Maternal And Child Health Research Articles

Shedding light on maternal mental health in LMICs: a cornerstone of maternal and child health care.

Maternal and Child Health (MCH) programs have long been integral to global public health initiatives, aiming to safeguard the well-being of both mothers and their offspring. However, amidst the comprehensive approach to physical health, the mental well-being of mothers has often been overlooked, representing a critical gap in these programs. This paper examines the importance of addressing maternal mental health within the framework of MCH programs, highlighting its significance and the repercussions of its neglect. Despite its profound impact on maternal and child outcomes, issues such as postpartum depression, anxiety, and maternal stress are frequently disregarded in MCH interventions. This oversight not only undermines the holistic nature of maternal health but also perpetuates cycles of poor mental health within families and communities. Herewith, an effort was made to highlight the importance of maternal mental health and the need to focus and strengthen awareness about it through policy and programs.

A statewide system for maternal-infant linked longitudinal surveillance: Indiana's model for improving maternal and child health

Indiana, located in the Midwest region of the United States, faces significant challenges with respect to health, especially maternal and child health (MCH). These challenges include high rates of stillbirth, neonatal abstinence syndrome (NAS) and congenital syphilis (CS). Not only are these often-fatal conditions underreported, but it can also be difficult to track them longitudinally, as mothers and infants are not routinely linked through electronic health records (EHRs). This paper describes the process, structure and planned outcomes of a partnership between Indiana University, Regenstrief Institute and public health partners in support of the U.S. Centers for Disease Control and Prevention's Pregnant People-Infant Linked Longitudinal Surveillance (PILLARS) program. Together, academic, clinical and public health organisations are collaboratively developing an infrastructure and deploying novel methods to surveil stillbirth, CS and NAS longitudinally. The infrastructure includes: (a) deploying deterministic and probabilistic algorithms to link mothers and their infants using multiple, linked data sources; (b) creating and maintaining a registry of maternal-infant dyads; (c) using the registry to perform longitudinal surveillance in collaboration with Indiana public health authorities on stillbirth, NAS and CS and (d) translating information from surveillance activities into action by collaborating with public health and community-based organisations to improve and implement prevention activities in vulnerable Indiana communities. Our long-term goal is to improve outcomes for these conditions and other priority MCH outcomes by expanding our work to additional MCH use cases.

Completion of maternal and child health continuum of care and associated factors in West Gondar Zone, North West Ethiopia, 2023: a community based cross sectional study

BackgroundThe maternal and child health continuum of care integrates services from pre-pregnancy through childhood to enhance maternal and child outcomes. It is crucial for reducing maternal and child mortality by focusing on comprehensive health interventions. Despite its significance, comprehensive studies on the continuum remain limited. This study aimed to assess the completion of the maternal and child health continuum of care and associated factors among mothers with index children aged 12–23 months in the West Gondar Zone, Northwest Ethiopia, in 2023.MethodsA community-based cross-sectional study was conducted from May 1–30, 2023, by interviewing mothers of 12-23-month-old children in West Gondar zone. A simple random sampling method was used to select 1,019 mothers. Data were collected via KoboCollect and analyzed in Stata version 14.0. Binary logistic regression was used to examine associations between independent variables and the continuum of care. Variables with a p value < 0.2 in bi-variable analysis were included in the multivariable model. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p values < 0.05 were used to determine statistical significance. The Hosmer and Lemeshow goodness-of-fit test was computed.ResultsThe overall rate of completion of the maternal and child health continuum of care was 6.19% (95% CI: 4.69–7.68). The factors associated were having the first ANC visit before 16 weeks of pregnancy [AOR: 4.25 (CI: 2.14–8.47)], birth preparedness and complication readiness [AOR: 3.02 (CI: 1.41–6.46)], history of modern contraceptive use [AOR: 2.34 (CI: 1.16–4.73)], intended pregnancy [AOR: 3.25 (CI: 1.63–6.48)], receiving maternal services during ANC visits [AOR: 2.69 (CI: 1.07–6.80)], and the health facility being less than an hour away from home [AOR: 2.53 (CI: 1.06–6.03)].ConclusionsThe maternal and child health (MCH) continuum of care in West Gondar was low. Key factors affecting completion included birth preparedness and complication readiness, early ANC initiation, planned pregnancy, family planning use, proximity to health facilities, and maternal health services provided during ANC. Efforts should target these factors and ensure services at each stage of the continuum to stay mothers along the path of the MCH continuum of care.

