Child Health Indicators Research Articles

The role of educational institutions in supporting children and adolescents with selective mutism

Selective mutism is an anxiety disorder that is increasingly common in the preschool and early childhood population. There is a constant search for effective therapeutic, educational intervention approaches for children experiencing anxiety who cannot communicate freely in non-familial and, especially, educational settings. This paper therefore emphasises the role that educational institutions play or should play in this regard, especially in the areas of prevention, diagnosis, as well as support in relation to the social and emotional well-being and mental health of children and adolescents. The paper characterises the specificity of selective mutism. The diagnostic specifiers and aetiological factors are discussed. Potential difficulties in working with children with selective mutism, as well as forms of therapeutic and behavioural interventions that can be implemented in educational institutions are also discussed. The main conclusion of this study is that teachers, in cooperation with specialists working in schools, have a good insight and a broader view of the possibility to help students who experience anxiety in social relationships. They can support children and also their families in acquiring communication competences in the school environment, learning new adaptive skills and coping with difficult situations. This seems particularly important in a context where, unfortunately, reported research findings indicate that mental health indicators for children and adolescents are deteriorating very rapidly and the number of children in need of psychological and psychiatric support is steadily increasing.

Neonatal, Infant, and Child Mortality in India: Progress and Future Directions.

In India, considerable progress has been made in reducing child mortality rates. Despite this achievement, wide disparities persist across and socio-economic strata, and persistent challenges, such as malnutrition, poor sanitation, and lack of clean water. This paper provides a comprehensive review of the state of child health in India, examining key risk factors and causes of child mortality, assessing the coverage of child health interventions, and highlighting critical public health programs and policies. The authors also discuss future directions and recommendations for bolstering ongoing efforts to improve child health. These include state- and region-specific interventions, prioritizing social determinants of health, strengthening data systems, leveraging existing programs like the National Health Mission (NHM) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY), and the proposed Public Health Management Cadre (PHMC). The authors argue that reducing child mortality requires not only scaled-up interventions but a comprehensive approach that addresses all dimensions of health, from social determinants to system strengthening.

Level and Trend of Child Health and Nutrition Status in Nepal: Evidence from Demographic and Health Survey (1996-2016).

Child health and nutrition are key indicators of the country's socioeconomic development and quality of life. The purpose of the paper was to examine the level, trend, and socio-demographic differences of selected child health and nutrition indicators and to provide policy recommendations for improvement. Desk review was conducted to compile secondary information on child health and nutrition status published in the Nepal Demographic and Health Survey reports prepared by Ministry of Health and Population from 1996 to 2016. Trend lines, bar diagram, and GIS maps were prepared to study and present the findings. A substantial decrease in under-five mortality, from 118 to 39 (67% point decline) and neonatal mortality, from 50 to 21 (58% point decline) deaths per 1000 live births, was noted between 1996 and 2016. Full immunization coverage decreased from 87% in 2011 to 78% in 2016. 36% of children under the age of five were stunted, 25% were underweight, and 10% were wasted in 2016. Boys were more likely to receive treatment for diarrhoea (72%), compared to girls (56%). The majority of the children (74%) had their acute respiratory infections managed at private medical centers. Child health and nutritional status differed by geographic regions, being better in Gandaki and Bagmati and poor in Karnali and Madesh. Overall health and nutrition status of children were better among educated, and wealthier families. To further reduce childhood mortality and reach the targets for the Sustainable Development Goal, targeted interventions must be implemented to improve immunization coverage plus health and nutritional status among disadvantaged populations.

