Child Health Research Articles

Post-partum depression: Its association with IYCF practices and effect on child growth indicators in urban slums of AAA, BBB.

BackgroundThe nexus of postpartum depression (PPD) does not limit itself to maternal health but has a profound impact on child health through compromised caregiving and nursing practices of the mother. This impairs child’s cognitive, emotional, and physical health during crucial stages of growth. ObjectiveThe paper aims to identify the association between PPD and Infant and Young Child Feeding practices and the effect of PPD on child growth during the first 1000 days of life in urban slum settings of AAA. ResultsFor infants below six months of age, bottle-feeding practices, initiation of breastfeeding within one hour of birth, and exclusive breastfeeding for the first 2 days were associated with PPD (p<0.05). For children, 6 to 24 months, minimum meal frequency, minimum dietary diversity, zero consumption of fruits and green vegetables, and initiation of semisolid and soft food were associated with the postpartum depression status of the mother (p<0.05). The infants of the depressed mothers were 10%, 16% and 20% more likely to be underweight, wasted and stunted as compared to infants of the mothers who do not show symptoms of PPD. ConclusionMeasurement of prevalence of PPD is essential to manage it. It is essential to build mental health inclusive policies/programmes for mother and child health, engage in capacity building of grassroot workers to spread awareness about PPD, and be skilled to identify and refer the early signs of PPD

Current state of home health in children with medical complexity

BackgroundHome health services are a right for children in the US, but higher survival rates of extremely preterm infants have led to an increase in children with medical complexity (CMC) and therefore an increased demand for home health services. Unfortunately, an adequately trained and compensated workforce to support medially complex children at home does not exist. MethodsAfter identifying the existing research, common themes were identified. This article was written to give an overview of these themes and highlight specific supporting data. ResultsA lack of resources in the home health arena and the financial barriers that accompany them, as well as the clear impact this issue has on the health and well-being of families and caregivers, were frequently present in the literature. ConclusionsReasonable next steps for research and advocacy include a focus on recruitment and retention of home health nurses, as well as training specific to the level of skill required to adequately care for CMC. Further research is needed, as in our search we found several unexplored, unassessed avenues that could help health care professionals understand the problem more fully. These steps are necessary if we want CMC to live the healthiest life available to them.

'We are pulled to the four corners': Qualitative role descriptions of advanced practice children's nurses in Malawi.

This study investigated emerging roles among specialist child health nurses (CHNs) in Malawi. Advanced nursing role development is globally advocated. Nursing role descriptions provide an evidential basis for workforce planning. Rigorously developed role descriptions are scarce worldwide, especially for Africa. Advanced nursing roles were introduced in Malawi's child health system a decade ago. We followed guidance on generating nursing role descriptions to collect and analyse qualitative data from interviews and focus groups, using qualitative content analysis. We used COREQ reporting standards. More than half (41/80) of Malawi's child health nursing workforce participated. Richly descriptive accounts of roles elicited three themes: leading and developing new services and improving existing ones; holding rare knowledge which uplifts care quality; and responsibility for developing the role. These responsibilities are experienced as a privilege and a burden, often meaning CHNs are 'pulled to the four corners'. We found evidence of remarkable achievements by Malawi's CHNs but also suggestions that they are under heavy strain. Because multi-stakeholder agreement about role content is crucial to successfully implementing advanced nursing roles, we hope the approach taken by this study, and the information generated, could be useful as part of human resources for health strategy development in other lower-resourced countries globally.

Routine data in a primary care performance dashboard, Ethiopia.

