Family Health Research Articles

Quality of Life in Children with Cerebral Palsy: The Role of Having Access to Rehabilitation Services

Background: Cerebral palsy (CP) is a neurological motor disability, and children with CP should receive rehabilitation services to achieve their full potential. Objectives: The purpose of this study was to explore the quality of life (QOL) of children with CP across various domains and to assess the role of access to rehabilitation services on their QOL. Methods: We conducted a cross-sectional study involving all 126 children aged 4 - 12 with CP and their parents in Saqqez county, Kurdistan province, Iran. The "Physical Rehabilitation Accessibility Assessment Questionnaire" and the "Parental Proxy CP QOL-Child questionnaire" were used to measure the main variables. The analysis performed separately for two subpopulations: 27 children aged 4 - 6 years and 99 children older than six, using SPSS version 23. After prforming Kolmogorov-Smirnov test, the Spearman correlation coefficient was employed to identify correlations. Results: The average age of the participants was 8 ± 2.36 years, with 51 (40.5%) being girls. Of the 126 children with CP, 45 (35.7%) had independent mobility function (GMFCS levels I and II). The mean CP QOL-Child domain scores ranged from 35.3 ± 25.1 in the 'access to services' domain to 74.5 ± 16.1 in the 'Emotional well-being and self-esteem' domain. The average accessibility score was 53.8 ± 22.1. Among children older than 6 years, access to rehabilitation services showed a significant correlation with all CP QOL-Child domain scores (P < 0.05), except for 'social well-being and acceptance.' In children aged 4 - 6 years, only the Family Health domain score was significantly correlated with access to rehabilitation services (r = 0.44, P = 0.021). Conclusions: Access to rehabilitation services is a significant predictor of QOL in children older than 6 years. Further experimental research is needed to examine changes in various aspects of QOL in children with CP following improved access to rehabilitation services.

Hypertension subtypes at high altitude in Peru: Analysis of the Demographic and Family Health Survey 2016-2019.

The prevalence of hypertension in Peru has increased over the years. Approximately one third of the Peruvian population lives at high altitudes. This population presents particular physiological, genetic and environmental characteristics that could be related to the prevalence of hypertension and its subtypes. To assess the association between altitude and hypertension in the Peruvian population through an analysis of a nationally representative survey. We conducted a cross-sectional analysis of the Demographic and Family Health Survey for the period 2016-2019. We included 122,336 individuals aged 18 years and older. Hypertension was defined according to the JNC-7 guidelines. High-altitude location was defined as a residential cluster located above 2,500 meters above sea level. We utilized generalized linear models from the Poisson family with a log-link function to assess the magnitude of the association between high altitude and hypertension. Additionally, we employed multinomial regression models to analyze the association between high altitude and subtypes of hypertension, including isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). In the adjusted Poisson regression model, we found that the prevalence of hypertension among participants living at high altitudes was lower compared to those living at low altitudes (aPR: 0.89; 95% CI: 0.86-0.93). In the adjusted multinomial regression model, we observed a lower prevalence rate of ISH among participants residing at high altitudes (aRPR: 0.68; 95% CI: 0.61-0.73) and a higher prevalence rate of IDH among participants residing at high altitudes (aRPR: 1.60; 95% CI: 1.32-1.94). Residents at high altitudes in Peru have a lower prevalence rate of ISH and a higher prevalence rate of IDH compared to those living at low altitudes. Further studies are needed to determine the influence of other biological, environmental, and healthcare access factors on this relationship.

Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru

BackgroundViolence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region.MethodsCross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR).ResultsData from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17–1.33), physical aPR = 1.52 (95% CI: 1.38–1.67), and sexual aPR = 1.99 (95% CI: 1.57–2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14–1.50) than women suffering only one type of violence.ConclusionWomen who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

WeChat use and social participation among community‐dwelling adults with severe mental disorders: A mixed‐methods study

AbstractThe social media platform WeChat is increasingly used by individuals with severe mental disorders (SMDs). However, few studies have examined WeChat use of adults with SMDs and its association with social participation in the Chinese context. This mixed‐methods study examined the effects of WeChat use on this population's social participation. The results indicate that WeChat use was positively and significantly associated with social participation among older adults with SMDs, helping them maintain contact with family, relatives, friends, community residents, and mental health professionals. Owing to different life stages and associated social expectations, younger adults with SMDs were mainly concerned with employment or family obligations and were less likely to use WeChat for social interactions with friends and community residents. WeChat can be a useful tool to encourage social participation among older adults with SMDs; age‐related expectations for participation need to be considered in the design and delivery of intervention services.

