Child Health Research Articles

Assessment of knowledge, attitude and practice towards maternal healthcare among mothers in Illam: a cross-sectional study from Nepal.

Healthcare during pregnancy and childbirth and after delivery is important for the survival and well-being of both the mother and the neonate. Maternal healthcare in Nepal faces challenges due to various causes. However, providing proper knowledge on maternal healthcare to mothers and promoting a positive attitude towards it can have a significant impact on maternal and child health outcomes. The objective of this study was to assess knowledge, attitude and practice towards maternal healthcare among mothers in Illam. A cross-sectional study was conducted among 197 mothers in Illam municipality who gave birth within the last 5 years. The study used face-to-face interviews with a semi-structured questionnaire to collect data. Descriptive as well as inferential statistics were used to analyze the data. The total number of participants was 197. The results showed majority (48.22%) belonged to the age group of 22-29 years and the mean age of the participants was 30.2± 5.37, majority were home-makers (44.7%), mean age at marriage was 21.39±3.99 years, mean age at first pregnancy was 23.9±4.33years and mean birth spacing from last child was 70±41.28 months. Overall, we found that knowledge, attitude and practice regarding antenatal care (ANC) were 72%, 83% and 69%, respectively. Similarly, knowledge, attitude and practice regarding post-natal care (PNC) were 39%, 91%, and 43%, respectively. Mothers showed satisfactory knowledge on ANC but inadequate knowledge on PNC. Most had a positive attitude towards both practices. However, actual practices related to ANC and PNC were poor despite adequate knowledge and attitude.

Socioeconomic inequality in child health outcomes in India: analyzing trends between 1993 and 2021

BackgroundThe health of India’s children has improved over the past thirty years. Rates of morbidity and anthropometric failure have decreased. What remains unknown, however, is how those patterns have changed when examined by socioeconomic status. We examine changes in 11 indicators of child health by household wealth and maternal education between 1993 and 2021 to fill this critical gap in knowledge. Doing so could lead to policies that better target the most vulnerable children.MethodsWe used data from five rounds of India’s National Family Health Survey conducted in 1993, 1999, 2006, 2016, and 2021 for this repeated cross-sectional analysis. We studied mother-reported cases of acute respiratory illness and diarrhea, hemoglobin measurements for anemia, and height and weight measurements for anthropometric failure. We examined how the prevalence rates of each outcome changed between 1993 and 2021 by household wealth and maternal education. We repeated this analysis for urban and rural communities. ResultsThe socioeconomic gradient in 11 indicators of child health flattened between 1993 and 2021. This was in large part due to large reductions in the prevalence among children in the lowest socioeconomic groups. For most outcomes, the largest reductions occurred before 2016. Yet as of 2021, except for mild anemia, outcome prevalence remained the highest among children in the lowest socioeconomic groups. Furthermore, we show that increases in the prevalence of stunting and wasting between 2016 and 2021 are largely driven by increases in the severe forms of these outcomes among children in the highest socioeconomic groups. This finding underscores the importance of examining child health outcomes by severity.ConclusionsDespite substantial reductions in the socioeconomic gradient in 11 indicators of child health between 1993 and 2021, outcome prevalence remained the highest among children in the lowest socioeconomic groups in most cases. Thus, our findings emphasize the need for a continued focus on India’s most vulnerable children.

A New Hybrid Classification Framework in Childhoods Allergies with Dataset Slicing Method

Childhood allergies, particularly food allergies, are growing more frequent. Their major influence on children's health and well-being has piqued the interest of worldwide public health officials. The increased prevalence of childhood allergies in Turkey, where these patterns are also relevant, adds urgency to the need for effective classification and management options. This study addresses the shortcomings of simple classification algorithms in obtaining high accuracy by presenting a novel hybrid classification methodology. The research creates a novel method where three different prediction models are built by combining Support Vector Machine and Decision Tree classifiers. This method improves the classification process by taking into account instances that have been incorrectly classified as possible sources of useful information instead of just being noise. This instance filtering-based hybrid classification algorithm that is used in this study maintains the simplicity of interpreting learning outcomes while achieving comparatively high accuracy. Extensive experiments on the allergy dataset show the effectiveness of this hybrid approach, with an impressive accuracy of 0.906. This greatly outperforms the fundamental classification algorithms. The experimental outputs have important implications for medical professionals. This study might add a valuable contribution to the literature by giving a fresh solution to childhood allergy classification.