To explore the feasibility of building a primary care performance dashboard using DHIS2 data from Ethiopia's largest urban (Addis Ababa), agrarian (Oromia) and pastoral (Somali) regions. We extracted 26 data elements reported by 12 062 health facilities to DHIS2 for the period 1July 2022 to 30June 2023. Focusing on indicators of effectiveness, safety and user experience, we built 14 indicators of primary care performance covering reproductive, maternal and child health, human immunodeficiency virus, tuberculosis, noncommunicable disease care and antibiotic prescription. We assessed data completeness by calculating the proportion of facilities reporting each month, and examined the presence of extreme outliers and assessed external validity. At the regional level, average completeness across all data elements was highest in Addis Ababa (82.9%), followed by Oromia (66.2%) and Somali (52.6%). Private clinics across regions had low completeness, ranging from 38.6% in Somali to 58.7% in Addis Ababa. We found only a few outliers (334 of 816 578 observations) and noted that external validity was high for 11 of 14 indicators of primary care performance. However, the 12-month antiretroviral treatment retention rate and proportions of patients with controlled diabetes or hypertension exhibited poor external validity. The Ethiopian DHIS2 contains information for measuring primary care performance, using simple analytical methods, at national and regional levels and by facility type. Despite remaining data quality issues, the health management information system is an important data source for generating health system performance assessment measures on a national scale.

Associations Between Mercury Exposure During Pregnancy and Lactation and Child Health and Development Outcomes: An Overview of Reviews

Associations Between Mercury Exposure During Pregnancy and Lactation and Child Health and Development Outcomes: An Overview of Reviews

Real-world Study on the Effect of PARPi as Maintenance Therapy on Platinum Sensitivity after First- and Second-line Chemotherapy in Patients with Recurrent High-grade Serous Epithelial Ovarian Cancer.

This study investigated the effect of poly(ADP-ribose) polymerase inhibitors (PARPi) as maintenance therapy after first- and second-line chemotherapy on platinum sensitivity in patients with recurrent high-grade serous epithelial ovarian cancer (rHGSOC). This study retrospectively analyzed 172 patients with rHGSOC treated at Zhejiang Cancer Hospital and Jiaxing Maternity and Child Health Care Hospital between January 2017 and December 2021. The 1st-PARPi group comprised patients who received a PARPi as maintenance therapy after first-line chemotherapy (n=23), and the 1st-control group comprised those who did not (n = 105). Similarly, the 2nd-PARPi group comprised patients not given a PARPi in their first-line treatment (n = 30), and the 2nd-control group comprised those who were given a PARPi (n = 89). Among the 23 patients in the 1st-PARPi group and the 105 patients in the 1st-control group, nine and 99 were platinum-sensitive, and 14 and six were platinum-resistant, respectively (hazard ratio [HR]: 14.46, P < 0.0001). Among the 30 patients in the 2nd-PARPi group and 89 patients in the 2nd-control group, 10 and 71 were platinum-sensitive, and 20 and 18 were platinumresistant, respectively (HR: 4.37, P < 0.0001). Age, stage, residual tumor, the courses of platinumbased chemotherapy, and breast cancer susceptibility gene mutations were not associated with platinum sensitivity when using a PARPi as maintenance therapy after first- and second-line chemotherapy. Patients with rHGSOC using a PARPi were more likely to be platinum-sensitive and develop platinum resistance independent of PARPi duration. Care should be taken when using a PARPi as maintenance therapy after first- and second-line chemotherapy.

Child health prioritisation in national adaptation policies on climate change: a policy document analysis across 160 countries.

Integration of child-specific adaptation measures into health policies is imperative given children's heightened susceptibility to the health impacts of climate change. Using a document analysis method, we examined 160 national adaptation policies for inclusion of child-relevant measures and identified 19 child health-related adaptation domains. 44 (28%) of 160 countries' policies that were analysed failed to include any domains, 49 (31%) included at least one child-related domain, 62 (39%) included between two and six domains, and five (3%) included at least seven domains. Predominant domains among child-specific adaptation measures included education and awareness raising, followed by community engagement and nutrition. No country addressed children's direct needs in the domain of mental health. National adaptation policies tend towards overly simple conceptualisations of children across four major lenses: age, social role, gender, and agency. Limited inclusion of child-specific measures in national adaptation policies suggests insufficient recognition of and action on children's susceptibility to climate change effects.