Validity and reliability of the Turkish version of the transition of primiparas becoming mothers scale

BackgroundThe transition to motherhood is an important life event in a woman’s life and represents an important developmental process that brings physical, psychological and social changes to gain a new role. However, research on the transition to motherhood in Turkish society is scarce. There is a need for a comprehensive, practical and reliable tool to evaluate the transition to motherhood in primiparous mothers. This study evaluated the reliability and validity of the Turkish version of the Transition of Primiparous Becoming Mothers Scale (TMP-S) to evaluate the transition process of primiparous mothers to motherhood.MethodsThis methodological research was carried out in obstetrics and gynecology outpatient clinics, pediatric outpatient clinics, and family health centers of a hospital in Türkiye. The sample consisted of primiparous mothers of 0 to 6- month-old babies who visited clinics and family health centers for routine postnatal examinations (n ​​= 305). After evaluating the language equivalence and content validity of the scale, test-retest reliability, internal consistency and construct validity were examined. Factor analysis, Pearson’s correlation, retest reliability, and Cronbach’s alpha were employed to evaluate structural validity and reliability.ResultsThe final TPM-S had two dimensions with 25 items. Exploratory factor analysis revealed a two-factor solution, which accounted for 59.276% of the variance. Confirmatory factor analysis showed that the model fit of the two-factor model also reached a satisfactory model ft after modification. The comparative fit index was 0.894, the Tucker‒Lewis index was 0.882, and the root mean square error of approximation was 0.079. The content validity index of the scale ranged from 0.56 ~ 0.77. The Cronbach’s alpha coefficient was 0.93 for the total scale, and the test–retest reliability was 0.96.ConclusionsIt is a valid and reliable tool for evaluating the transition to motherhood among primiparous mothers of 0 to 6 month-old babies in Türkiye. Turkish researchers and healthcare professionals can routinely apply this measurement tool to primiparous mothers in the first six months after birth to evaluate their transition to motherhood.

Cost-Effectiveness of an Intensive Upper Limb Rehabilitation Therapy for Children With Unilateral Cerebral Palsy: An Economic Evaluation of a Randomized Controlled Trial

Background: Unilateral cerebral palsy is a major cause of childhood disability and a substantial economic burden. Intensive group-based therapy, consisting of hybrid constraint-induced movement and bimanual therapies, has been shown to be effective in improving specific quality-of-life domains in children with this disability. Our objective in this study was to assess if this intervention was cost-effective compared with standard care. Methods: An open-label, parallel, randomized controlled trial with an embedded economic evaluation of the intervention was conducted. A total of 47 children were randomized to either the intervention group (n = 27) or the standard care (n = 20) group. The effectiveness of the intervention was assessed using the Cerebral Palsy Quality of Life (Child) questionnaire across several domains. Nonparametric bootstrapping was used to quantify uncertainty intervals (UIs) for incremental cost-effectiveness ratios. Results: The incremental cost-effectiveness ratios for the intervention were $273 (95% UI: $107 to $945) for Pain and Impact of Disability, $1071 (95% UI: -$5718 to $4606) for Family Health and $1732 (95% UI: -$6448 to $8775) for Access to Services. For the 4 remaining domains, the intervention was dominated by standard care. At a willingness-to-pay threshold of $1000, only for the Pain and Impact of Disability domain was the intervention likely to have a probability of being cost-effective exceeding 0.75. Conclusions: Other than the Pain and Impact of Disability domain, there was insufficient evidence demonstrating the intervention to be cost-effective over a 13-week time horizon.

Cost-Effectiveness of an Intensive Upper Limb Rehabilitation Therapy for Children With Unilateral Cerebral Palsy: An Economic Evaluation of a Randomized Controlled Trial.

