUSION: In this study, we demonstrate that children with craniosynostosis utilize mental health care, rehabilitation therapies, and other medical subspecialty services at a higher rate than controls. While surgical correction may be considered an isolated event, these children should be monitored for developmental and mental health support longitudinally. Future work should explore risk factors driving utilization, including suture involvement, repair type, and comorbidities.

Predictors of utilization of facility-based ante-natal care and delivery services in a Nigerian Rural Community.

With maternal mortality ratio of 2,000/100,000 live births and perinatal mortality rate of 40/1,000 total births, Cross River State is one of the states with the highest maternal and perinatal deaths in Nigeria. One of the causes of these poor health indices is low utilization of facility-based maternal and child healthcare services during pregnancy and childbirth. The objective of this study was to assess the predictors of utilization of antenatal care and delivery services in Akpabuyo, a rural community in Cross River State of Nigeria. This was an analytical cross-sectional survey. Data were collected from 370 pregnant women between June and July, 2013 and analyzed using SPSS version 25. Binary logistic regression showed that compared with women with tertiary education, women with non-formal education were less likely to attend antenatal clinic (AOR=0.510, 95% CI=0.219-1.188) although the difference was not statistically significant. Also, compared with farmers, full-time housewives were less likely to deliver in a health facility (AOR=0.650, 95% CI=0.305-1.389) while civil servants were nearly five times more likely to deliver in the health facility (AOR=4.750, 95%CI=1.616-13.962). The predictors of antenatal care and facility delivery services utilization identified by the study were educational status and occupation. This raises the need for policies and programmes to ensure girl child education and the economic empowerment of women.

Factors influencing the utilization of antenatal and postnatal care services by women of reproductive age group: a cross-sectional study in rural community of Maharashtra

Background: Antenatal care (ANC) and postnatal care (PNC) care services intended to secure and improve maternal health are utilized only to a limited extent. Therefore, this study was conducted to assess various barriers and association of various sociodemographic factors like age, education, economic status and religion with the utilization of services. This revealed the reasons which avert the ladies from utilising the services adequately.Methods: 150 women residents of Uruli Kanchan, a village in Pune district of Maharashtra, having at least 1 child below the age of five years were selected by simple random sampling technique. The data was collected by house-to-house survey and interview technique.Results: In the present study, better utilization of ANC services was observed (99.234%) as compared to PNC services (65.33%). Education, good socioeconomic conditions and religion were the factors which greatly influenced the utilization of PNC services. Lack of desire and awareness of PNC visits (in 55% women) was an important factor for underutilization of PNC services. Lack of trust towards government services (by 34.02%) women was observed.70% of women showed satisfaction towards the maternal and child health care (MCH) services provided by the government.Conclusions: Women showed high level of utilization of ANC services as compared to PNC services which still need a lot of attention and awareness. Women show lack of trust in the government facility.

Assessment of maternal and child health care services performance in the context of COVID-19 pandemic in Addis Ababa, Ethiopia: evidence from routine service data

BackgroundIn many settings, health care service provision has been modified to managing COVID-19 cases, and this has been affecting the provision of maternal and child health services. The aim of this study was to assess trends in selected maternal and child health services performance in the context of COVID-19 pandemic.MethodsA cross-sectional data review was conducted in Addis Ababa, Ethiopia from April to May 2021. Routine health management information system database was reviewed from Addis Ababa Health Bureau for the period from July 2019 to March 2021 across all quarters. Proportion and mean with standard deviation were computed. T-test was used to assess statistically significant differences in services mean performance.ResultsPostnatal care visit, new contraceptives accepters, safe abortion care and number of under-5 years old children treated for pneumonia significantly decreased by 9.3% (p-value 0.04), 20.3% (p-value 0.004), 23.7% (p-value 0.01) and 77.2% (p-value < 0.001), respectively during the first 8 months of the COVID-19 pandemic compared to the previous 8 months’ average performance. The trends in Antenatal care first visit, new contraceptive accepters, pentavalent-3 vaccination and under-five children treated for pneumonia began to decline in January to March 2020, a quarter when the COVID-19 pandemic began; with accelerated declines in April to June 2020 following national lockdown. The trends for the stated services began to increase during July–September 2020, the last quarter of national lockdown. Contraceptive accepters and pentavalent-1 vaccination continued to decline and showed no recovery until January–March 2021 when this study was completed.ConclusionsMost of the maternal and child health services performance declined following the onset of COVID-19 pandemic and national lockdown, and most of the services began recovering during July–September 2020, the last quarter of national lockdown. However, new and repeat contraceptive accepters and pentavalent-1 recipients continue to decline and show no recovery during end of the study period. Implementing COVID-19 prevention measures and assuring the community about the safety of service delivery is imperative to ensure continuity of the maternal and child health services. Regular monitoring and evaluation of services performance is required to identify slowly recovering services and respond to potentially volatile changes during the COVID-19 pandemic.

