Maternal Child Care Research Articles

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.

Does maternity leave reform impact on the labour supply of the elderly? Evidence from a natural experiment in Vietnam

AbstractThe aging population has been rising rapidly in every country, slowing the labour force and causing lower per capita growth. Many policies incentivize working in old age as it can alleviate the challenges of the aging population. This study examines the impacts of the extended maternity leave reform in Vietnam on elderly labour market outcomes. As grandparents' childcare responsibility may be reduced by maternal childcare following the extended maternal leave, especially for elderly living with children smaller than 1 year old, the reform gives older adults or grandparents more flexibility to join the labour market. Using the difference‐in‐differences model, we find that older people in the treatment group are more likely to return to the labour market following the reform implementation. The effect is positive and most robust for the self‐employment group rather than waged employment and for males rather than females. Our study suggests that there is a need for a policy design to shift public finance into the healthcare and pension system.

Effect of mHealth based intervention on Maternal Knowledge and Practices of Child Care: A quasi-experimental study

Background:Child malnutrition contributes to elevated rates of mortality and morbidity, profoundly affecting child welfare. Maternal childcare knowledge and practices play a pivotal role in addressing this issue. Objective:This study aims to evaluate the impact of the mHealth App on maternal knowledge and practices in child care. Method:A randomized controlled trial was conducted in Yogyakarta, Indonesia, from May to August 2022. Mother-child pairs were assigned to either the intervention (n=100) or control (n=100) groups. Data on maternal knowledge and practices were collected at baseline, follow-up 1, and follow-up 2. Maternal knowledge was assessed using a structured questionnaire covering child growth and development, while feeding practices were evaluated using a yes-no checklist. The analysis of maternal knowledge and practices involved mean difference, t-test, and general estimating equations in STATA-15. Result:The results revealed a consistent increase in knowledge and practice scores between follow-ups 1 and 2. The mHealth application significantly enhanced maternal knowledge about child growth, development, and feeding at follow-up 2 compared to baseline, with improvements of 1.42 (CI 95% 1.34-1.89), 1.32 (CI 95% 1.22-1.72), and 1.45 (CI 95% 1.34-2.42), respectively. Additionally, growth and development monitoring practices increased by 0.80 (CI 95% 0.08-0.99) and 0.98 (CI 95% 0.21-0.99). Conclusion:The mHealth application significantly enhances maternal knowledge and practices related to child growth, development, and feeding. Key words: mHealth; maternal; knowledge; practices; children

Parents' Experiences with Postpartum Support Groups using Videoconferencing: Perceptions of Safety in the Virtual Space.

To explore new parents' experiences with web-based videoconferencing as a mechanism of offering postpartum virtual support groups. Virtual support sessions and individual interviews were conducted to explore participants' experiences with virtual postpartum groups. Thirty-seven parents participated in seven virtual support sessions and 19 participated in individual interviews. Participant narratives centered on perceptions of safety when engaging in virtual support groups. Tools within the virtual space (camera; mute) created a relational paradox which provided safeguards but also hindered the building of trust. Participants described negotiating the fear of harm and judgment within virtual spaces alongside feelings of security in connecting from the safety of their homes. The virtual environment provides a forum for new parents to access information and support and an avenue for engagement with maternal child nurses and care providers. Awareness of how parents perceive safety in the virtual environment is an important part of facilitating and structuring parent groups on videoconferencing platforms. Nurses should be familiar with videoconferencing technology and be able to guide parents. Experience facilitating virtual groups to ensure safety and security while providing needed support is a valuable nursing skill.

State-Level Safety Net Spending and Educational Gaps in Maternal Time with Children.

We examine how state spending on children is associated with the size of socioeconomic gaps in maternal childcare time. Persistent socioeconomic divides in the amount and nature of parental time with children have prompted consideration of the factors that mitigate inequalities within the family. At both the national and local levels, the welfare state plays an important role in structuring opportunities for children. Thus it is important to understand the institutional factors that shape parental behavior. Yet, little research examines how the social safety net is associated with family processes. Using rich data on maternal time with children from the American Time Use Surveys (2003-2016), combined with longitudinal data on public spending in states on major programs affecting children and families, we examine how state spending on children is associated with the size of socioeconomic gaps in maternal childcare time. We found that higher levels of state spending were associated with significant increases in childcare time among low-educated mothers at both the extensive and intensive margin, increasing the likelihood of spending any minutes on primary childcare in a typical day, as well as increasing the number of minutes spent on childcare. In contrast, we observed no variation in the behavior of highly-educated mothers as state spending changes. State-level investments could meaningfully narrow socioeconomic gaps in maternal time with children.