Maternal and child health services during COVID-19 in India: Highlighting the role of primary care physicians in maintaining continuum of care

ABSTRACT Background: This study aims to address the lack of substantial evidence regarding the effect of COVID-19 on maternal and child health (MCH) services in India and also highlight the role of primary care physicians in maintaining essential services during a pandemic. While studies conducted worldwide and in India have examined the effects of COVID-19 on these services, a significant gap in robust evidence remains. Methods: Forty-two districts were selected randomly from seven regional states of India. Data on five selected MCH indicators were extracted from HMIS for the months from March to June 2019 and 2020. Relative changes in service utilization for each month from March to June over the two years were compared. Comparisons were also made between the selected districts based on the COVID-19 categorization into red and green zones. Results: COVID-19 and its associated restrictive measures created significant disruption to essential MCH service utilization in India across all states reviewed. Both institutional, and outreach services were impacted; however, hospital-based services were more impacted. Institutional deliveries and emergency obstetric services saw a decline in March and April 2020 which gradually improved between May and June in some states. Immunization sessions held in 2020 observed a decrease in April. Conclusions: The analysis indicates a disruption in service delivery during the initial phase of the lockdown. However, the services resumed gradually as national and state-specific operational guidelines were implemented to maintain a continuum of care.

Reimagining maternal resilience: Incorporating the socioecological framework, lifecourse theory, and weathering hypothesis.

Women of color are at least twice as likely as non-Hispanic White women to die during the perinatal period or deliver infants who are low birthweight, preterm, or die within the first year of life. Maternal stress before and during pregnancy is associated with adverse obstetric outcomes. A growing body of literature has explored maternal resilience as protective factors contributing to healthy maternal and child health (MCH) outcomes. However, several gaps exist in how this construct has been conceptualized and operationalized. First, extant research has primarily conceptualized maternal resilience as individual attributes that enable women to "bounce back" after facing adversity during pregnancy, thereby failing to incorporate the broader systemic and environmental factors that contribute to chronic stress, particularly among vulnerable groups. Second, the literature has largely neglected to examine resilience in relation to maternal stress, therefore not acknowledging that women who experience greater stress will likely require more resources. Third, though resilience has been investigated at discrete life stages, longitudinal research has not been conducted to explore how it develops over the lifecourse. This article critically evaluates the resilience literature, expands upon the gaps described, and proposes a conceptual framework that reimagines material resilience using three population health theories, including Bronfenbrenner's socioecological framework, Elder's lifecourse theory, and Geronimus' weathering hypothesis. The proposed framework will inform future research that examines the development of multilevel resilience resources over the lifecourse as well as interventions to increase resilience and ultimately yield healthier MCH outcomes among vulnerable communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identifying the active ingredients in payment for performance programmes using system dynamics modelling

Payment for performance (P4P) is not a uniform intervention, with programme effect dependent on several interconnected factors. In this study, a system dynamics model was developed to explore the pathways to improved outcomes and how changes in the design, implementation and context of a P4P programme affected maternal and child health (MCH) service delivery outcomes in Tanzania. A previously developed causal loop diagram of the programme effects was used to inform model development, with further data sources (including an impact evaluation of programme, health surveys, stakeholder feedback and relevant literature) used to build the model. A number of pathways were identified to improved services under P4P, with increased availability of drugs underpinning the content of care outcome (intermittent preventative treatment during ANC), which together with increased supervision, enhanced health worker motivation. This in turn increased perceived quality of care at the facility which improved the coverage of services outcome (facility-based deliveries), and with increased outreach, increased awareness of services also boosted demand. Minor delays in payment reduced provider purchasing power for medicines, with severe delays driving erosion of provider trust and motivation for programme participation. Allocating a larger share of funds for facility operations can enhance performance effects, particularly for those services that rely on efficient drug administration. Contextual factors including limited baseline provision of essential medications, lower community awareness of facility services and dispersed/distant populations reduced programme effect. This paper demonstrates the feasibility and the potential of such models to inform the design of effective health system interventions.