The unintended consequences of COVID-19 public health measures on health care for children with medical complexity.

The aim of this work is to explore the unintended consequences of pandemic public health measures on health care service usage by children with medical complexity. Medical complexity is characterized by the presence of complex, chronic conditions requiring specialized care, substantial health needs, functional dependence and/or limitations, and frequent health care usage. Children with medical complexity are among the highest users of paediatric health care services. A web-based, cross-sectional survey was conducted in British Columbia, Canada, between August and September 2020. Inclusion criteria were (a) parent/guardian of at least one child (age 0 to 18 years, inclusive) with medical complexity and (b) residence in British Columbia. A convenience sample of 156 parents completed the survey. Data were analysed using a series of descriptive analyses (frequencies, cross-tabulations) and inferential analyses (binary logistic regressions). Respondents provided information for 188 children with medical complexity. Access to allied health therapies (physio, occupational, and speech and language) and medical specialists drastically declined in the initial months of the pandemic, with a shift from in-person to virtual platforms for these aspects of care. Regression modelling indicated that age and family structure influenced decisions to use in-patient hospital services. Public health measures implemented in the initial months of the pandemic decreased access to health care services for children with medical complexity. The long-term ramifications of these measures are unknown. Family structure was found to influence decisions to avoid accessing Emergency Department care. Given the volume of services used by these children, paediatric hospital leaders need to take their unique needs into consideration in disaster planning to ensure minimal disruptions in care.

Quotidian Beliefs and Practices in Maternal and Child Health Care: An Empirical Study Among the Irula Tribe of Tamil Nadu

The present paper explores the cultural context of maternal and child health (MCH) care practices and beliefs of Irula tribes. It identifies the factors and analyses the pattern of their domiciliary deliveries and neonatal care among Irula, which is one of the PVTGs (Particularly Vulnerable Tribal Groups) in Tamil Nadu. The paper adopted a descriptive research design based on the pilot survey and ethnographic fieldwork. It examines the health care beliefs and practices relating to maternal and neonatal care connected with a holistic view of the Irula community’s cultural dimensions. The paper also demonstrates the factors for domiciliary deliveries, non-utilization of prevailing state’s health interventions, and incentives for maternal and child health care services among the Irulas. Keeping in view the aforementioned argument, an empirical study was carried out in six Irular settlements of Villupuram district in Tamil Nadu.

Prevalence of wasting and associated factors among children aged 6-59 months in Wolkite town of the Gurage zone, Southern Ethiopia, 2020. A cross-sectional study.