Exploring the impact of maternal marital status on child health: insights from the 2022 Tanzanian Demographic and Health Survey.

The SDG 2.2 targets the end of all forms of malnutrition by 2030. Despite the efforts by the Tanzania government to attain this goal, over 30 percent of children under-five are stunted. This study explored the relationship between maternal marital status and child health outcomes in Tanzania using the Tanzania Demographic and Health Survey data set of 2022. A multiple logistic regression was conducted with the binary outcome variable "Stunted," using predictors such as the mother's age and education level, the child's birth size, birth order, and gender, as well as other household characteristics. The study findings highlight a significant association between maternal marital status and child stuntedness. The mothers in a marriage relationship are 30% less likely to have stunted children (OR=0.70, 95%CI, 0.56-0.86) compared to the mothers outside the marriage relationship. Mothers with primary and secondary education or higher, show a lower likelihood of having stunted children (OR=0.90, 95%CI 0.70-1.17) and (OR=0.68, 95%CI 0.44- 1.03) respectively compared to their uneducated counterparts. In other words, a mother being married or educated reduces the odds of her children being stunted. The probability of child stuntedness reduces as the wealth quintile of the household increases. This study contributes to the understanding of the factors influencing child health outcomes in Tanzania especially the role of marriage.

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.

Peer Review of "Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study".

Peer Review of "Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study".

Peer Review of "Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study".

Peer Review of "Development of a Digital Platform to Promote Mother and Child Health in Underserved Areas of a Lower-Middle-Income Country: Mixed Methods Formative Study".

Burnout among medical residents, coping mechanisms and the perceived impact on patient care in a low/ middle income country

BackgroundBurnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.MethodsThis was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and < 33 in personal accomplishment. Overall high risk of burnout was defined as high-risk scores in 2 or more of the 3 categories. Categorical variables were analysed using descriptive statistics and reported as frequency counts and corresponding percentages. Chi-square test was applied to test for association of burnout and the categorical variables. P value of < 0.05 was considered statistically significant. To assess the impressions on patient care and evaluate the coping mechanisms employed in the context of burnout residents participated in four focus group discussions reaching thematic saturation.Results95 out of 120 residents consented to participate in the study, 47.3% of whom had a high risk of burnout. A significant association was found between gender and burnout risk with more female residents having high risk of burnout compared to their male counterparts; 58.0% and 35.6% respectively (P value 0.029). Residents in paediatrics and child health had the greatest risk of burnout (8 out of 10) compared to those in other programmes (P value of 0.01). Thematic analysis from focus group discussions revealed that main sources of stress included departmental conflict and struggle to balance work and other aspects of life. All focus group discussions revealed that burnout and stress are associated with negative coping mechanisms. Respondents reported that when under stress, they felt more likely to make medical errors.ConclusionThis study reported high risk of burnout among post graduate residents which is consistent with other global studies. The sources of stress cited by residents were mostly related to the workplace and many perceived sub-optimal patients care resulted from burnout. This highlights a need for preventive measures such as wellness programs within the training programmes.Trial registration numberNot applicable.

The effects of exclusive breastfeeding on child health in Chad: evidence from national representative survey data

The effects of exclusive breastfeeding on child health in Chad: evidence from national representative survey data

Bridging the gaps in health and social equity for disabled children in low- and middle-income countries.

Bridging the gaps in health and social equity for disabled children in low- and middle-income countries.

On the importance of internet access for children’s health and subjective well-being: the case of China

ABSTRACT Digital technology is transforming children’s daily routines and can potentially have long-lasting effects on their lives. This paper studies the impact of internet access on the health and subjective wellbeing of Chinese children. To conduct such analysis, we employ data from the China Education Panel Survey (CEPS), a longitudinal dataset of Chinese seventh-year students representative of the whole country. This database allows us to control for unobserved individual heterogeneity and socio-economic characteristics. We use two alternative methods to address endogeneity concerns. The first one employs a recursive system of equations that allows unobserved individual heterogeneity to simultaneously affect both health outcomes and digital access. The second approach exploits the fact that Chinese students cannot choose which school to attend and employ the proportion of students owning a computer in the same school as an instrumental variable. Regardless of the method, we find that internet access improves health. We also find some positive impact of digital access on subjective wellbeing, albeit the evidence is weaker. This stands in stark contrast to prior research, which has found a negative effect of internet use on mental health in Western countries.

Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda

ObjectiveThis meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras.DesignUsed a systematic review and meta-analysis methodology.Data sourcesReviewed...

Sociodemographic Correlates of High Cardiovascular Health Across Childhood and Adolescence: A Prospective Study Among 2 Cohorts in the ECHO Consortium.

This study seeks to characterize cardiovascular health (CVH) from early childhood to late adolescence and identify sociodemographic correlates of high CVH that serve as levers for optimizing CVH across early life. Among 1530 youth aged 3 to 20 years from 2 cohorts in the ECHO (Environmental Influences on Child Health Outcomes) consortium, we first derived CVH scores on the basis of the Life's Essential 8 construct comprising 4 behavioral (nicotine use/exposure, physical activity, sleep, and diet) and 4 health factors (body mass index, blood pressure, non-high-density lipoprotein cholesterol, and fasting glucose) during early childhood (mean age, 3.5 years), middle childhood (8.0 years), early adolescence (13.3 years), and late adolescence (17.8 years). Next, we used generalized regression to estimate the probability of high (versus not high) CVH with respect to sociodemographic characteristics. Overall CVH score was stable across life stages: 81.2±7.6, 83.3±8.0, and 81.7±8.9 of 100 possible points in early childhood, middle childhood, and early adolescence, respectively. Accordingly, during these life stages, most children (63.3%-71.5%) had high CVH (80 to <100). However, CVH declined by late adolescence, with an average score of 75.5±10.2 and 39.4% high CVH. No children had optimal CVH (score=100) at any time. Correlates of high CVH include non-Hispanic White race and ethnicity, maternal college education, and annual household income >$70 000. These associations were driven by behavioral factors. Although most youth maintained high CVH across childhood, the decline by late adolescence indicates that cardiovascular disease prevention should occur before the early teen years. Disparities in high CVH over time with respect to sociodemographic characteristics were explained by behavioral factors, pointing toward prevention targets.

Optimal prenatal genetic diagnostic approach for posterior fossa malformation: karyotyping, copy number variant testing, or whole-exome sequencing?

BackgroundPosterior fossa malformation (PFM) is a relatively uncommon prenatal brain malformation. Genetic diagnostic approaches, including chromosome karyotyping, copy number variant (CNV) testing, and whole-exome sequencing (WES), have been applied in several cases of fetal structural malformations. However, the clinical value of appropriate genetic diagnostic approaches for different types of PFMs has not been confirmed. Therefore, in this study, we aimed to analyze the value of different combined genetic diagnostic approaches for various types of fetal PFMs.MethodsThis retrospective study was conducted at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital. Fifty-one pregnant women diagnosed with fetal PFMs who underwent genetic testing in our hospital from January 1, 2017 to December 31, 2022 were enrolled; women with an isolated enlarged cisterna magna were excluded. All participants were categorized into two groups according to the presence of other abnormalities: isolated and non-isolated PFMs groups. Different combined approaches, including karyotype analysis, CNV testing, and trio-based WES, were used for genetic analysis. The detection rates of karyotype analysis, CNV testing, and WES were measured in the isolated and non-isolated groups.ResultsIn isolated PFMs, pathogenic/likely pathogenic (P/LP) CNVs were detected in four cases (36.36%, 4/11), whereas G-banding karyotyping and WES showed negative results. In non-isolated PFMs, a sequential genetic approach showed a detection rate of 47.5% (19/40); karyotyping revealed aneuploidies in five cases (16.67%, 5/30), CNV testing showed P/LP CNVs in five cases (16.13%, 5/31), and WES identified P/LP variants (in genes CEP20, TMEM67, OFD1, PTPN11, ARID1A, and SMARCA4) in nine cases (40.91%, 9/22). WES showed a detection rate of 83.33% (5/6) in fetuses with Joubert syndrome. Only six patients (five with Blake’s pouch cyst and one with unilateral cerebellar hemisphere dysplasia) survived.ConclusionsWe recommend CNV testing for fetuses with isolated PFMs. A sequential genetic approach (karyotyping, CNV testing, and WES) may be beneficial in fetuses with non-isolated PFMs. Particularly, we recommend WES as the first-line genetic diagnostic tool for Joubert syndrome.