Background: Unilateral cerebral palsy is a major cause of childhood disability and a substantial economic burden. Intensive group-based therapy, consisting of hybrid constraint-induced movement and bimanual therapies, has been shown to be effective in improving specific quality-of-life domains in children with this disability. Our objective in this study was to assess if this intervention was cost-effective compared with standard care. Methods: An open-label, parallel, randomized controlled trial with an embedded economic evaluation of the intervention was conducted. A total of 47 children were randomized to either the intervention group (n = 27) or the standard care (n = 20) group. The effectiveness of the intervention was assessed using the Cerebral Palsy Quality of Life (Child) questionnaire across several domains. Nonparametric bootstrapping was used to quantify uncertainty intervals (UIs) for incremental cost-effectiveness ratios. Results: The incremental cost-effectiveness ratios for the intervention were 107 to 1071 (95% UI: -4606) for Family Health and 6448 to 1000, only for the Pain and Impact of Disability domain was the intervention likely to have a probability of being cost-effective exceeding 0.75. Conclusions: Other than the Pain and Impact of Disability domain, there was insufficient evidence demonstrating the intervention to be cost-effective over a 13-week time horizon.

Dynamics of caste and early childbearing in India: a perspective of three decades

BackgroundEarly childbearing disrupts girls’ otherwise healthy growth into adulthood and adversely affects their education, livelihood, and health. Individual, sociocultural, economic, environmental, and health service-related factors contribute to childbearing among young females. In India, caste affects health outcomes despite several affirmative policies aimed at improving the health and welfare of the backward castes/tribes. However, there is a dearth of empirical evidence about the impact of caste on early childbearing, more specifically, regarding the trajectory of inter-caste disparities in early childbearing.MethodThis study used data from all five rounds of the National Family Health Survey (NFHS) in India to assess the association between caste and early childbearing over the last three decades. All women aged 20–24 [NFHS-1 (n = 17,218), NFHS-2 (n = 15,973), NFHS-3 (n = 22,807), NFHS-4 (n = 122,955) and NFHS-5 (n = 118,700)] were considered to create a pooled data set (n = 297,653) for analysis. Bivariate analysis and binary logistic regression were conducted using Stata (v17). ArcMap (v10.8) presented the caste-wise prevalence of early childbearing among the states and Union Territories (UTs).ResultsMany women continue to have early childbearing despite a considerable reduction over the last three decades from 47% in 1992-93 to 15% in 2019-21. Compared to NFHS-1, the odds of early childbearing increased by 15% in NFHS-2 and, after that, declined by 42% in NFHS-3 and 64% in NFHS-4 and NFHS-5. The inter-caste disparity in early childbearing persists, albeit with a narrowing gap, with the Scheduled castes (SC) remaining the most vulnerable group. Adjusting the effects of socio-demographic and economic characteristics, SC women had significantly higher odds of early childbearing (OR = 1.07, CI = 1.04–1.11) than those from the General caste.ConclusionTo decrease early childbirth, a focus on adolescent marriage prevention and increasing contraceptive use among young SC women is necessary. Strengthening ongoing programs and policies targeting educational and economic empowerment of the socially weaker castes/tribes will help in reducing early childbearing. Efforts to prevent early childbearing will accelerate the achievement of the Sustainable Development Goals (SDGs)-especially those related to health, poverty, nutrition, education, and general wellbeing, in addition to protecting women’s reproductive rights.

Ethnobotanical knowledge in state schools and family health teams of Juazeiro do Norte – CE: a case study

Ethnobotany refers to the study of the relationship between man and plants as well as their mode of use. This popular knowledge is part of the history and culture of peoples from its origin to the present day, and is passed on generation after generation, representing a more accessible alternative to treat illnesses. Some communities develop sacred rituals involving the medicinal power of plants, and scientifically, it is from the chemical compounds present in them that new drugs are produced. The aim of this study was to investigate the ethnobotanical knowledge of students in the second year of high school and of biology teachers in the EEM José Bezerra Menezes, EEMTI Figueiredo Correia and EEEP Professor Moreira de Sousa; the Health Agents working in FHS 30 and 52 and the Nurse responsible for the team that works at São Lucas Maternity Hospital, in the municipality of Juazeiro do Norte, southern Ceará. The highest number of citations was found for the plants Peumus boldus Molina (37.41%), Lippia alba (Mill.) N.E.Br. ex Britton & P. Wilson (28.78%), Mentha spicata L. (20.86%) and Matricaria recutita L. (12.95%). This study is expected to find out which medicinal plants are most used by the researched communities as well as their mode of use, in addition to contributing to this knowledge being better shared among the population.