Traditional Birth Attendant in the Maternal and Child Health Space in Nigeria: Ancient Practices and Modern Recommendations

Background: Arguments on the usefulness of Traditional Birth Attendants (TBAs) in maternal and child health care and the reduction of maternal and child morbidity and mortality indices or not, persist. This paper sought to explore the ancient practices of TBAs and to strike a balance to portray modern recommendations that would contribute to improved maternal and child health status. Methods: The method used was review of relevant literatures from open-access journals and google scholar data base, as well as research reports on variables of the subject in developing countries. Results: Findings revealed that the overlapping root of TBAs’ practice burden include poor social amenities, inadequate health facilities and services in rural areas where over 70% of the population reside. While evidencebased report showed that even when 93% of rural women registered for Ante-Natal Care, 49% were delivered at home by TBAs and 73% has sought help from them for retained placenta with bleeding. Also, 41% of women of child bearing age indicated that maternal and child infection is a risk associated with the patronage of TBAs, whereas 32.8% indicated that bleeding during and after delivery were equally risks associated with TBA-provided maternal health services. Such circumstances of service were associated with harmful practices with attendant health and medical complications to recipient mother and child. However, helpful ancient practices of TBAs include; home visiting to promote well-being of mother and child (9.84%), sitz bath (17.20%), encouraging breastfeeding up to 2years (18.90%) etc. The modern recommendations, x-rayed the remedial actions on the harmful practices and associated negative consequences to improving maternal and child health indices in Nigeria. Conclusion: For reasonable and sustainable reduction in the burden associated with the practices of TBAs in maternal and child health care in Nigeria, contextual focused training and continuous mentoring is a necessity.

Spatial association and modelling of under-5 mortality in Thailand, 2020.

Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thailand, despite significant steps made in child health, disparities in U5MR persist across different provinces. We examined various socio-economic variables, health service availability and environmental factors impacting U5MR in Thailand to model their influences through spatial analysis. Global and Local Moran's I statistics for spatial autocorrelation of U5MR and its related factors were used on secondary data from the Ministry of Public Health, National Centers for Environmental Information, National Statistical Office, and the Office of the National Economic and Social Development Council in Thailand. The relationships between U5MR and these factors were modelled using ordinary least squares (OLS) estimation, spatial lag model (SLM) and spatial error model (SEM). There were significant spatial disparities in U5MR across Thailand. Factors such as low birth weight, unemployment rate, and proportion of land use for agricultural purposes exhibited significant positive spatial autocorrelation, directly influencing U5MR, while average years of education, community organizations, number of beds for inpatients per 1,000 population, and exclusive breastfeeding practices acted as protective factors against U5MR (R2 of SEM = 0.588).The findings underscore the need for comprehensive, multi-sectoral strategies to address the U5MR disparities in Thailand. Policy interventions should consider improving socioeconomic conditions, healthcare quality, health accessibility, and environmental health in high U5M areas. Overall, this study provides valuable insights into the spatial distribution of U5MR and its associated factors, which highlights the need for tailored and localized health policies and interventions.