Method Validation Study for SARS-CoV-2 Viral RNA Detection in Cervical, Rectal, Amniotic Fluid, Placental, Umbilical Cord Blood, and Breastmilk Specimens in a Cohort of Unvaccinated Women in Manila, Philippines.

To validate a method in detecting SARS-CoV-2 via RT-qPCR in pregnant and non-pregnant samples other than nasopharyngeal swabs and/or oropharyngeal swabs such as cervical, rectal, amniotic fluid, placental, umbilical cord blood, and breastmilk. We performed a validation experiment using MGI easy extraction kits and BGI PCR kits on non-conventional specimens, including cervical, rectal, amniotic fluid, placental, umbilical cord blood, and breastmilk to detect and confirm the presence of SARS-CoV-2. In addition, we tested the validated method on 572 purposively sampled field-collected non-conventional specimens from a cohort of 109 unvaccinated pregnant and 47 unvaccinated non-pregnant women to assess which candidate non-conventional maternal- and fetal-associated specimens may contribute to maternal-fetal viral vertical transmission. Positive detection of SARS-CoV-2 viral RNA in non-conventional specimens was demonstrated and verified. Of the 572 non-conventional samples tested, 1.8% (10/572) were positively validated by RT-qPCR for SARS-CoV-2 in the maternal-associated specimens particularly the rectal (5), placental (1), and cervical (4) swabs among six pregnant and four non-pregnant individuals. In contrast, no SARS-CoV-2 viral RNA was detected in fetal-associated specimens. The results of the validation study may serve as an additional diagnostic screening layer to support maternal-child care. Furthermore, viral detection in these non-conventional maternal specimens may also be utilized to provide guidance in the clinical management of neonates, and pregnant women during delivery.

UNDER THE SAME ROOF: GRANDPARENTAL CO-RESIDENCE AND CO-PARENTING PATTERNS IN MODERN CHINESE FAMILIES

Abstract This study aimed to examine the role of grandparental co-residence in shaping coparenting patterns in the Chinese family context. Using a sample of 5,795 children (Mean age = 6.74 years; SD = 3.82) from the China Family Panel Studies 2012-2018, we offered a novel typology of six coparenting patterns based on daytime and nighttime childcare information: a) grandparental care only (15.4%); b) grandparent-parent coparenting (10.9%); c) parental care only (44.5%); d) grandparent-private coparenting (4.2%); e) parent-private coparenting (16%); and f) private care only (e.g., paid nanny, nursery schools/kindergartens, and others, 9.1%). Fixed-effects multinominal logistic regression was applied to investigate the effects of grandparental co-residence on daytime and nighttime childcare, and on daily coparenting patterns over time, controlling for a set of child and parental characteristics and family conditions. Grandmother co-residence contributed to both daytime and nighttime grandparenting, while grandfather co-residence increased the likelihood of grandparenting and private care during the daytime. In terms of daily coparenting, grandmother co-residence was associated with increased probability of grandparent-parent coparenting as well as grandparent-private coparenting, while grandfather co-residence merely increased the likelihood of parent-private coparenting. It also found that child’s experience of separation with mother during the last year and mother’s employment were two key determinants of coparenting behavior in Chinese families. Findings suggest that co-residing grandparents, particularly grandmothers, may function as a kind of supplementary care resource in response to the lack of maternal childcare resulted from migration and labor force participation.

Sedentarization and maternal childcare networks: role of risk, gender and demography.

Women cooperate over multiple domains and while research from western contexts portrays women's networks as limited in size and breadth, women receive help, particularly with childcare, from a diverse range of individuals (allomothers). Nonetheless, little exploration has occurred into why we see such diversity. Wide maternal childcare networks may be a consequence of a lack of resource accumulation in mobile hunter-gatherers-where instead households rely on risk-pooling in informal insurance networks. By contrast, when households settle and accumulate resources, they are able to retain risk by absorbing losses. Thus, the size and composition of mothers' childcare networks may depend on risk-buffering, as captured by mobile and settled households in the Agta, a Philippine foraging population with diverse lifestyles. Across 78 children, we find that childcare from grandmothers and sisters was higher in settled camps, while childcare from male kin was lower, offering little support for risk-buffering. Nonetheless, girls' workloads were increased in settled camps while grandmothers had fewer dependent children, increasing their availability. These results point to gender-specific changes associated with shifting demographics as camps become larger and more settled. Evidently, women's social networks, rather than being constrained by biology, are responsive to the changing socioecological context. This article is part of the theme issue 'Cooperation among women: evolutionary and cross-cultural perspectives'.