Changing Roles: Promoting Cognitive Health in Hispanic Families Through the Community Health Clubs Model (P5-9.013)

Changing Roles: Promoting Cognitive Health in Hispanic Families Through the Community Health Clubs Model (P5-9.013)

Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021

BackgroundEliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors.MethodsWe used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15–49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021.ResultsThe prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1– 21·2%) in 1993, to 9·4% (95% CI: 9·3–9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3–28·6%) and Mizoram (18·9%, 95% CI: 17·2–20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1–14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5–13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15–19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021.ConclusionsThe existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030.

Emotional and relational realms of unaccompanied migrant adolescents: an approach to their lived experiences

After the arrivals of unaccompanied migrant adolescents to Spain reached their peak in 2018, the trends have varied in the last few years, significantly decreasing in 2019 and slowly starting to increase again in 2020. These adolescents represent one of the most vulnerable groups due to their unique characteristics closely linked with the stressors encountered in their migratory process and the host society. All these experiences have been found to affect their well-being in different domains; however, very little is known about their perception of the matter, which is critical to understanding their needs and perspectives. This paper aims to look into the lived experiences of these children and how this process has affected their relational and emotional spheres, which are paramount to their development, especially during adolescence. These experiences were gathered using qualitative methodology consisting of interviews and focus groups conducted in a reception centre for unaccompanied migrant children in Catalonia. The view of these children is enriched with the contributions of the staff working in the reception centre. Analysis of the verbatims yielded six main topics revolving around frustrated expectations, obtention of legal documents, freedom, contact with the Spanish society, family and mental health. These are discussed considering how they affect emotional and relational well-being in the three stages of the migration process.

A CASE OF TREATMENT OF CONGENITAL ICHTHYOSIS IN A NEWBORN CHILD

Congenital ichthyoses (CI) are a group of rare inherited disorders that cause keratinization defects. This group includes hereditary ichthyosis and hereditary syndromes with ichthyosiform lesions. Offi cial statistics are not yet available in Ukraine. The most common clinical manifestation is nonbullous hyperkeratosis characterized by thick hyperkeratotic scales, skin thickening, severe skin dryness and erythema. In more severe forms – ectropion, eclabion. Skin permeability is increased in CI patients, resulting in increased fl uid and calorie loss, diffi culty in thermoregulation, and reduced elasticity, which limits mobility. Symptoms can vary in severity, but severe manifestations at birth are not always indicative of a more severe course later in life. Challenges in defi nitive diagnosis are due to the need for karyotyping, which is quite expensive. Currently available treatment modalities include continuous moisturization, reduction of transepidermal water loss, control of hyperkeratotic layer thickness (reducing it to a minimum) with local keratolytics, emollients, and systemic retinoids in severe cases. The article presents a clinical case of successful local treatment of CI with a pronounced eff ect without the use of systemic retinoids. The publication of the materials has been approved by the Bioethics Commission of the CI «Regional Medical Center for Family Health» DRC». All anamnestic data, examination results and photographs are provided with prior written consent of the parents. Conclusion. Congenital ichthyoses require careful monitoring. The initial clinical manifestations can not be a marker for the severity of the disease course.

Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India.

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period.

'Like a torch that enlightens new parents along a narrow and winding path into parenthood' - Midwives' experiences by an interview study.

The core of postnatal care is that midwives recognise the needs of women and new-born babies and provide the highest possible quality of care and medical safety to optimise the health and well-being of new families. The study aimed to describe midwives' experiences in providing postnatal care for families during the first week after the birth of their baby. An interview study included 18 midwives who interchangeably worked within the models of traditional hospital care, hotel-based care, home-based care, hospital-based check-ups, and specialist care at a breastfeeding clinic at one university hospital in Sweden. Data collected were analysed using thematic analysis according to Braun and Clarke. The main theme: 'Like a torch that enlightens new parents along a narrow and winding path into parenthood - a midwife's transitional support' was explored and comprised two themes: (1) Strengthening parents' self-confidence in their parental role by handling over parental responsibility; and (2) Challenging to facilitate parents' understanding of their parental role. Midwives expressed that supporting parents in the parental transition was a delicate task and included balancing mothers', babies', and partners' needs. The midwives guided parents into parenthood during postnatal care in a strategic manner by strengthening parents in their parental role. Postnatal care delivered by midwives is crucial for new parents and their babies.