Analysis of Social Factors on Immunization Refusal in Jungkat Village

Analysis of Social Factors on Immunization Refusal in Jungkat Village

Evaluation of the Neonatology Unit in the Care of Sick Newborns at the Institute of Child Nutrition and Health (INSE)

Evaluation of the Neonatology Unit in the Care of Sick Newborns at the Institute of Child Nutrition and Health (INSE)

Assessment of awareness among parents about dietary habits and its relation to oral health in children: a cross sectional study

Assessment of awareness among parents about dietary habits and its relation to oral health in children: a cross sectional study

Exploring Nurse Responses to Spontaneous Breastfeeding Episodes During Routine Infant Health Checks in Finland: A Multimodal Conversation Analytic Approach

ABSTRACT Support for mothers’ uptake and longevity in breastfeeding is a global health priority. The benefits of breastfeeding are well documented, ranging from immediate health benefits for the infant that include provision of the best nutrition, to longer-term impacts such as reducing the risk of future digestive complications and obesity in adulthood. We analyze how impromptu breastfeeding might be supported by health-care nurses in Finnish maternity and child health clinics during routine infant health checks. The video data analyzed explore naturally occurring breastfeeding during these clinic encounters, using the analysis of ethnomethodology and conversation analysis (EMCA) approach to explore breastfeeding interactions between mothers, infants, and nurses. Findings demonstrate that, in extract 1 the nurse makes herself freely available, offering verbal and physical support when needed, and in extract 2 the mother manages a close intimate interaction feeding her baby whilst also engaging in knowledge exchange regarding important information with the nurse. We discuss how spontaneous breastfeeding interactions during routine clinic visits provide opportunities for nurses to support breastfeeding, where they are acknowledged as rather complex activities requiring focus. Considerations for professional practice are made by exploring how these early perinatal visits provide opportunities for nurses to observe and converse with mothers about how they are managing breastfeeding. A further conclusion suggests that an EMCA methodological exploration of breastfeeding interactions can inform future nurse practice in Finland and other countries.

Maternal fat intake in pregnancy and risk of depressive symptoms in Japanese adolescents: the Kyushu Okinawa Maternal and Child Health Study

The current prebirth cohort study investigated the association between maternal intake of specific types of fatty acids during pregnancy and adolescent depressive symptoms based on the Center for Epidemiologic Studies Depression Scale. Subjects were 873 mother–child pairs. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. The risk of depressive symptoms was 23.3% among the 873 adolescents at 13 years of age. Higher maternal saturated fatty acid intake during pregnancy was independently associated with a reduced risk of depressive symptoms in adolescents. Maternal intake of total fat, monounsaturated fatty acids, n-3 polyunsaturated fatty acids, α-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid, n-6 polyunsaturated fatty acids, linoleic acid, arachidonic acid and cholesterol during pregnancy was not significantly related to depressive symptoms in adolescents. Higher maternal intake of saturated fatty acids during pregnancy may be inversely associated with adolescent depressive symptoms.

Digital therapeutics-based lifestyle intervention for gestational diabetes mellitus prevention of high-risk pregnant women: a study protocol for a non-randomised controlled trial

IntroductionDigital therapeutics have been approved as a treatment aid for various medical conditions and are increasingly prevalent. Despite numerous studies on the potential of digital therapeutic interventions in preventing gestational...