Benefits of Investing on Mother and Child Healthcare in Tanzania

Purpose: Maternal and child healthcare play crucial role in reducing global mortality rates, with a significant impact on the overall burden of disease. The Sustainable Development Goal 3 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030. Sub-Saharan Africa, including Tanzania, carries a high burden of mortality rates and experiences a significant share of maternal and child deaths, exacerbating the global figures. The average prevalence of below 5 years mortality in SSA between 2010 and 2018 was 4.10% according to Ahinkorah (2021). Recognizing the severity of this issue, the government of Tanzania through the Development Agenda 2025, Draft health policy 2020 and the current Health Sector strategic plan 2021-2026 plans to reduce infant and maternal mortality rates through mother and child healthcare investment. The Health Sector Strategic Plan focuses on strengthening the health systems in the country and aims to sustain the achievements made in enhancing the health of reproductive, maternal, newborn, children, and adolescent populations. This study sought to assess the benefits of investing on mother and child healthcare in Tanzania. The study was guided by the investment commodity theory developed by the economist John Maynard Keynes in 1936. The study evaluated the current status of mother and child health indicators, the benefits of investing in mother and child health on overall health outcomes and identified the existing gaps and challenges in the provision, access and utilization of mother and child healthcare services in Tanzania.
 Methodology: The study was a desktop review-based study which relied on existing published information, data, and literature.
 Findings: The study found out that there have been improvements in certain areas of mother and child health indicators but maternal and child mortality rates remain high. Health interventions such as vaccination programs, improved access to healthcare services, and the use of maternal and child health insurance cards showed positive effects on reducing child mortality, improving child health outcomes, and enhancing maternal healthcare utilization. The significant gaps and challenges in the provision, access, and utilization of mother and child healthcare services include disparities in access to healthcare services based on factors such as education level and wealth status, inadequate healthcare infrastructure, long distances to health facilities, sociocultural barriers, and financial constraints.
 Unique contribution to theory, practice and policy: The study recommends strengthening of healthcare infrastructure, enhancing access to maternal and child healthcare services, especially for vulnerable populations, promoting health education and raising awareness about maternal and child healthcare practices, addressing the shortage of skilled healthcare professionals, improving data collection and use and monitoring of maternal and child health indicators, addressing socio-cultural barriers that hinder access and utilization of healthcare services and increasing investment in mother and child health care programs through allocate adequate resources.

Alpha NSW: What would it take to create a state-wide paediatric population-level learning health system?

The health and well-being of children in the first 2000 days has a lasting effect on educational achievement and long-term chronic disease in later life. However, the lack of integration between high-quality data, analytic capacity and timely health improvement initiatives means practitioners, service leaders and policymakers cannot use data effectively to plan and evaluate early intervention services and monitor high-level health outcomes. Our exploratory study aimed to develop an in-depth understanding of the system and clinical requirements of a state-wide paediatric learning health system (LHS) that uses routinely collected data to not only identify where the inequities and variation in care are, but also to also inform service development and delivery where it is needed most. Our approach included reviewing exemplars of how administrative data are used in Australia; consulting with clinical, policy and data stakeholders to determine their needs for a child health LHS; mapping the existing data points collected across the first 2000 days of a child's life and geospatially locating patterns of key indicators for child health needs. Our study identified the indicators that are available and accessible to inform service delivery and demonstrated the potential of using routinely collected administrative data to identify the gap between health needs and service availability. We recommend improving data collection, accessibility and integration to establish a state-wide LHS, whereby there is a streamlined process for data cleaning, analysis and visualisation to help identify populations in need in a timely manner.

Recent trends in maternal and child health inequalities in Latin America and the Caribbean: analysis of repeated national surveys

BackgroundAlthough most Latin American and the Caribbean (LAC) countries made important progress in maternal and child health indicators from the 1990s up to 2010, little is known about such progress in the last decade. This study aims at documenting progress for each country as a whole, and to assess how within-country socioeconomic inequalities are evolving over time.MethodsWe identified LAC countries for which a national survey was available between 2011–2015 and a second comparable survey in 2018–2020. These included Argentina, Costa Rica, Cuba, the Dominican Republic, Guyana, Honduras, Peru, and Suriname. The 16 surveys included in the analysis collected nationally representative data on 221,989 women and 152,983 children using multistage sampling. Twelve health-related outcomes were studied, seven of which related to intervention coverage: the composite coverage index, demand for family planning satisfied with modern methods, antenatal care (four or more visits and eight or more visits), skilled attendant at birth, postnatal care for the mother and full immunization coverage. Five additional impact indicators were also investigated: stunting prevalence among under-five children, tobacco use by women, adolescent fertility rate, and under-five and neonatal mortality rates. For each of these indicators, average annual relative change rates were calculated between the baseline and endline national level estimates, and changes in socioeconomic inequalities over time were assessed using the slope index of inequality.ResultsProgress over time and the magnitude of inequalities varied according to country and indicator. For countries and indicators where baseline levels were high, as Argentina, Costa Rica and Cuba, progress was slow and inequalities small for most indicators. Countries that still have room for improvements, such as Guyana, Honduras, Peru and Suriname, showed faster progress for some but not all indicators, although also had wider inequalities. Among the countries studied, Peru was the top performer in terms of increasing coverage and reducing inequalities over time, followed by Honduras. Declines in family planning and immunization coverage were observed in some countries, and the widest inequalities were present for adolescent fertility and antenatal care coverage with eight or more visits.ConclusionsAlthough LAC countries are well placed in terms of current levels of health indicators compared to most low- and middle-income countries, important inequalities remain, and reversals are being observed in some areas. More targeted efforts and actions are needed in order to leave no one behind. Monitoring progress with an equity lens is essential, but this will require further investment in conducting surveys routinely.

