Health Handbook Research Articles

Peningkatan Kapasitas Ibu Hamil Melalui Buku KIA Kelas Ibu Hamil Tahun 2024

Health development programs in Indonesia are currently prioritized towards improving the health status of mothers and children, particularly in the most vulnerable groups such as pregnant women, mothers giving birth, perinatal infants, toddlers, and women of reproductive age. In response to this, a community service activity titled "Enhancing the Capacity of Pregnant Women through the Maternal and Child Health (MCH) Handbook in Pregnant Women's Classes in the Working Area of Puskesmas Cempaka, Banjarbaru City, in 2024" was conducted. This initiative aims to reduce child mortality rates and improve maternal health. The use of the MCH Handbook is considered a strategic step to enhance community independence. The target of this community service activity was 12 pregnant women attending the Pregnant Women's Class facilitated by Midwife Maulida. The implementation methods included preparation and execution of activities in June 2024 in Bangkal, Cempaka Subdistrict, Banjarbaru City. Evaluations were conducted through pre-test and post-test assessments of the mothers' knowledge about the MCH Handbook. The results showed that 83% of the participants always brought the MCH Handbook during antenatal visits, 41.6% had read the handbook in its entirety, and 58.3% only read the sections related to examinations. Therefore, further evaluations of pregnant women's knowledge about pregnancy through the MCH Handbook are needed to broaden their insights and enable effective implementation.

Maternal weight status at conception predicts offspring body fat at age 11 years: population data from the Japan Kids Body Composition Study using dual-energy X-ray absorptiometry

BackgroundMaternal preconception overweight status has been reported to be associated with an increased risk of overweight offspring. However, there are no published population-based studies on the association between maternal preconception weight and offspring body fat measured by dual-energy X-ray absorptiometry (DXA). The present population-based retrospective cohort study aimed to examine the association between maternal weight at conception and offspring body fat measured by DXA.MethodsThe source population consisted of 5th-grade students (1244 students aged 11 years) registered at 8 municipal elementary schools in Kitakata, Fukuroi, Hamamatsu, and Himeji in Japan. The present analyses included 964 participants who provided complete information. Maternal body mass index (BMI) at conception was calculated using records in the Mother and Child Health Handbook (MCHH). Offspring body fat at age 11 years was measured with the same QDR-4500A DXA instrument in a mobile test room that was brought to each school. With regard to the prediction of excess fat in offspring, the area under the curve (AUC) calculated with receiver operating characteristic curve analysis was used to quantify the diagnostic accuracy of maternal BMI at conception.ResultsAdjusted odds ratios for excess body fat in offspring of the overweight mother group (odds ratios, 4.93 to 15.32) were significantly higher than those in the non-overweight mother group. For the prediction of excess offspring fat, AUCs and 95% confidence intervals for maternal BMI at conception were greater than 0.5.ConclusionMaternal overweight status at conception might be a risk factor for excess body fat in offspring. Maternal BMI values calculated using MCHH data have the potential to distinguish between the presence and absence of excess fat in the next generation.

A/Void Pregnancy? Yagi Emi’s Kūshin techō and Fake Pregnancy as a Means of Exploring Women’s Struggles

Kūshin techō (Diary of a void), Yagi Emi’s brilliant debut in the Japanese literary scene, was published in 2020 and proceeded to win the 36 th Osamu Dazai Prize. With its provocative tones, the novel addresses maternal issues during a very crucial moment for literature. Indeed, contemporary women’s writing from all over the world is growing more and more engaged with issues such as illness, disease, healthcare, medical practice, and clinical institutions, as well as with the topic of “care,” usually depicted as a women’s responsibility. In this paper, I argue that, through the parody of the Maternal and Child Health Handbook, Yagi Emi advances a critique of the condition of Japanese women in contemporary Japan. More specifically, the use of the fake pregnancy and the diary as a narrative strategy serve as a means to explore contradictions and gender gaps women face during pregnancy, in the workplace and at home, such as sekuhara (sexual harassment) and matahara (maternal harassment), social pressure, prejudice and stigma, and economic inequality. At the same time, I argue that the absence of a male partner throughout the narrative reveals the prejudice and stigma surrounding unmarried pregnant women in Japan, and on the other hand, it makes it possible to read Kūshin techō as an example of Hélène Cixous’ écriture feminine.