Children health learning through Project Based Learning (PBL) in Kota Kinabalu, Sabah Malaysia

Children who learn through Project-Based Learning (PBL) in preschool can be an environment that gives children the opportunity to gain wider knowledge to understand the reality of life and how to deal with it. This study aims to see the effect of the Project Based Learning (PBL) method on the development level of preschool children's health learning. This study used an action research design involving three boys and three-year-old girls from a preschool in Kota Kinabalu, Sabah. Data from observations, interviews and related documents were collected and analyzed narratively before and after the implementation of PBL. The results of the study found that the development level of children's health learning increased after being directly involved in the implementation of PBL. Findings also show positive behavioral changes. In addition, the study successfully gave positive implications to the need for preschool teachers to be exposed to the skills of the PBL method in order to create more effective teaching methods.

Using digital technology as a platform to strengthen the continuum of care at community level for maternal, child and adolescent health in Tanzania: introducing the Afya-Tek program

Inadequate care within Tanzania’s primary health system contributes to thousands of preventable maternal and child deaths, and unwanted pregnancies each year. A key contributor is lack of coordination between three primary healthcare actors: public sector Community Health Workers (CHWs) and health facilities, and private sector Accredited Drug Dispensing Outlets (ADDOs). The Afya-Tek program aims to improve the continuity of care amongst these actors in Kibaha district, through a mobile-application based digital referral system that focuses on improving maternal, child and adolescent health. The digital system called Afya-Tek was co-created with users and beneficiaries, and utilises open-source technology in-line with existing government systems. The system guides healthcare actors with individualised decision support during client visits and recommends accurate next steps (education, treatment, or referral). From July 2020 to June 2023, a total of 241,000 individuals were enrolled in the Afya-Tek program covering 7,557 pregnant women, 6,582 postpartum women, 45,900 children, and 25,700 adolescents. CHWs have conducted a total of 626,000 home visits to provide health services, including screening clients for danger signs. This has resulted in 38,100 referrals to health facilities and 24,300 linkages to ADDOs. At the ADDO level, 48,552 clients self-presented; 33% of children with pneumonia symptoms received Amoxicillin; 34% of children with diarrhoea symptoms received ORS and zinc; and 4,203 referrals were made to nearest health facilities. Adolescents preferred services at ADDOs as a result of increased perceived privacy and confidentiality. In total, 89% of all referrals were attended by health facilities. As the first digital health program in Tanzania to demonstrate the linkage among public and private sector primary healthcare actors, Afya-Tek holds promise to improve maternal, child and adolescent health as well as for scale-up and sustainability, through incorporation of other disease conditions and integration with government’s Unified Community System (UCS).

Consumption Quintile Groups in the Analysis of Poverty and Development Issues

Background: This paper provides computer program which facilitates to create consumption quintile groups (CQGs), and demonstrates some benefits of the created CQGs in the analysis of poverty and development issues. Methods: The proposed computer program is tested by creating CQGs using the data of 28,670 individuals enumerated in a sample of 5,988 households of Nepal Living Standard Survey (NLSS) III instigated by the Central Bureau of Statistics in 2010/11, and identifies some disadvantages of the lowest 20% of population compared to the highest 20% of population. Results: Some identified disadvantages of the lowest population are - excessive number of children, low literacy rate among the working-age population and low expenditure on non-food items, including education and health of children. Conclusion: This paper illustrates how to compute income inequality, an important issue of sustainable development, by Gini coefficient when the income distribution is across the CQGs and the computed value was 0.46. Novelty: This paper tries to draw attention of scholars on the use of CQGs in the analysis of poverty and development issues.