PERFORMANCE TESTING ANALYSIS OF BANDUNGTANGINAS APPLICATION WITH JMETER

The bandungtanginas.id application was created to serve the needs of data collection on maternal andchild health at every posyandu in the city of Bandung. This application is planned to be able to servearound 1,982 posyandu in the city of Bandung, around 10,000 users, who are expected to be able toaccess the bandungtanginas.id application. In the current condition of the application supportinfrastructure still has limitations in supporting the bandungtanginas.id application. Withspecifications that tend to be low, an improvement effort is needed through generating applicationusage scenarios so that the services provided can be optimally available using the existinginfrastructure. This research focuses on analyzing the application performance by using load testing.This research has four stages: determining the test's purpose, creating a test scenario, carrying outscenario testing, and analyzing the results. The analysis will be carried out with the results of loadtesting experiments based on the scenarios that have been made. Test scenarios are made to obtainexperimental data, last further analysis and conclusions will be made. Scenarios are created based onan estimate of the optimal number of users the application should serve. The test scenario will use atarget user of between 10 – 200 users who are divided in five groups of load testing scenarios. Fromthis trial, it will be seen how the performance of the bandungtanginas.id application for each scenariogroup that has been created. The result of this study showed that the best scenario forbandungtanginas.id application could serve users in the range of 30-50 users. It is obtained from theresponse time results, which show the average results are under 30 seconds according to the SLA(Service Level Agreement) standard for application users.

Factor Associated with Nutritional Status Among Children Aged 6 – 59 Months in Colol Public Health Center: A Cross-Sectional Study Article Sidebar

Objective: Malnutrition is one of the main factors influencing growth and development in children. Undernourishment still became a significant public health issue, including in Indonesia. This study aims to assess the prevalence and risk factors of nutritional status among children aged 6-59 months in Colol Public Health Center, East Manggarai Regency, and Indonesia. Material and Methods: A cross-sectional observational community-based study was conducted in the working area of Colol Public Health Center in August 2023. This study included 138 parents and children aged 6 to 59 months who visited Posyandu, chosen by a simple random cluster sampling technique. The data were collected using a structured questionnaire, secondary data from the Maternal and Child Health (MCH) book, and anthropometrical measurements. Three anthropometric indicators (underweight, stunted, and wasted) were assessed according to the 2006 WHO Child Growth Standards and analyzed by SPSS 25.0. Bivariate and multivariate analyses were used to identify risk factors associated with children’s nutritional status. The statistical significance was stated at p-value &lt;0.05 with 95% confidence intervals. Results: The prevalence of underweight, stunted, and wasted among children aged 6-59 months was 18.8%, 22.4%, and 6.5%, respectively. The multivariable logistic regression model showed that low birth weight increased the risk of underweight (AOR = 13.73 (95% CI: 2.40-78.63)), stunted (AOR = 30.55 (95% CI: 3.16-295.09)), and wasted (AOR = 12.16, 95% (CI: 2.02-73.37)) among children aged 6-59 months. Children with mothers aged &lt;20 or &gt; 35 years old increased odds for underweight (AOR 2.99 (95% CI: 1.13-7.94)). Meanwhile, children aged 24-59 years old were more likely stunted (AOR 4.89 (95% CI: 1.89-12.64)). Conclusion: Undernutrition still becomes a public health problem among children aged under 5 years old in the working area of Colol Public Health Center, East Manggarai Regency. Low birth weight, age of the mother &lt;20 or &gt; 35 years old, and age of the children 24-59 years are significantly associated with nutritional status. The primary health center should cooperate with stakeholders across sectors, especially promoting programs to prevent low birth weight

Men’s perception and participation in maternal and child health care in the field practice area of a teaching hospital: A cross-sectional study from rural Bengal

ABSTRACT Introduction: Participation of men in maternal and child health (MCH) is crucial for the reduction of infant and maternal mortality. MCH care services have been focused on providing information and services to women, but males’ behaviour and decisions affect the health of the child and mother. Objectives: The objectives of the study were to assess the perception and participation of males in MCH care as well as, to identify the association of their perception and participation with socio-demographic characteristics and to find out the correlation between perception and participation regarding MCH care. Materials and Methods: A descriptive type of observational study with a cross-sectional design was conducted among 125 male residents from selected subcentres in Budge Budge II block of South 24 Parganas. Data were collected by face-to-face interviews using a predesigned, pretested, structured schedule. Multivariable binary logistic regression was done to identify the association between dependent and independent variables (P &lt; 0.05). The correlation between perception and participation was assessed by Spearman’s rho. Results: The mean age of the participants was 34.3 (±5.6) years with most (59.2%) between the ages of 31–40 years of age. About 24% were unaware of pregnancy registration time, and 30.4% did not know the number of minimum antenatal check-ups. In total, 20% of study participants did not accompany their partner to the Antenatal Care (ANC) clinic, 6.4% did not accompany them during delivery, and almost 33.6% did not accompany their child to the immunization session. No variables were found to be significantly associated with the dependent variables. A statistically significant positive correlation was found between perception and participation (ρ = 0.3). Conclusion: Men’s perception and participation in MCH care services were found to be reasonably good though they can be improved. Awareness raises about the importance of men’s role in supporting their partner’s health during pregnancy and postpartum, as well as the overall well-being of their children through public health campaigns, community events, and targeted educational programs.