Nutrition in modern socio-economic conditions of Ukraine as a health-forming factor (literature review)

A retrospective analysis of modern scientific literature was carried out. An analysis of modern features and trends in the state of the population's health and the influence of a complex of environmental factors on it, including nutrition, was carried out. The data on morbidity of the population of Ukraine according to the statistical collections for 2019–2022 were analyzed, and the health indicators of children of Ukraine were analyzed for the period (2019–2022). Nutrition is one of the environmental factors that directly affects the health of a person of any age. Rational and safe nutrition contributes to the normal growth and development of children, the prevention of diseases, the prolongation of people's lives, the increase in working capacity and provides conditions for their adaptation to the environment. Food is a multicomponent environmental factor containing more than 600 substances necessary for the normal functioning of the human body. Each of these substances occupies a certain place in the complex harmonious mechanism of biochemical processes and contributes to the proper physical development of a person. Unsatisfactory indicators of children's health are an urgent problem today. The steady decline in the number of practically healthy children, the ever-increasing flow of children suffering from chronic pathology and the disabled, is considered by many researchers today as a national tragedy. Analyzing the reasons for unsatisfactory indicators of the health of the population, it is possible to distinguish the influence of the following groups of factors: socio-economic (50%), environmental (20%), genetic (20%), state of medical care (10%). In the last decade, pediatricians, hygienists, and anthropologists have noted with great concern a particularly sharp deterioration in physical development and other criteria of health and motor fitness. Therefore, in our opinion, it is relevant to assess the health indicators of the child population as a prospect for the development of the future of the modern state. This study becomes especially relevant against the background of the incidence and prevalence of childhood diseases in recent years. Keywords: healthy lifestyle, hygienic assessment, diet, quality of life, morbidity, children.

Increasing Impact of Mobile Health Programs: SAHELI for Maternal and Child Care

Underserved communities face critical health challenges due to lack of access to timely and reliable information. Nongovernmental organizations are leveraging the widespread use of cellphones to combat these healthcare challenges and spread preventative awareness. The health workers at these organizations reach out individually to beneficiaries; however such programs still suffer from declining engagement. We have deployed SAHELI, a system to efficiently utilize the limited availability of health workers for improving maternal and child health in India. SAHELI uses the Restless Multiarmed Bandit (RMAB) framework to identify beneficiaries for outreach. It is the first deployed application for RMABs in public health, and is already in continuous use by our partner NGO, ARMMAN. We have already reached ~100K beneficiaries with SAHELI, and are on track to serve 1 million beneficiaries by the end of 2023. This scale and impact has been achieved through multiple innovations in the RMAB model and its development, in preparation of real world data, and in deployment practices; and through careful consideration of responsible AI practices. Specifically, in this paper, we describe our approach to learn from past data to improve the performance of SAHELI’s RMAB model, the real-world challenges faced during deployment and adoption of SAHELI, and the end-to-end pipeline.