Effects of the COVID-19 Pandemic on the Lifestyle and Mental Health of Children in the Puducherry District: A Community-Based Cross-Sectional Study

Effects of the COVID-19 Pandemic on the Lifestyle and Mental Health of Children in the Puducherry District: A Community-Based Cross-Sectional Study

Caries prevalence and associated factors in children from public versus private schools: Cross-sectional study

Introduction: Childhood caries remains a major public health issue in Brazil’s impoverished communities. Although government-sponsored programs have targeted improvement of oral health in children from public schools, more information is needed on the effectiveness of these programs. Objective: The objective was to analyze the prevalence and factors associated with caries in children aged 5 and 12 years in public versus private schools. Methods: This cross-sectional study included 857 children aged 5 (n=509) and 12 years (n=348) who attended public (n=416) or private (n=441) schools in Patos, PB-Brazil. Between March–September 2018 we examined caries from this study population using the DMFT/dmft index and obtained data on its demographics, toothbrushing frequency, socioeconomic status and schools’ oral health program and services via questionnaires. Statistical analyses were performed using multiple logistic regression (p&lt;0.05). Results: Among 5-years-old children from public vs private schools, untreated caries prevalence was 51.5% (n=117) vs 28.4% (n=80) and dmft index, 2.34 vs 1.04. In 12-years-old children, untreated caries prevalence of 41.3% (n=78) and DMFT index=0.99 in public and of 22% (n=35) and DMFT index=0.50 in private schools were observed. Public school children showed 2.19 (5-years-old) and 2.41 (12-years-old) higher caries odds than private school children (p&lt;0.01). Among 5-years-old children, caries odds were 3.6 higher in low-income households (p=0.025) and 42% lower in children who received periodical dental visits at schools (p=0.011). Conclusion: Children aged 5 and 12 from public schools had higher caries odds than children from private schools. At 5 years old, households with higher incomes and access to dental care in public schools can decrease the odds of dental caries.

Incidence, Causes, and Perinatal Outcomes of “Near-Miss” Obstetric Emergencies during the COVID-19 Pandemic: Experience from a Tertiary Referral Center of Western Rajasthan, India

Abstract Background: Pregnant women and neonates are often considered as being a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. Several studies have compared the impact of COVID-19 on pregnant and nonpregnant women. This study aimed to examine the reasons for severe acute maternal morbidity (SAMM) and “near-miss cases” and their effects on perinatal outcomes before and during the COVID-19 pandemic. Materials and Methods: All women admitted to our facility with pregnancy-related complications for birth or in the puerperium who required critical care unit (CCU) or high dependency unit (HDU) admission were included in the study. A modified version of the World Health Organization (WHO)’s Maternal Near-Miss Screening Tool was used to identify maternal near-miss cases and other obstetric emergencies requiring CCU admission. Results: The incidence of “near-miss” obstetric emergencies was -30.7 per 1000 live births. Over the 3 years of data obtained, 152 near-miss cases were found. Thirty-five cases were seen in the pre-COVID-19 period, whereas 117 near-miss cases were noted during the COVID-19 pandemic. The most common cause of near-miss cases in both groups was severe preeclampsia (65.8%). The rate of ICU admissions was 80.3% (94/117) during COVID-19, while only three cases required ICU before the COVID-19 pandemic. There were a total of 11 maternal deaths, and all were reported during the COVID-19 pandemic. Conclusion: There was a significant increase in ICU admission rates and “near-miss” obstetric emergencies during the COVID-19 pandemic. The COVID-19 infection indirectly led to higher maternal morbidity secondary to lockdown effects on antenatal care and delayed referrals. This study will contribute to the existing literature on the impact of the COVID-19 pandemic on maternal and child health. The results will help inform policy decisions and guide the development of interventions to improve the quality of care for pregnant women during the pandemic.