Mtoto Wetu Growth and Temperature Monitoring System for Tanzania Child Healthcare Clinics

In most government maternal and child health (MCH) clinics in sub-Saharan countries caregivers rely on manual methods for data acquisition, storage, and analysis, leading to challenges such as errors, inefficiencies, and limited accessibility. Recognising the transformative potential of digital technology, this design aims to innovate the child growth monitoring paradigm by introducing a comprehensive Digitized Child Growth Monitoring System. The "Mtoto Wetu Growth and Temperature Monitoring System" is a comprehensive framework designed to monitor and assess the growth and temperature patterns of infants and young children on a monthly basis. This system integrates various components, including anthropometric measurements, temperature monitoring, immunisation schedule, automated growth chart generation, and parental, caregiver, and health care professionals’ involvement, to provide a holistic approach to child health monitoring. Implemented with standardised protocols, training sessions, and robust data management systems, the monitoring system aims to facilitate early detection of growth abnormalities, and health concerns. By promoting early intervention, preventive care measures, parental empowerment, and continuity of care, the Mtoto Wetu system strives to optimise health outcomes, foster parental engagement, and promote health equity among children. The system was able to provide results with a small amount of error compared to the standard weighing machines, tap measure and digital thermometer

The effects of the SARS-CoV-2 pandemic on the delivery of maternal and child health services in South Africa

ObjectiveThe COVID-19 pandemic severely interrupted the functioning of healthcare systems, negatively affecting the global provision of maternal and child health (MCH) services. This study aims to specify the effects of COVID-19 on these services in the Gauteng province (South Africa) and to put forward context-specific recommendations aimed at augmenting them and ensuring ongoing uninterrupted coverage, even and especially during pandemics. MethodsIn this quantitative study, a retrospective review of District Health Information System data routinely collected between February 2019 and March 2021 was conducted, comparing performance of the relevant indicators across the two-year span. The data were analyzed using Stata 16 statistical software (StataCorp). The two sample t-test with equal variance and the Mann-Whitney test were applied to evaluate the equality of the indicators. ResultsRoutine MCH services were negatively impacted, with marked declines in all relevant indicators from the onset of the pandemic. There was a statistically significant decline in cervical cancer coverage and maternal postnatal visits within six days of delivery. While declines in the other critical indicators were likewise observed, they were not statistically significant. ConclusionThe South African response to the pandemic had negative repercussions on all MCH services in the Gauteng province. The lessons to be drawn from the pandemic experience should help to strengthen health system capacities, boost service provision, and mitigate future damage to the healthcare system.

The Maternal and Child Health Workforce: A Snapshot of Current and Future Needs From Public Health WINS 2021.

To summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module. Responses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States. Demographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs. The MCH workforce predominantly self-identified as women (91.2%) and as White, non-Hispanic (55.2%). At least 70% of respondents reported MCH competencies as important in their daily work, but only 44% to 57% reported being proficient in those competencies. The MCH workforce in LHDs were less likely than those in state health departments to report being proficient in MCH competencies (adjusted prevalence rate ratio range: 0.83-0.92) or have growth and leadership development opportunities (adjusted prevalence rate ratio range 0.76-0.90). The MCH module highlights a need to further prioritize workforce development efforts for governmental public health staff, especially in LHDs. There is an ongoing need to meet public health professionals where they are and to tailor training models and workforce development plans to account for new and ongoing stressors faced by the workforce.

Capitalizing on Community Groups to Improve Women's Resilience to Maternal and Child Health Challenges: Protocol for a Human-Centered Design Study in Tanzania.