The Economic Well-Being of Nonresident Fathers and Custodial Mothers Revisited: The Role of Paternal Childcare

Based on panel data from the German Socio-Economic Panel (SOEP) for the years 1998 to 2018, we investigate the association between paternal childcare and parental economic well-being after separation in Germany. Referring to the post-separation year, we explore a sample of 176 separated couples with resident mothers and nonresident fathers, where fathers differ in their childcare involvement during weekdays. We propose equivalized annual net household income after exchange of alimony and child maintenance payments among the ex-partners as a novel indicator of parental economic well-being. Our study reveals the importance of considering both paid and received alimony, and child maintenance payments in analyzing post-separation economic well-being. Fathers’ childcare engagement during weekdays is not significantly associated with maternal post-separation income. Resident mothers take up the major or even full childcare burden. On the other hand, fathers with non-zero childcare hours manage to combine some paternal engagement with intensified employment. Mothers, however, fail to gain substantial ground on the labor market, which is unlikely to be due to differences in human capital, but rather due to persistently high maternal childcare involvement. We conclude that neither high levels of own resources, nor receiving help with childcare during the week shield resident mothers from economic deterioration after separation.

Rapid Deployment of a Mobile Medical Clinic During the COVID-19 Pandemic: Assessment of Dyadic Maternal-Child Care.

ObjectivesTo describe demographic characteristics and health-related social needs of families who accessed maternal-infant care through a mobile medical clinic (MMC) during the COVID-19 pandemic and to explore feasibility, acceptability, perceived benefits, and barriers to care.MethodsIn this mixed-methods observational study, chart reviews, telephone surveys, and qualitative interviews in English and Spanish were conducted with caregivers who accessed the MMC between April and November 2020. Qualitative interviews were analyzed with the constant comparative method alongside descriptive chart and survey data analyses.ResultsOf 139 caregiver-infant dyads contacted, 68 (48.9%) completed the survey; 27 also completed the qualitative interview. The survey participants did not differ from the larger sample; most (86.7%) were people of color (52.9% identified as Latino and 33.8% as Black). Health-related social needs were high, including food insecurity (52.9%), diaper insecurity (44.1%), and anxiety (32%). Four women (6.1%) were diagnosed with hypertension requiring urgent evaluation. Nearly all (98.5%) reported being very satisfied with the services. Major themes from qualitative interviews included (1) perceived patient- and family-centered care, (2) perceived safety, and (3) perceived benefits of dyadic mother-infant care.Conclusions for PracticeIn this assessment of caregivers who accessed the MMC—a rapidly-developed COVID-19 pandemic response—insights from caregivers, predominantly people of color, provided considerations for future postpartum/postnatal service delivery. Perceptions that the MMC addressed health-related social needs and barriers to traditional office-based visits and the identification of maternal hypertension requiring urgent intervention suggest that innovative models for postpartum mother-infant care may have long-lasting benefits.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10995-022-03483-6.

It Takes a Village: Childcare and Women's Paid Employment in India

AbstractWhy is maternal employment higher in rural than in urban India? Among the relevant supply‐side factors, previous research has emphasized that rural work is more compatible with childcare. Results from the Indian Time Use Survey of 2019 show that hours of active maternal childcare are only slightly lower in rural areas, but the temporal and spatial flexibility of paid employment is much greater, making it easier for mothers to accommodate childcare responsibilities. In particular, rural women's work affords them greater access to flexible hours and the ability to work in close proximity to the home. Consequently, the negative effects of motherhood on employment are significantly greater for urban women than for rural women. This finding cannot be explained by rural–urban differences in household structure or resource constraints. These results redirect attention from average levels of time use towards a more nuanced analysis of sequence, timing, and opportunities for joint production or multitasking.

High Depressive Symptoms, Low Family Functioning, and Low Self-Efficacy in Mothers of Children With Autism Spectrum Disorder Compared to Two Control Groups.