The rich-poor divide: Unravelling the spatial complexities and determinants of wealth inequality in India

This study presents the first in-depth analysis of spatial differences and factors influencing wealth distribution among households in India. It uses data from the latest National Family Health Survey, covering 707 districts. Techniques like the Lorenz curve, Gini coefficient, Location Quotient, Morans statistics, and Univariate and Bivariate LISA methods explore inequalities, concentration, and clustering patterns of rich-poor households at the district level. Additionally, spatial regression models such as OLS, GWR, and MGWR help to uncover spatial disparities and variability. Our findings demonstrate significant regional disparities, with the affluent household concentration being notably higher in north-western and southern India, while central, eastern, and northeastern regions exhibit greater inequality. Key factors impacting wealth inequality include rurality, low female literacy rates, educational level of household heads and prevalence of Scheduled Castes/Tribes. This study highlights the spatial dimensions of wealth inequality and provides a nuanced understanding of the factors contributing to these patterns. The GWR and MGWR models prove most effective, explaining more than 90% of the variation in wealth distribution factors. This study sheds light on the spatial dynamics and factors behind wealth disparities in India, offering strategic insights for equitable growth initiatives targeting diverse socio-economic sectors.

The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour.

The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status. We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model. we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = -0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (β = -0.350; P < 0.001) and health behaviour (β = -0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (β = -0.569, P < 0.001). This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.

Burden of undernutrition among under-five Bengali children and its determinants: Findings from Demographic and Health Surveys of Bangladesh and India.

Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals.

CURRENT ISSUES OF REORGANIZATION OF REGIONAL MEDICAL INSTITUTIONS. EVOLUTION OR REVOLUTION

One of the leading trends in healthcare is the reorganization of the majority of hospitals by merging them into large multidisciplinary hospitals. Recently, new powerful multidisciplinary hospitals have been established in various regions of Ukraine. This model has already proven itself from various positive sides.Aim. Analysis, evaluation, discussion of experiences and nuances of formation of a new capable network and creation of large competitive multidisciplinary clinical centers with the beginning of the second stage of medical reform.Research materials and methods. A retrospective analysis of the experience of merging the Dnipropetrovsk Regional Children’s Clinical Hospital and the Dnipropetrovsk Regional Perinatal Center was conducted.Research results. The article describes the main steps of the reorganization of two large multi- faceted medical centers and the creation of a new institution – «Regional Medical Center of Family Health» DOR», which in terms of size and range of medical services became the second children’s hospital in Ukraine.Conclusions. The creation and development of large competitive multidisciplinary clinical centers with the beginning of the second stage of medical reform in the form of the creation of a multidisciplinary hospital is the most expedient, which is confi rmed by the economic performance of the institution during the reorganization process and after its completion.

Comprehensive Review of Kaphaja Yonivyapath: Etiology, Diagnosis and Management Strategies

A family's health is guaranteed by a healthy woman. Ayurveda and contemporary medicine have both discussed the idea of a healthy yoni at various stages of a woman's life, from adolescence to menopause. These days, vaginal infections are a major concern for people of all ages and socioeconomic backgrounds. Because women have a special role of giving birth, gynecological illnesses have gained enormous relevance in the medical field. The majority of gynecological problems are included under the word "Yonivyapad," which is used in Ayurveda to refer to women's health care. Among 20 Yoni Vyapath’s Kaphaja yonivyapath is the one which is due to vitiation of Kapha, this vitiated Kapha reaches the Yoni Pradesha causes signs and symptoms like Kandu, Picchila Srava and Alpa Vedana as well as Sthanika and Sarvadaihika Kapha Prakopa Laxana. The treatment of Kaphaja Yonivyapath explained in classic as Kapha hara Dravyas and Shodhana Chikitsa mainly Vamana is indicated. This can be correlated with vulvovaginitis which is caused due to bacterial vaginosis, moniliasis and trichomans vaginalis. In this review an attempt has been made in this work to provide a conceptual analysis that covers nearly all of the Nidana, Samprapti and Chikitsa of Kaphaja Yoni Vyapad according to both Ayurveda and modern.