Maternal and neonatal deaths remain a major public health issue worldwide. Income Generation Associations (IGAs) could form a critical entry point to addressing poverty-related contributors. However, there have been limited practical interventions to leverage the power of IGAs in addressing the challenges associated with maternal care and childcare. This study aims to co-design an intervention package with women in IGAs to improve their readiness and resilience to address maternal and child health (MCH) challenges using a human-centered design approach. The study will use a qualitative descriptive design with purposefully selected women in IGAs and key MCH stakeholders in the Shinyanga and Arusha Regions of Tanzania. A 4-step adaptation of the human-centered design process will be used involving (1) mapping of IGAs and exploring their activities, level of women's engagement, and MCH challenges faced; (2) co-designing of the intervention package to address identified MCH challenges or needs considering the perceived acceptability, feasibility, and sustainability; (3) validation of the emerging intervention package through gathering insights of women in IGAs who did not take part in initial steps; and (4) refinement of the intervention package with MCH stakeholders based on the validation findings. The participants, procedures, and findings of each co-design step will be presented. More specifically, MCH challenges facing women in IGAs, a list of potential solutions proposed, and the emerging prototype will be presented. As of August 2024, we have completed the co-design of the intervention package and are preparing validation. The findings from the validation of the emerging prototype with a new group of women in IGAs and its refinement through multistakeholder engagement will be presented. A final co-designed intervention package with the potential to improve women's resilience and readiness to handle MCH challenges will be generated. The emerging intervention package will be discussed given relevant literature on the topic. We believe that subsequent testing and refinement of the package could form the basis for scaling up to broader settings and that the package could then be promoted as one of the key strategies in addressing MCH challenges facing women in low- and middle-income countries. DERR1-10.2196/54323.

Linking Maternal and Child Health Data to Enhance Public Health Surveillance in Indiana

Indiana faces significant challenges in maternal and infant health, ranking 45th worst in infant mortality with a rate of 6.5 deaths per 1,000 live-births, and 21st in stillbirths. Indiana further has the 3rd highest rate of maternal mortality with 44 deaths per 100,000 live-births. Despite these alarming statistics, comprehensive surveillance of maternal and infant health is absent, and data often remains fragmented across disparate information systems. In response, the Indiana University Fairbanks School of Public Health and Regenstrief Institute secured a cooperative agreement through the CDC's Pregnant People-Infant Linked Longitudinal Surveillance (PILLARS) program, collaborating with the Indiana Health Information Exchange, Indiana Department of Health, and Marion County Public Health Department. The initiative aims to enhance Indiana's infrastructure for surveillance of maternal and child health (MCH) using electronic health records (EHRs), public health, and administrative data. Key efforts have included development, validation, and application of linkage algorithms across records for mothers and children; integration of case data across data sources; design of routine surveillance reports; and design of longitudinal studies to examine determinants and outcomes in MCH populations. Using deterministic linkage algorithms, we have created over 800,000 mother-infant dyads; this number will expand with the implementation of probabilistic approaches. We also have developed a computational phenotype for identifying cases of pregnancy in the EHR even when not explicitly flagged in the EHR. Future efforts will build on this infrastructure to draw from additional public health data sources and/or expand surveillance efforts to include prioritized MCH outcomes.

Relationship Between Mother's Knowledge Level In Utilizing The Maternal and Child Health Book With The Nutritional Status Of Toddlers

The Maternal and Child Health (MCH) book is an initiative by the Indonesian Ministry of Health aimed at addressing child nutrition problems. However, at the Karang Mulia Health Center UPTD, the distribution and utilization of the MCH book among mothers of toddlers have not met the national target. The area has reported 164 cases of undernutrition and 74 cases of overnutrition in children under five. This study aims to determine the relationship between the level of maternal knowledge in utilizing the MCH book and the nutritional status of toddlers aged 12-59 months in the working area of the Karang Mulia Health Center UPTD. This correlational analytic research used a cross-sectional approach. The study population included 640 toddlers, with 90 selected samples of mothers who had the MCH book. Purposive sampling was employed, and data were analyzed using the Statistical Program for Social Science (SPSS) version 16.0, applying the chi-square test. The study found no significant relationship between maternal knowledge in using the MCH book and the nutritional status of toddlers. The p-values for the BB/A, PB/A or TB/A, and BB/PB or BB/TB indices were 0.345, 0.851, and 0.282, respectively, all greater than 0.05. There is no significant relationship between maternal knowledge of the MCH book and the nutritional status of toddlers aged 12-59 months in the Karang Mulia Health Center UPTD.