BackgroundUndernutrition among children is one of the leading major public health problems and about 49.5 million children were wasted worldwide. Asia and African countries contributed 69% and 27.2% of wasting respectively. In Ethiopia, 7% of children were wasted and 1% was severely wasted. Although Ethiopia has achieved remarkable progress in reducing under-five mortality and designed multi-dimensional approaches to address malnutrition, the data on acute malnutrition among children in the study setting is limited. Therefore, this study was aimed to assess the prevalence of acute malnutrition and associated factors among 6-59-month-old children.MethodsCommunity-based cross-sectional study design was conducted at Gurage Zone, Southern Ethiopia. A total of 293 study participants were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires by face-to-face interview. Data entry and analysis were made using Epi Data version 4.6 and Statistical Package for Social Science (SPSS) version 24 respectively. Descriptive statistical analysis and some of the statistical tests like the odds ratio were carried out. Both Bivariable and multivariable logistic regression analysis with 95% confidence interval was carried out to identify associated factors and variables with P value < 0.05 were taken as statistically significant.ResultsThe prevalence of wasting among children aged from 6–59 months in this study was 14.7% (95% CI: 10.9, 18.8). After controlling for all possible confounding factors, the result revealed that age of children between 6–11 months [AOR = 2.78(95% CI: 1.67, 6.19)], caregivers who were unable to read and write [AOR = 2.23 (95% CI: 1.04, 5.34)], presence of diarrheal disease in the past two weeks [AOR = 1.68 (95% CI: 1.23, 5.89)] and mothers who had a history of poor handwashing practice before food preparation and child feeding [AOR = 2.64(95% CI: 1.52, 4.88)] were found to be significantly associated with wasting.ConclusionsThe study findings indicate that respondents’ wasting was mainly affected by age of the child, educational status of caregivers, presence of diarrheal disease and hand washing practice of the mother. Providing acceptable, quality and honorable care for all children is very crucial to prevent child wasting and proper handwashing during breastfeeding and food handling is recommended and interventions aimed at improving maternal health and access to health care services for children are urgently needed.

Effect of mobile health interventions in increasing utilization of Maternal and Child Health care services in developing countries: A scoping review.

Mobile health (mHealth) technology is being used predominantly in low- and middle-income countries. Developing countries with low level of investment in health infrastructure can augment existing capacity by adopting low-cost affordable technology. The aim of the review was to summarize the available evidence on mHealth interventions that aimed at increasing the utilization of Maternal and Child Health (MCH) care services. Further, this review investigated the barriers which prevent the use of mHealth among both health care workers as well as beneficiaries. A scoping review of literature was undertaken using the five-stage framework developed by Arksey and O'Malley. The articles published between 1990 and 2021 were retrieved from three databases (PubMed, Cochrane Reviews, and Google Scholar) and grey literature for this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was followed to present the findings. A total of 573 studies were identified. After removing duplicates, studies not related to mHealth and MCH and publications of systematic reviews and protocols for studies, a total of 28 studies were selected for review. The study design of the research articles which appeared during the search process were mostly observational, cross-sectional, and randomized controlled trials (RCTs). We have classified the studies into four categories based on the outcomes for which the mHealth intervention was implemented: MCH care services, child immunization, nutrition services, and perceptions of stakeholders toward using technology for improving MCH outcomes. This brief review concludes that mHealth interventions can improve access to MCH services. However, further studies based on large sample size and strong research design are recommended.

Situational Analysis of Access to Essential Healthcare Services in Nigeria: Implication for Trans-Sectorial Policy Considerations in Addressing Health Inequities

Background: Socioeconomic factors influence health outcomes and the distribution of health resources within and between countries globally. In Nigeria, there are various socio-economic factors that have been reported to be responsible for health inequities across the different geopolitical zones. Objective: To assess health inequities in relation to socio-economic factors that affect access to essential health care services in Nigeria, using family planning, maternal care, and childcare as indicators. Method: The study involved a cross-sectional secondary analysis of data from the 2018 Nigeria Demographic and Health Survey (NDHS) and a literature review of transdisciplinary approaches to addressing health inequities. Result: The overall result from the findings suggests a strong influence of geographical and socioeconomic factors in the distribution of healthcare services. Specifically, family planning services were more readily available and accessible in the Southern zones of Nigeria than in the Northern zone of Nigeria, which could be attributed to socio-cultural, religious, and access-related barriers. Results also showed that access to most maternal and child health care services was often skewed towards the southern zones, which could be due to the presence of more healthcare workers who provide these services coupled with higher access to maternal care, hence a higher uptake and utilization of maternal care services. Also, children in the northern zones had lesser odds of receiving basic and age-appropriate vaccination than those in other regions, which could be attributed to the supply-side disparities that exist between the northern and southern regions. Conclusion: This study concludes that level of educational attainment, wealth quintiles, as well as financial barriers, are the major socio-economic factors that influence access to maternal and childcare services.