Respiratory conditions and health symptoms associated with air pollution amongst children aged six years and below in Melusi Informal Settlement, Tshwane Metropolitan Municipality, South Africa: a cross-sectional study

BackgroundRespiratory conditions and health symptoms associated with air pollution in children are a major public health concern, as their immune systems and lungs are not yet fully developed. This study aimed to assess self-reported respiratory conditions and health symptoms associated with air pollution sources amongst children aged six years and below in Melusi informal settlement, Tshwane Metropolitan Municipality, South Africa.MethodsWith a quantitative cross-sectional study design, parents/caregivers of children aged six years and below (n = 300) from eight Early Childhood Development Centres were invited to participate in the study. This study employed complete sampling, and data was collected using the modified International Study of Asthma and Allergies in Children. The chi-square and multiple logistic regression models were used to analyze data, with p < 0.05 in the adjusted odds ratios considered as being statistically significant.ResultsThree models were run to examine the predictors of wheezing in the past 12 months, dry cough, and itchy-watery eyes. The model for asthma was excluded, as only seven participants reported having asthma. Wheeze in the past 12 months was associated with participants living in the area for more than three years (OR 2.96 95%CI: 1.011–8.674). Furthermore, having a dog in the house in the past 12 months was associated with wheeze in the past 12 months (OR 5.98 95%CI: 2.107–16.967). There was an association between duration of stay in a residence and dry cough prevalence (OR 5.63 95%CI: 2.175–14.584). Trucks always or frequently passing near homes was associated with itchy-watery eyes (OR 3.27 95%CI: 1.358–7.889). 59% (59%) of participants perceived the indoor air quality in their homes to be good, while 6% perceived it as poor. In contrast, 36% of participants perceived the outdoor air quality to be good, and 19.7% perceived it as poor.ConclusionThe association between perceived air pollution exposure, self-reported respiratory conditions, and health symptoms amongst children is complex. Further research is required to better understand the multifaceted nature of air pollution and its impact on the health of children.

Toothbrushing Behavior and The Incidence of Dental Caries In Children

One of the most common children's dental health problems is dental caries. Childhood is the beginning of behavior formation, therefore it is hoped that parents can educate their children to behave correctly in maintaining healthy teeth and mouth.This research used descriptive survey research methods. The design of this research is cross sectional. The research was conducted at MIS Cempaka Putih and MIS Sungai Baru, South Kalimantan. The population in this study was all students in grades 4-6 at MIS Cempaka Putih and MIS Sungai Baru, there are 41 people. The sampling technique in this research used the total sampling method. The variables in this study are children's dental health behavior and the DMF-T index. The data that has been collected will be processed through editing, coding, tabulation and descriptive data analysis. This research was conducted at MIS Cempaka Putih and MIS Sungai Baru Banjarmasin in February 2022. Respondents were 10-12 years old. The dental health behavior of children in the good category was 14 people (34.15%), 15 people (36.58%), and 12 people less (29.27%). DMF-T index in the very high category was 3 people (7.32%), high was 4 people (9.76%), medium was 18 people (43.90%), low was 13 people (31.70%), and very low 3 people (7.32%). Based on the research results, it can be concluded that the dental health behavior of children in grades 4-6 at MIS Cempaka Putih and MIS Sungai Baru is mostly adequate for 15 people (36.58%). The class 4-6 DMF-T index in MIS Cempaka Putih and Sungai Baru has an average value of 3.5, including the medium category.

Health promotion intervention to educate mothers of preschool children to promote wellness

Preschoolers are delicate individuals with higher rates of mortality and morbidity. Nowadays, the focus is to reduce mortality rates by focusing on risk factors, including preventable causes and elements that affect children's health. Creating an awareness among mothers in a particular community will help prevent and promote health among such children. Therefore, a study is designed to find out the effectiveness of focused intervention on health promotion among mothers of preschool children in selected urban area of Chennai. To validate the effectiveness of focused intervention a pre-test and posttest outcomes were measured to enable the wellness of preschool children. A quantitative research approach and pre-experimental design were used to gather data from 100 mothers of preschool children using convenience sampling technique. Self-structured knowledge questionnaires were used during pretest and post-test. After pretest, a focused intervention on health promotion among mothers of pre-school children was given. The outcome of the study was measured through a post-test. The data collected was analyzed, interpreted and the outcomes were reported. The average pre-test level of knowledge score of mothers was 8.22 and the average post-test knowledge score was 16.05, a significant difference (7.83). Mothers in nuclear family in the urban area having more than one child showed better outcome. Statistical significance was calculated using the chi-square test. The preliminary study’s findings support that focused intervention helps mothers to gain more knowledge that may help to maintain the health of their children. Such studies may be recommended to educate the mothers help reduce under five child mortality.