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.

Impact of integrated WASH and maternal and child health interventions on diarrhea disease prevalence in a resource-constrained setting in Kenya

BackgroundWater, sanitation and hygiene (WASH) and child health interventions are proven simple and cost-effective strategies for preventing diarrhea and minimizing excess mortality. Individually, they are able to prevent diarrhea though sub-optimally, and their effectiveness when combined may be higher. This study examined the effect of integrated WASH and maternal and child health (MCH) interventions on prevalence of diarrhea, in a resource-limited setting in Kenya.MethodsA controlled intervention was implemented in Narok County. The interventions included WASH interventions integrated with promotion of MCH. A structured questionnaire was used to collect data on targeted indicators before and after the interventions. Data were analyzed using descriptive statistics and Chi-square to establish the impact of the interventions.ResultsA total of 431and 424 households and 491 and 487 households in intervention and control sites, respectively, participated in the baseline and endline surveys. Following implementation of the interventions, prevalence of diarrhea decreased by 69.1% (95% CI: 49.6–87.1%) and 58.6% (95% CI: 26.6–82.4%) in the intervention and control site, respectively. Treatment of drinking water and animal husbandry practices were significantly associated with diarrhea post-interventions.ConclusionsIntegrating WASH interventions with other diarrhea control strategies and contextualizing them to meet site-specific needs may effectively prevent diarrhea.

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.

Linking Maternal and Child Health Data to Enhance Public Health Surveillance and Implement Sustainable Interventions.

Our initiative aims to enhance the public health informatics infrastructure for surveillance of maternal and child health (MCH) using data captured from electronic health records (EHRs), public health information systems, and administrative health data. Our work includes development, validation, and application of linkage algorithms across records for mothers and children; integration of data across myriad sources; design of routine surveillance reports; and design of longitudinal studies to examine determinants and outcomes in MCH populations. Our work is conducted in partnership with governmental public health agencies, health care providers, academic institutions, and community-based organizations. Future work will build on the enhanced informatics infrastructure to draw from additional public health data sources and/or expand surveillance efforts to include prioritized MCH outcomes. We will further translate knowledge gained from surveillance into action, working with our partners to improve and sustain better MCH equitably in our population.

Spatiotemporal trends and geographic disparities in spatial accessibility to maternal and child health services in Nanning, China: impact of two-child policies

BackgroundChina’s family planning policies have experienced stages of one-child policy, partial two-child policy, and universal two-child policy. However, the impact of these policy shifts on the spatial accessibility to maternal and child health (MCH) services for women and children remains uncertain. This study aimed to evaluate the spatiotemporal trends and geographic disparities in spatial accessibility to MCH services in the context of two-child polices.MethodsThis study was conducted in Nanning prefecture, China, from 2013 to 2019. Data on the transportation networks, MCH institutes, the annual number of newborns, and the annual number of pregnant women in Nanning prefecture were collected. Gaussian two-step floating catchment area (Ga2SFCA) method was employed to measure the spatial accessibility to MCH services at county, township, and village levels. Temporal trends in spatial accessibility were analyzed using Joinpoint regression analysis. Geographic disparities in spatial accessibility were identified using geographic information system (GIS) mapping techniques.ResultsOverall, the spatial accessibility to MCH services showed an upward trend from 2013 to 2019 at county, town, and village levels, with the average annual percent change (AAPC) being 5.04, 4.73, and 5.39, respectively. Specifically, the spatial accessibility experienced a slight downward trend during the period of partial two-child policy for both parents only children (i.e., 2013–2014), a slight upward trend during the period of partial two-child policy for either parent only child (i.e., 2014–2016) and the early stages of universal two-child policy (i.e., 2016–2018), and a large upward trend in the later stages of universal two-child policy (i.e., 2018–2019). Spatial accessibility to MCH services gradually decreased from central urban areas to surrounding rural areas. Regions with low spatial accessibility were predominantly located in remote rural areas.ConclusionWith the gradual opening of the two-child policies, the spatial accessibility to MCH services for women and children has generally improved. However, significant geographic disparities have persisted throughout the stages of the two-child policies. Comprehensive measures should be considered to improve equity in MCH services for women and children.