Adherence of inactivated polio vaccine immunization for children in Central Java Province

Indonesia is a country with high-risk polio transmission. Administering inactivated polio vaccination (IPV) after drops-polio or oral polio vaccination (OPV) was a strategy stopping polio transmission because its ability to ward off poliovirus which was very dangerous. The IPV coverage was very low and have never reached the target since it was launched in 2016. The study purpose was analyzing determinants factors of IPV adherence. A cross-sectional survey conducted in 31 districts in Central Java Province. Sample was 685 children aged 11-23 months and selected using purposive and accidental sampling method. Collecting data by interview using structured questionnaire and observation with maternal and child health (MCH) Handbook to identify immunization status. The collected data was analyzed univariate, bivariate, and multivariate. As many as 74.3% of children received IPV. Partially, variables of delivery history, immunization status, knowledge, attitudes, sources of information, and service satisfaction were related to IPV adherence. Simultaneously, immunization status, attitudes, and sources of information influenced IPV adherence with an overall effect 35.2%. Immunization status as the dominant influencing factor. Efforts were needed reducing resistance to IPV through psychological approach that was motivating and personal, also using of social media as a medium for positive information and communication, in addition to improve immunization service system.

Anemia in young pregnant women: A cross-sectional study in Indonesia

Background: The prevalence of anemia among pregnant women in Indonesian remains high at 48.9%, with the highest rates observed among young mothers aged 15-24 years. Anemia is associated with adverse outcomes for both mothers and their children. Understanding the determinants of anemia in young mothers is crucial for taking preventive measures. However, there are currently no national studies in Indonesia on the prevalence and risk factors of anemia in pregnant women aged 15 to 24 years.Objective: To measure the prevalence and factors associated with anemia in young pregnant women in Indonesia.Methods: This cross-sectional study utilized on secondary data from the 2018 Basic Health Research (Riset Kesehatan Dasar= Riskesdas). The subject of this research were pregnant women aged 15 to 24 years who participated in Riskesdas 2018 and had independent variables data including hemoglobin measurement data, age, education, residence, occupation, travel time to health facilities, age at first pregnancy, ownership of the maternal and child health (MCH) handbook, history of previous abortion, gestational age, number of iron supplement tablets, supplementary feeding, and chronic energy deficiency. Univariate analysis was conducted to analyse the subject characteristics and hemoglobin data, while chi-square and logistic regression were used to determine factors associated with anemia in young pregnant women Results: The study found that 36.2% of young pregnant women had anemia. The incidence of anemia was associated with gestational age but not with other factors. Pregnancy in the first trimester poses the highest risk compared to other trimesters (cOR=3.89; 95%CI:1.47-10.30; p=0.006), as confirmed by multivariate analysis (aOR=4.44; 95%CI: 1.41-13.95; p=0.01).Conclusion: Anemia affects 36.2% of pregnant women aged 15 to 24 years in Indonesia. The risk of anemia in young pregnant women is significantly associated with gestational age with the first trimester being the most critical period.

Guidance on breastfeeding according to the child’s record: a version for the Karipúna Creole language

Breastfeeding provides nutrition and strengthens the bond between mother and baby, with positive impacts for the entire family. That is why it is recommended during the first six months of life, exclusively, and is supplemented until the age of two or more. Unfortunately, indigenous children were affected by early weaning, making it urgent to adapt the guidelines in the Child Health Handbook to the language of each ethnic group, in order to solve the lack of continuing education instruments for health professionals. This article presents the translation of the Child Health Handbook from Brazilian Portuguese to the language of the Crioulo Karipúna ethnic group, with regard to breastfeeding guidelines. The work was carried out by Nutrition students, with a proposal to return to society, especially to their indigenous community of origin, educational instruments to guide mothers and family members about breastfeeding.