Does access to water, sanitation, and hygiene improve children's health? An empirical analysis in Indonesia

AbstractMotivationMuch of the world's population still lacks access to safe drinking water and sanitation, particularly people living in poverty and in rural areas. The literature suggests that lack of access to water, sanitation, and hygiene (WASH) contributes to poor development of young children. That further leads to inadequate cognitive stimulation, stunting, iodine and iron deficiency, and lower productivity.PurposeWe aim to study the status of early childhood health in Indonesia by measuring an Early Childhood Health Index and to examine the role of access to safe water, sanitation, and hygiene in improving children's health using the national representative data of Indonesian Family Life Survey (IFLS) waves 4 (in 2007) and 5 (in 2014).Methods and approachOur methodological approach consisted of two steps. First, we developed WASH Index and Early Childhood Health Index using polychoric Principal Component Analysis (PCA), then assessed the association between the two indices using Ordinary Least Squares (OLS) regression.FindingsOverall, we found significant associations between the WASH Index and children's health status and nutritional status. The results also show that several important indicators of WASH (in particular, quality of drinking water, washing and bathing water, and sanitation) improved between 2007 and 2014. Children's access to health care and several children's health indicators also got better. Nevertheless, we still observed stable conditions or even worsening conditions in other components, namely an increase in stunting and children's morbidity.Policy implicationsThis study provides evidence that access to safe drinking water, sanitation, and hygiene is essential to improve children's health status. In accordance with Government Regulation of the Republic of Indonesia number 185 from 2014, the government at the national, provincial, and district levels must accelerate the development of public infrastructure to ensure access to safe drinking water, sanitation, and hygiene for the entire population as this investment is essential to improve young children's health and reduce the prevalence of stunting in Indonesia.

Hospital-based case-control study of risk factors for early neonatal mortality in the Gaza Strip.

Early neonatal death is an essential epidemiological indicator of maternal and child health. To identify risk factors for early neonatal deaths in the Gaza Strip. This hospital-based case-control study included 132 women who experienced neonatal deaths from January to September 2018. The control group comprised 264 women who were selected using systematic random sampling and gave birth to live newborns at the time of data collection. The controls who had no history of neonatal death or stillbirth were less likely to have an early neonatal death than women who had such history. The controls who did not have meconium aspiration syndrome or amniotic fluid complications were less likely to have an early neonatal death than women who experienced these complications during delivery. The controls who had a singleton birth outcome were less likely to have an early neonatal death than women who had multiple births. Interventions are needed to provide preconception care, improve the quality of intrapartum and postnatal care, provide high-quality health education, and improve the quality of care provided by neonatal intensive care units in the Gaza Strip.

Evaluation of maternal and child care continuum in Guinea: a secondary analysis of two demographic and health surveys using the composite coverage index (CCI)

IntroductionThe composite coverage index (CCI) is the weighted average coverage of eight preventive and curative interventions received along the maternal and childcare continuum. This study aimed to analyse maternal and child health indicators using CCI.MethodsWe performed a secondary analysis of demographic and health surveys (DHS) focused on women aged 15 to 49 and their children aged 1 to 4. This study took place in Guinea. The CCI (meeting the need for planning, childbirth assisted by qualified healthcare workers, antenatal care assisted by qualified healthcare workers, vaccination against diphtheria, pertussis, tetanus, measles and Bacillus Calmette-Guérin, taking oral rehydration salts during diarrhoea and seeking care for pneumonia) is optimal if the weighted proportion of interventions is > 50%; otherwise, it is partial. We identified the factors associated with CCI using the descriptive association tests, the spatial autocorrelation statistic and multivariate logistic regression.ResultsThe analyses involved two DHS surveys, with 3034 included in 2012 and 4212 in 2018. The optimal coverage of the CCI has increased from 43% in 2012 to 61% in 2018. In multivariate analysis, in 2012: the poor had a lower probability of having an optimal CCI than the richest; OR = 0.11 [95% CI; 0.07, 0.18]. Those who had done four antenatal care visits (ANC) were 2.78 times more likely to have an optimal CCI than those with less OR = 2.78 [95% CI;2.24, 3.45]. In 2018: the poor had a lower probability of having an optimal CCI than the richest OR = 0.27 [95% CI; 0.19, 0.38]. Women who planned their pregnancies were 28% more likely to have an optimal CCI than those who had not planned OR = 1.28 [95% CI;1.05, 1.56]. Finally, women with more than 4 ANC were 2.43 times more likely to have an optimal CCI than those with the least OR = 2.43 [95% CI; 2.03, 2.90]. The spatial analysis reveals significant disparities with an aggregation of high partial CCI in Labé between 2012 and 2018.ConclusionThis study showed an increase in CCI between 2012 and 2018. Policies should improve access to care and information for poor women. Besides, strengthening ANC visits and reducing regional inequalities increases optimal CCI.

Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review.

Suboptimal infant vaccination is common in Nigeria and multiple interventions have been deployed to address the situation. Child health indicators are reported to be worse in urban slums compared with other urban areas, but urban data are usually not disaggregated to show these disparities. Examining the timeliness and completion of infant vaccination in urban slums is important to determine the effectiveness of existing interventions in improving infant vaccination among this vulnerable population. This study explored the trends of infant vaccination in selected urban slum communities in Ibadan, Southwest Nigeria between November 2014 and October 2018. This was a cross sectional study where infant vaccination data were extracted from the immunization clinic records of six primary health care centers that were providing infant vaccination services for seven urban slum communities. Data was analyzed using descriptive statistics and Chi square test at α = 05. A total of 5,934 infants vaccination records were reviewed, 2,895 (48.8%) were for female infants and 3,002(50.6%) were from Muslim families. Overall, only 0.6% infants had both timely and complete vaccination during the four years under study. The highest number of infants with timely and complete vaccination were seen in 2015(12.2%) and least in 2018(2.9%). Regarding timeliness of the vaccines, BCG, was the least timely among the vaccines given at birth and the pentavalent and oral polio vaccines' timeliness reduced as the age of the infants increased. Both yellow fever and measles vaccines were timelier than the pentavalent vaccines. Vaccines were most timely in 2016(31.3%) and least timely in 2018(12.1%). Those from Muslim families significantly had delayed and incomplete vaccinations compared with those from Chrisitan families (p = 0.026). Infant vaccinations were significantly delayed and incomplete in the study communities during the years reviewed. More focused interventions are required to ensure optimal vaccination of the infants.

Cannabidiol Use Patterns and Efficacy for Children Who Have Cerebral Palsy.

Cannabidiol (CBD)-containing supplements are used by children with cerebral palsy (CP), but the prevalence and efficacy of their use have not been studied. We sought to describe CBD use patterns and perceived efficacy in the pediatric population with CP, evaluating any association between CBD use and health-related quality of life. Patients with CP were prospectively enrolled, and caregivers were offered the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) Questionnaire and a survey assessing CBD use. Of 119 participants, 20 (16.8%) endorsed CBD use (CBD+) and 99 (83.2%) denied it (CBD-). Participants in the CBD+ group had worse functional status (85% Gross Motor Function Classification System level IV-V for CBD+ vs 37.4% for CBD-, P<.001) and lower health-related quality of life (mean CPCHILD score of 49.3 for CBD+ vs 62.2 for CBD-, P=.001). Spasticity was the rationale most cited for CBD use (29%), followed by pain and anxiety (both 22.6%). CBD was perceived to be most effective for improving emotional health, spasticity, and pain. Fifty percent of the patients in the CBD+ group underwent surgery in the previous 2 years and most endorsed a general benefit in the postoperative setting. The most common side effects noted were fatigue and increased appetite (both 12%). Most participants endorsed no side effects (60%). CBD may serve as a useful adjunct for some children with CP, especially those with worse disease severity. Caregivers perceive CBD as offering some benefits, particularly in the domains of emotional health, spasticity, and pain. We found no evidence of severe adverse events in our small cohort. [Orthopedics. 2024;47(1):52-56.].