Opportunities to Integrate Primary Health Care Digital Innovations in Maternal and Child Health Care Services in Kenya

Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.

Influence of Structured Training Programme on Healthcare Workers' Knowledge of Recommended Postnatal Care Services in Nigeria.

IntroductionThe lack of continuous training of maternal and child healthcare providers has been identified as one of the factors contributing to the poor quality of maternal and child healthcare services in Nigeria.ObjectivesThe study aimed to evaluate the level of postnatal care-related knowledge among healthcare workers in Osun State and the impact of a structured training program on their learning.MethodA quasi-experimental research design using pre-test and post-test control groups was utilized in this study. One hundred and sixty-one healthcare workers were recruited from six Local Government Areas (LGA) and randomized into intervention and control groups. The healthcare workers in the intervention group (n = 82) were exposed to a 3-day structured training program. A structured questionnaire was used to collect data before, immediately, and 3-months after the training. Data were analyzed using descriptive statistics, multiple linear regression, t-test, and repeated measure analysis of variance (ANOVA) with posthoc pairwise comparison.ResultsThe mean ages of healthcare workers in the intervention and control groups are 40.96 ± 6.91 and 42.52 ± 7.58, respectively. At baseline, the mean knowledge score of the intervention and control groups were 60.0 ± 11.6 and 63.7 ± 10.4, respectively. There is a significant difference in the mean knowledge score of healthcare workers in the intervention group compared with those in the control group immediately after the training (t = 12.04, p < .001) and after 3-months of data collection training (t = 5.92, p < .001). A multivariate linear regression confirmed the positive effect of group membership (intervention vs. control) on the post-test knowledge among respondents (p < .001).ConclusionAn educational training significantly improved the knowledge of healthcare workers on the recommended postnatal care.

Prevalence and its predictors of intimate partner violence against pregnant women amid COVID-19 pandemic in Southwest Ethiopia, 2021: A cross-sectional study.

Objectives:Preventive measures like staying-at-home and social distancing are among the top strategies on the list to avert the spread of coronavirus disease 2019 and its consequences. However, this strategy brings off another shadow pandemic of intimate partner violence against women, and no study has been done to assess the magnitude of intimate partner violence against pregnant women during the pandemic in Ethiopia. Therefore, this study was aimed to determine the prevalence of intimate partner violence and its predictors in Southwest Ethiopia amid the coronavirus disease 2019 pandemic.Methods:A community-based cross-sectional study was conducted, from 15 June 2021 to 15 August 2021, on a total of 590 pregnant women recruited by systematic random sampling techniques. Pretested structured questionnaires were used to collect data, and the data were entered using EpiData version 3.1 and analyzed by SPSS version 24. Logistic regression analysis was used to identify predictors of intimate partner violence. Finally, statistical significance was declared at a p-value <0.05.Results:The prevalence of intimate partner violence was 39.2%. Of this, 29.8%, 26.8%, and 22.2% of the pregnant women had experienced physical, sexual, and emotional intimate partner violence, respectively. Being illiterate (adjusted odds ratio = 2.36, 95% confidence interval: 1.33–4.19), having illiterate husbands (adjusted odds ratio = 4.79, 95% confidence interval: 2.69–8.55), household decisions made by the husband alone (adjusted odds ratio = 4.91, 95% confidence interval: 3.74–9.33), and pandemic-induced economic downturns (adjusted odds ratio = 9.03, 95% confidence interval: 5.18–15.98) were the predictors that were significantly associated with intimate partner violence.Conclusion:The prevalence of intimate partner violence against pregnant women during the coronavirus disease 2019 pandemic has been found to be high in the study area. Thus, more efforts should be tried to integrating intimate partner violence screening in maternal and child healthcare services, and early identification of high-risk individuals, and continuous community-based awareness creation activities are recommended.

Impact of COVID-19 on child health and healthcare services

Impact of COVID-19 on child health and healthcare services

Caregivers’ Perception of the Quality of Nursing Care in Child Health Care Services of the University College Hospital, Nigeria

Caregivers’ Perception of the Quality of Nursing Care in Child Health Care Services of the University College Hospital, Nigeria