Family Support for Maternal Health and Child Care during the First 1,000 Days of a Child's Life: An Exploration of the Experiences of Urban Families

This qualitative study examines the families' support regarding maternal health and child care toward mothers who demonstrated Good Compliance (GC) and Poor Compliance (PC) with nutrition interventions during the first 1,000 days of their child's life. The study employed an in-depth interview method to gather data from 20 fathers and 7 grandparents residing in Bogor City. The data were analyzed using a constant comparison approach between the GC and PC groups for each theme. The findings indicated that family members provided more specific support for child feeding than for maternal Iron-Folic Acid Supplementation (IFAS), given that the mothers encountered more difficulties on child feeding. Encouraging the mothers to continue taking IFA supplement despite their hesitance was predominantly reported by fathers in the GC fathers. Regarding child feeding, in addition to encouraging the child to eat and feeding them, the GC fathers often engaged in discussions with their wives. In contrast, the PC fathers rarely engaged in such discussions and were only consulted when their wives reported problem. Furthermore, fathers considered their wives to be more knowledgeable on these issues as fathers had limited time due to work commitment. Grandmothers primarily offered advice on child feeding based on their own experiences, sometimes providing less suitable advice for PC mothers. While fathers in both groups did not proactively seek information about maternal health and child care, the GC fathers were more likely to be encountered such information through discussions initiated by their wives, prompting them to pursue further reading. The interaction of fathers in both groups with health professionals only occurred during antenatal visits, with minimal communication. It is recommended that strategies be developed to engage family more highlight their crucial role in fostering a supportive environment for mothers. It is aslo advised that antenal visits be optimized and the Maternal and Child Health (MCH)handbook be utilized to raise awareness and enhance paternal involvement.

Body Mass Index Changes at 1.5 and 3 Years of Age Affect Adult Body Composition.

Early childhood lays the foundation for many outcomes in later life. Recent studies suggest that early childhood development may contribute to lifestyle-related diseases such as obesity, type 2 diabetes, and cardiovascular disease in adulthood; however, there have been few investigations on this association among adults in Japan. Therefore, we examined the relationship between recent physical measurements in adults who underwent health checkups at our university and their physical measurements at birth and during infancy recorded in the Maternal and Child Health Handbook. The median age and body mass index (BMI) of the participants were 36 years and 20.4 kg/m2, respectively. BMI at the time of health checkup in adults did not correlate with physical measurements at birth, but it was found to be associated with BMI at 1.5 (regression coefficient (β) 0.53, p < 0.05) and 3 (β 0.7, p < 0.01) years of age. In addition, the waist-to-height ratio in adulthood was also associated with BMI at 1.5 (β 0.01, p < 0.05) and 3 (β 0.01, p < 0.05) years of age. These findings suggest that it is critical to provide appropriate guidance to children with high BMI and their parents during health checkups to prevent lifestyle-related disorders in adulthood.

Nocturnal enuresis in early adolescence and neurodevelopmental delay in infancy: A population‐based study

AbstractAimThe neurodevelopmental delay hypothesis may explain the mechanism of nocturnal enuresis (NE), but whether the hypothesis holds in early adolescence remains unknown, considering NE frequency. Therefore, we aimed to identify whether neurodevelopmental delays in infancy were associated with the frequency of NE in early adolescence.MethodsData were extracted from the Tokyo Early Adolescence Survey, in which 4478 children (mean age: 10.2 years) and their parents participated. Twelve developmental delays (eight motor, four verbal) were extracted from the Maternal and Child Health Handbook. The NE frequency was obtained from a parent‐answered questionnaire, which divided children into three categories according to DSM‐5 criteria (none, infrequent [&lt;1 time a week], and frequent [≥2 times a week]). Multinomial logistic regression analysis was performed to determine whether delayed developmental milestones in infancy were predictive of frequent/infrequent NE in early adolescence.ResultsDevelopmental delays, particularly those related to motor development but not verbal, such as holding their head up (odds ratio [95% confidence interval] = 2.1 [1.1–4.2]), crawling (2.1 [1.0–4.4]), walking with support (4.0 [1.9–8.4]), walking independently (5.8 [2.2–15.4]), and drawing a circle (5.0 [2.0–12.3]), were significantly associated with an increased risk of frequent NE in early adolescence (all ps &lt; 0.05). However, an association with infrequent NE was not found.ConclusionThis population‐based epidemiological study revealed that motor developmental delays increased the risk of frequent NE in early adolescence, but not of infrequent NE. This finding reinforces the neurodevelopmental delay hypothesis, which provides a biological explanation for the involuntary nature of enuresis. All children in early adolescence with frequent NE should be evaluated and treated by a medical expert.