Impact of community health interventions on maternal and child health indicators in the upper east region of Ghana

BackgroundThis paper reports on results of a health system strengthening implementation research initiative conducted the Upper East Region of northern Ghana. Transformative interventions to accelerate and strengthen the health delivery were implemented that included empowering community leaders and members to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, providing basic medical equipment to community clinics, and improving the skills of critical health staff through training.MethodsA mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. To assess impact, a pre-versus–post randomized cluster survey design was used. Qualitative research was conducted with focus group data and individual in depth interviews to gauge the views of various stakeholders associated with the implementation process.ResultsAfter intervention, significant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage were observed and increases in the proportion of deliveries occurring in health facilities and assisted by skilled health personnel relative to pre-intervention conditions. There was also increased uptake of oral rehydration salts (ORS) for treatment of childhood diarrhoea, as well as marked reductions in the incidence of upper respiratory infections (URI).ConclusionsA pre-and post-evaluation of impact suggests that the programme had a strong positive impact on the functioning of primary health care. Findings are consistent with the proposition that the coverage and content of the Ghana Community-based Health Planning and Services programme was improved by program interventions and induced discernable changes in key indicators of health system performance.

NC Child report card gives North Carolina's children's MH an ‘F’

NC Child released their 2023 child health report card on April 4, which grades North Carolina on 15 indicators of child health in the state, EdNC reported April 24. This year the report card's focus issue was children's mental health. North Carolina scored an “F” in mental health, showing a serious decline for students in the wake of the pandemic. Post pandemic, 10.2% of high school students who attempted suicide were reported, according to NC Child, a 23.2% increase from baseline. Adolescents ages 12‐17 with major depressive episodes similarly increased by 25.8%. More than one in 10 children ages 3–17 in North Carolina had a diagnosis of depression or anxiety in 2020 — a 49% increase from 2016.” The report finds that children who experience discrimination are disproportionately impacted, reporting worse mental health than their counterparts. “LGBTQ+ students are more than three times more likely to consider or attempt suicide than their heterosexual peers,” the report says. Hispanic or Latinx high school students reported the highest rates of attempted suicide within the past year, at 13.3%. That number was 12.5% for white high school students and 11.8% for African American or Black students.

Growth Monitoring and Promotion and Index Development for Improved Child Health: A Scoping Review Using Rodgers Concept Analysis Framework

Purpose: The purpose of this scoping literature review is to explore the breadth of the available literature, and identify knowledge gaps to inform future research through the use of Rodgers evolutionary concept analysis framework. The literature review also seeks to describe the key child indices developed and their characteristics so as to guide the development of a GMP index for improved child health in Zimbabwe. Methods: The keywords growth monitoring and promotion, community health workers, caregivers of children under five years, child health indices, and index development were used to search for relevant literature from Science Direct, Google Scholar, EBSCO, and PUBMED databases in English. The initial electronic database search yielded 535 research articles, and 316 were further assessed for their relevance to the study. An additional 140 articles were excluded from the search as they did not contain adequate evidence as per the Rodgers Evolutionary Framework. After the full-text review, 80 articles out of 220 articles met the inclusion criteria. Those found to be suitable were 25 articles and were thus included in the final analysis. Results: Key Antecedents: distance and socio-cultural constraints, CHW activeness, participation of fathers in GMP activities, poor understanding and interpretation of growth charts, poor communication between caregivers and CHWs, full vaccination status and complacency; Attributes: education status of parents, knowledge, attitude, and practices of caregivers and Consequences: timely health interventions, improved child health outcomes, a platform to promote optimal child health practices of GMP activities were identified. Conclusion: More research needs to be explored to form indices that incorporate behaviour change metrics. This will lead to an increased evidence base to guide the health system, funders, and policy makers conclusively.