Mixed influence of COVID-19 on primary maternal and child health services in sub-Saharan Africa: a scoping review

IntroductionThe COVID-19 pandemic profoundly affected the provision of and demand for routine health services in the world. The objective of this scoping review was to synthesize the influence of the COVID-19 pandemic on primary maternal and child health (MCH) services in sub-Saharan Africa.MethodsThe studies searched original studies reporting on the influence of the COVID-19 pandemic on primary MCH services. Four scientific databases (Pubmed, AJOL, CAIRN, CINAHL) and one gray literature database (Google Scholar) were used for this search. We also searched through the snowball citation approach and study reference lists.ResultsThe influence of the COVID-19 pandemic on primary MCH services has been mixed in sub-Saharan Africa. Attendance at some health centers declined for antenatal care, deliveries, immunization, and pneumonia cases. Other health centers did not experience a significant influence of the pandemic on some of these services. In fact, antenatal care increased in a number of health centers. MCH service indicators which declined during COVID-19 were linked on the demand side to regulatory measures against COVID-19, the perceived unavailability of resources for routine services, the perceived negative attitude of staff in these facilities, the perceived transmission risk in primary health care facilities and the perceived anticipated stigma. On the supply side, factors included the lack of equipment in primary facilities, the lack of guidelines for providing care in the pandemic context, the regulatory measures against COVID-19 taken in these facilities, and the lack of motivation of providers working in these facilities.ConclusionThis study recommends prioritizing the improvement of infection prevention measures in primary health care facilities for resilience of MCH indicators to epidemic crises. Improvement efforts should be tailored to the disparities in preventive measures between health centers. The identification of best practices from more resilient health centers could better guide these efforts.

Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso

ABSTRACT Background Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally. Objective This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso. Methods We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle. Results There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective. Conclusions Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

Co-creating a global shared research agenda on violence against women in low- and middle-income countries

BackgroundDespite a large growth in evidence on violence against women (VAW) over the last 25 years, VAW persists, as do gaps in the field’s knowledge of how to prevent and respond to it. To ensure that research on VAW in low- and middle-income countries (LIMCs) is addressing the most significant gaps in knowledge, and to prioritise evidence needs to reduce VAW and better support victims/survivors, the Sexual Violence Research Initiative (SVRI) and Equality Institute (EQI) led a process of developing a global shared research agenda (GSRA) on VAW in LMICs.MethodsThe GSRA was developed through a six-stage adaptation of the Child Health and Nutrition Research Initiative (CHNRI) method, which draws on the principle of the ‘wisdom of the crowd’. These steps included: a review of the literature on VAW in LMICs and development of domains; the generation of research questions within four domains by an Advisory Group; the consolidation of research questions; scoring of research questions by a Global Expert Group and the Advisory Group according to three criteria (applicability, effectiveness and equity); consultation and validation of the findings with the Advisory Group; and wide dissemination of the findings.ResultsThe highest ranked research questions in the GSRA pertain to the domain of Intervention research, with some highly ranked questions also pertaining to the domain of Understanding VAW in its multiple forms. Questions under the other two domains, Improving existing interventions, and Methodological and measurement gaps, were not prioritised as highly by experts. There was strong consistency in top ranked research questions according to experts’ characteristics, albeit with some important differences according to experts’ gender, occupation and geographical location.ConclusionsThe GSRA findings suggest that currently the VAW field is shifting towards intervention research after several decades of building evidence on understanding VAW, including prevalence, drivers and impacts of violence. The findings also suggest a strong emphasis on under-served populations, and under-researched forms of VAW. Future priority setting exercises in LMICs that seek to decolonise knowledge should ensure that methodologies, and modalities of engagement, put diverse voices at the centre of engagement.Trial registration Not applicable

Using the universal design for learning framework to improve child and adolescent mental health

AbstractPoor mental health in childhood and adolescence has a significant impact on both physical and mental health throughout life. However, growing evidence suggests that current levels of child and adolescent mental health (CAMH) care are insufficient to meet the needs of many children and adolescents in the United States as evidenced by increasing rates of mental health problems, inequities in diagnosis, and inaccessibility of services. This article provides a discussion of current problems in CAMH and school mental health services and emphasizes a developmental perspective of CAMH, including the co‐occurrence of school difficulties and mental health concerns. A universal design for learning framework for school‐wide mental health programs is suggested as a means of addressing barriers to care and promoting prevention and early intervention in CAMH.