Universal Health Care and the Maternal and Child Health Handbook for Indigenous Peoples: The Case of Tagbanua Mothers and Children of Coron Island, Palawan

Universal Health Care and the Maternal and Child Health Handbook for Indigenous Peoples: The Case of Tagbanua Mothers and Children of Coron Island, Palawan

Improving mothers' understanding of the mother and child health handbook in Nyamira County, Kenya

Background/Aims Mothers' knowledge of the mother and child health handbook positively affects their practice in child healthcare. However, there is evidence that their understanding of the handbook's contents and its purpose is limited. This study's aim was to assess the impact of a health education intervention designed to improve mothers' knowledge of the handbook's use and contents. Methods In this quasi-experimental study, participants were recruited from four selected health facilities. Participants in the experimental arm were given health training on the mother and child health handbook while those in the control arm received usual care. Data on participants' understanding of the handbook's purpose and contents were collected via questionnaire at baseline and, for intervention participants, after 9 months. Interviews were conducted with four healthcare providers, to explore their perception of women's understanding of the handbook. Data were analysed using the Chi-squared test, Fisher's exact test and odds ratios. Results Participants who received health education showed significant improvement in knowledge of the handbook's contents, with the exception of the HIV prophylaxis schedule. This included being more likely to know that weight-for-height monitoring (odds ratio=2.222; P&lt;0.001), height-for-age monitoring (odds ratio=2.308; P&lt;0.001) and a recommended vaccine schedule (odds ratio=3.000; P&lt;0.001) were found in the handbook. The proportion of mothers who recognised the growth monitoring curve also improved greatly (16.7% pre-intervention, 100.0% post-intervention). Conclusions Mothers' knowledge of the mother and child health handbook improved significantly after health education. Mothers should be given education to ensure that they can make full use of the handbook.

Mumps vaccination and immune status among Japanese university students: A multicenter cross-sectional study.

During the mumps outbreak in Japan in 2016, 159,031 cases were reported. In a survey conducted in 2015, mumps vaccination rates for the first dose were 30%-40%. However, the rates for two or more doses were not determined. We assessed the mumps vaccination rates and mumps infection prevalence according to vaccine doses received. This was a multicenter cross-sectional study. Students from three universities participated in 2019. Informed consent was obtained from the students and their guardians. The primary outcome was the prevalence of breakthrough mumps infection according to the number of doses of vaccine received. We collected data on past illnesses of vaccine-preventable diseases and vaccination history using a questionnaire, photocopies of the Maternal and Child Health Handbook from the guardians, and virus antibody titers from the universities' health centers. This study assessed 2004 eligible students and included 593 (29.6%); of these, 250 (42.7%) had a mumps infection history. Furthermore, 264 (44.6%), 31 (5.2%), and 2 (0.3%) students received the first, second, and third doses of mumps vaccine, respectively. The mumps seropositivity prevalence was 43.2% (n = 127), 36.7% (n = 97), 26.7% (n = 8), and 100% (n = 2) for the no-, first-, second-, and third-dose groups, respectively (p for trend = 0.09). The mumps infection prevalence rates were 69.8% (n = 203), 11.3% (n = 28), 3.9% (n = 1), and 0% for the no-, first-, second-, and third-dose groups, respectively. Approximately 1 in 10 students who had received only one dose of mumps-containing vaccine had a breakthrough infection history.