Dynamics of indicators characterizing the health of children in the territory of military conflict. The impact of rehabilitation measures: cohort study

Background. There are still understudied issues concerning the health indicators of children who are in conditions of conducting warfare in primary school age. Objective. The aim of the study is to evaluate comprehensive rehabilitation measures to optimize health indicators (physical, functional and mental capacity parameters) of primary school children in conditions of military conflict.Methods. An examination of 419 elementary school children was conducted in the period from March 2022 to September 2022 including. The main group: 128 children, who lived in the territory of military operations. Control group: 291 children who lived peaceful territories. The indicators (body mass index, Robinson index, vital index, strength index, V.A. Shapovalova power index and mental capacity of children according to the results of V.Ya. Anfimov correction task) were compared before the start of the developed comprehensive rehabilitation program and 6 months after the start of its implementation.Results. It was found that all elementary school children who lived in locations of military conflict had a decrease in physical and functional parameters of varying degrees of severity, as well as indicators of mental capacity. The comprehensive rehabilitation program promoted to the normalization of the studied indicators in evacuated (57/86, 56%) children in comparison with children who remained in the locations of military operations (43/70, 49%). The studied indicators had the highest recovery rates at the age of 7-8 years. The most vulnerable was a subgroup of 9-10 years old boys who permanently living in conditions of conducting warfare. The development and implementation of the comprehensive integration program using individual rehabilitation routes had an optimizing effect on the studied indicators of physical and functional conditions, as well as cognitive performance in 101 children of the main subgroups, which amounted to 78.9%.Conclusion. Under the influence of the comprehensive integration rehabilitation program, optimization of health indicators was observed in children living in locations of conducting warfare. The most pronounced effect was observed in children who left the territories of shelling as a result of evacuation to Rostov-on-Don.

Cerebralis paresisben szenvedő gyermekek egészségindexe

Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire is a measurement tool for assessing health status and wellbeing of disabled children, which evaluates children's quality of life from the caregiver point of view. The aim of our work was the Hungarian translation and cultural adaptation of the questionnaire and also validation of the CPCHILD on Hungarian cerebral palsy patients. Further aim was to test the eligibility of the questionnaire for superficial assessment of caregiver's psychological attitudes. Translation of the questionnaire was carried out according to the Beaton's guidelines. Test-retest, interrater reliability (ICC) and also internal consistency (Cronbach-alpha) were calculated for reliability. The importance of the questions was assessed for face validity and known group validity test was done to measure construct validity. For examining parental attitudes, the patients were divided into ambulatory and non-ambulatory groups and the 36 quality of life questions of the 7th domain were used to find relations. During test-retest reliability measurements, the ICC was 0.96 (95% CI: 0.88-0.98), and Cronbach-alpha exceeded the minimal expected value of 0.7 (0.74-0.97) except in the 5th domain (0.67), while measuring interrater reliability the ICC was 0.87 (95% CI 0.70-0.94). Face validity was above the 2.0 threshold in every question (2.6-4.5; mean: 3.4 ± 1.34) and the known group validity calculations showed significant differences between the CPCHILD scores of ambulatory and non-ambulatory groups. Examining parental attitudes, a significant difference was also shown among the parents of ambulatory and non-ambulatory children in assessing the importance of sitting in the quality of life of their children (2.89 ± 1.28 vs. 3.51 ± 0.82; p<0.01). The final outcome of our study is that CPCHILD questionnaire has become widely accessible in Hungarian language. Our result, that the answers referring to the sitting abilities and the activities should be carried out in sitting position, was significantly different among the caregivers of the ambulatory and non-ambulatory children, showing that the parents of the GMFCS IV and V category children evaluate the importance of sitting ability higher compared to those parents who care for GMFCS I, II and III category children. Furthermore, the results draw attention to the wellbeing and health of the children measurable with CPCHILD as well as that parental caregiver attitudes can be recognized which may give further help in finding the balance between expectations and possibilities during the rehabilitation of cerebral palsy children. Orv Hetil. 2023; 164(16): 610-617.