Associations between cerebellar development and autistic traits during adolescence: a population-based cohort study

IntroductionBrain maturation is associated with adolescent socio-cognitive development. The lateral posterior region of the cerebellum plays a critical role in higher cognitive processes, and deviations of this region are associated with autism-related behaviors. Hence, it is plausible that developmental changes in this region of the cerebellum during adolescence are different along a variation in autistic traits. Additionally, its difference may be moderated by parental age at birth and weight growth during infancy, which have effects on brain development.ObjectivesThe aim of this study was two folds: (1) to test whether cerebellar development during adolescence is different along a variation in autistic traits (2) to test whether parental age at birth and weight growth during infancy moderate the results of (1).MethodsLongitudinal study was conducted over a 6-year period with 256, 230 and 187 participants ranging from 10.5 to 17.6 years, observing adolescent development respectively at 2-year time periods. We undertook a detailed investigation into differences in the lateral posterior region of the cerebellum volume. The 50-item Autism-Spectrum Quotient (AQ) was rated by primary parents. Weight growth and parental age were evaluated using maternal and child health handbook records. A multiple regression analysis was performed to examine whether AQ subscales, sex, and their interactions affected cerebellar development. Moderation analysis assessed whether parental age and weight growth moderated associations between cerebellar development and autistic traits. All participants provided written informed consent, and the study was approved by the Ethics Committee (No.10069).ResultsInteractions between sex and attention switching and sex and attention to detail were significantly associated with cerebellar development in the bilateral gray matter (GM) and white matter (WM) of Crus I and Crus II (Fig1, 2). Simple slope analyses showed that the slopes of cerebellar development were significant for girls (pFDR &lt; 0.001). Although no significant interaction was found between them, the main effect of attention to detail was significantly associated with cerebellar development in WM of VIIB (pFDR = 0.006). Further, moderation analysis found that the association between the cerebellar development and autistic traits were significantly moderated by maternal age; the magnitude of its effect was significant for high maternal age in boys (pFDR = 0.036, Fig3). Paternal age, early (0-9 months) and late weight growth (4-18 months) also moderated associations between them, however, no significance remained after FDR controlling.Image:Image 2:Image 3:ConclusionsThere are significant associations between cerebellar development during adolescence and autistic traits, and its pattern of association can be moderated by parental ages at birth and weight growth during infancy in a cerebellar region- and sex-specific manner.Disclosure of InterestNone Declared

Strengthening implementation of the Maternal and Child Health Handbook for global maternal, newborn, and child health

Strengthening implementation of the Maternal and Child Health Handbook for global maternal, newborn, and child health

Report of the Keynote lecture and Workshop 1 for “Maternal and Child Health Handbook” on the 22nd Congress of the Federation of Asia and Oceania Perinatal Societies (FAOPS 2023)

Report of the Keynote lecture and Workshop 1 for “Maternal and Child Health Handbook” on the 22nd Congress of the Federation of Asia and Oceania Perinatal Societies (FAOPS 2023)

Overview of current revision of ‘Maternal and Child Health Handbook (MCH Handbook)’ in Japan

Overview of current revision of ‘Maternal and Child Health Handbook (MCH Handbook)’ in Japan

Association between gestational weight gain and behavioral problems of the offspring aged 6-7 years: A population-based study in Japan.

To identify the optimal gestational weight gain (GWG) thresholds for behavioral problems and prosocial behavior in 6- to 7-year-old children. A retrospective cohort study was conducted using data from the Adachi Child Health Impact of Living Difficulty study, including all first-graders in public schools in Adachi, Tokyo, in 2017, 2019, and 2021 (n = 11 048, response rate = 80.1%). GWG was based on clinical records in the Mother and Child Health Handbook. Total difficulties and prosocial behavior were assessed using the Strength and Difficulties Questionnaire. Logistic regression models with restricted cubic splines, and quintile categories were employed to examine the association of GWG with the clinical range of total difficulties and prosocial behavior, controlling for covariates. The association between GWG and total difficulties exhibited a reverse J-shaped pattern, with low GWG, but not high GWG, increasing the risk (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.01-1.42, P = 0.039 for GWG < 7 kg; OR 1.03, 95% CI 0.85-1.24, P = 0.786 for GWG > 14 kg), referencing the median (10 kg). High GWG was associated with a lower risk of problems in prosocial behavior (OR = 0.77, 95% CI 0.62-0.95, P = 0.017 for GWG > 14 kg; OR 1.06, 95% CI 0.88-1.27, P = 0.532 for GWG <7 kg). GWG less than 7 kg may increase the risk of total difficulties, whereas GWG over 14 kg may serve as a protective factor for prosocial behavior in 6- to 7-year-old children.

Effectiveness of Postnatal Home Visits in Reducing Fatigue Among Mothers with Unplanned Pregnancies

Objective: This study identified the risk factors for fatigue in child-rearing recognizable in early pregnancy and evaluated the effects of postnatal home visits on parenting fatigue. Methods: Data from 348 mothers who delivered live infants during January–March 2013 in Japan were collected retrospectively. The mothers received the Maternal and Child Health handbook in their first trimester and answered an accompanying questionnaire. For each family, we extracted the timing of postnatal home visits conducted by the Public Health Center. We compared the factors in early pregnancy between exhausted and non-exhausted mothers at nine months postpartum. We also compared the postpartum fatigue between mothers with and without early postnatal home visits. Results: There were significantly more unplanned pregnancies among exhausted mothers compared to mothers who did not experience exhaustion. Among those with unplanned pregnancies, we also found significantly more non-exhausted mothers among those who received postnatal home visits within two months postpartum compared with those who received home visits after two months. Conclusion: An unplanned pregnancy can be a risk factor for fatigue at nine months postpartum. Conducting home visits for mothers who had unplanned pregnancies within two months of delivery may reduce fatigue and positively contribute to mothers’ mental health.

Association between gestational weight gain and chronic disease risks in later life

To assess the association between gestational weight gain (GWG) and the risk of developing chronic diseases in later life, this historical cohort study of 318 non-overweight women was conducted between April 2017 and November 2020 at a hospital in Tokyo. Data about GWG in the last pregnancy and the development of any chronic diseases of the subjects were retrieved from the women’s Maternal and Child Health Handbooks and through a questionnaire survey, respectively. The outcomes were chronic diseases, such as diabetes mellitus (DM), hypertension, hyperlipidemia, and being overweight (body mass index [BMI] ≥ 25 kg/m2). Association between GWG and outcomes were assessed using a logistic regression analysis.There were significant positive linear associations between GWG and the risks of developing DM, hypertension, and being overweight (P = 0.013, 0.050, and 0.017, respectively). After adjusting for later-life BMI, a significant association between GWG and DM (P = 0.025) remained, but the association between GWG and hypertension disappeared. GWG was significantly associated with DM, hypertension, and being overweight later in life. Although the association between GWG and DM was partially independent of BMI later in life, the association between GWG and hypertension was influenced by being overweight later in life.

Factors Associated with Good Birth Preparedness and Complication Readiness among Pregnant Women in Malang District, Indonesia

Indonesia has a high maternal mortality rate, despite the prevalence of antenatal care and delivery assistance by competent birth attendants. This study aims to identify factors associated with good Birth Preparedness and Complication Readiness (BPACR) among pregnant women in Malang District. An observational study with a cross-sectional design was conducted, involving 60 pregnant women. Factors examined include socioeconomics, cultural beliefs, obstetric characteristics, and knowledge of BPACR. The participants had a mean age of 26.3 years and a mean gestational age of 26.4 weeks; 51.5% were in their second pregnancy, 53.3% had completed high school or higher education, and 83.3% were housewives. Additionally, 50% reported cultural beliefs or prohibitions against certain activities that could impede labor, while 51.7% adhered to food taboos perceived to affect labor. Of the participants, 91.7% had a Maternal and Child Health (MCH) handbook, 31.7% had read the entire handbook, and 21.7% were aware of at least two danger signs during pregnancy, childbirth, and the postpartum period. Good BPACR was defined as meeting at least three of four criteria, namely identifying a competent birth attendant, choosing a health facility for delivery, saving funds, and arranging transport. Reading the entire MCH handbook (aOR: 7.225) and holding certain cultural beliefs or prohibitions (aOR: 6.359) were significantly associated with good BPACR. These beliefs reflect a positive attitude toward recognizing obstetric danger signs.