Parents of children with autism spectrum disorder (ASD) face unique challenges in raising their children, and they are at higher risk for depression compared to parents of children with typical development (TD) and other disabilities. (1) To compare prevalence of depressive symptoms among mothers of children with ASD (n = 101), Down syndrome (DS, n = 101), and TD (n = 43) and (2) to describe the relationships among depression, self-efficacy, and family functioning, and describe the mediating role of maternal child care self-efficacy between depressive symptoms and child behavior. In this cross-sectional study, mothers completed the Social Communication Questionnaire, Aberrant Behavior Checklist, Patient Health Questionnaire-9 (PHQ-9), Family Assessment Device General Functioning Scale, and Maternal Self-Efficacy Scale. Mothers of children with ASD had significantly higher mean PHQ-9 scores (p < .001), higher proportion of positive depression screening (p < .001), and lower family functioning (p < .001). Better family functioning is associated with less depression, better self-efficacy, and less severe ASD symptoms and behaviors. Self-efficacy mediated the relationship between depression and child ASD symptoms, and problematic behavior. The rates of reported history of depression and low family functioning in mothers of children with ASD are twice the rate in mothers of children with DS and TD. Maternal child care self-efficacy is protective against maternal depression, even in the presence of severe child problematic behaviors and ASD symptoms. Interventions that increase child care self-efficacy and family functioning may be helpful in addressing depression in mothers of children with ASD.

Impact of COVID-19 on maternal health and child care behavior: Evidence from a quasi-experimental study of vulnerable communities in Boa Vista, Brazil

Impact of COVID-19 on maternal health and child care behavior: Evidence from a quasi-experimental study of vulnerable communities in Boa Vista, Brazil

Impact of COVID-19 on maternal health and child care behavior: Evidence from a quasi-experimental study of vulnerable communities in Boa Vista, Brazil

BackgroundCOVID-19 related distress has been shown to have negative associations with family well-being. ObjectivesTo determine the immediate impact of acute COVID-19 infection on maternal well-being and parenting practices among Brazilian families. Participants and settingWe studied 2′579 mothers (29′913 observations) of young children from vulnerable neighborhoods in Boa Vista, Brazil over 12 months. MethodsWe monitored family health and caregiving behavior including the incidence of COVID-19 infections in the surveyed households through bi-weekly phone interviews over 50 weeks, from June 2020 to May 2021. Primary outcomes were home-based child stimulation, positive parenting behavior, and parenting stress. We used fixed effects panel regressions to estimate the impact of household COVID-19 infections on parenting outcomes. ResultsOver the study period, 441 participants (17.1%; 831 (3.0%) observations) reported at least 1 positive COVID-19 infection in their household. Household COVID-19 infections significantly reduced home-based stimulation by 0.10 SDs (95%CI: −0.18, −0.01), positive parenting behaviors by 0.14 SDs (−0.21, −0.01), and increased parenting stress by 0.07 SDs (0.02, 0.12). The impact on home-based stimulation was most pronounced when the mother herself had a COVID-19 infection (−0.16; −0.29, −0.04). Parenting stress responded most strongly to mother or child COVID-19 infections. Effects were relatively short-lived, only children's infections' on parental stress was still detectable 2 weeks after initial infection. ConclusionOur findings suggest that COVID-19 infections cause substantial disruptions in children's home environments - additional short-term support for families with acute infections could attenuate the negative impact on children's home environment during the pandemic.

Oral Microbiota of Amazonian Kichwa Infants From Equador During the First Six Months of Life

BackgroundFor public health policy, this study aimed to identify the oral microbiota in babies of the Amazonian Kichwa (AK) population of Ecuador born vaginally during the first six months of life.MethodThe study was descriptive, observational, cross‐sectional, where the bacterial communities of infants were analyzed. Twenty‐five infants self‐identified as AK were recruited from 2 rural areas (Ñucanchi‐Llacta and Pano) and one urban area (center of Tena) of Ecuador. Saliva samples were collected from the infants using the self‐collection kit. DNA was extracted from salivary samples, bacterial amplicons (16S) were generated and sequenced using Nanopore MinION, and the sequences were pre‐processed and data analyzed using EPI2ME.ResultsHigh bacterial diversity was observed in infants' saliva [2191 operational taxonomic units with 1% divergence]. Firmicutes and Proteobacteria were the predominant bacterial phyla present in all samples. A total of 10 bacterial genera were present in our data set. The predominant genera in infant saliva were Streptococcus, Staphylococcus, Bacillus, Gemella, and Veillonella.Conclusionour data show a rich bacterial community in the baby's oral cavity. The oral microbiota of the infants was relatively stable during the period studied and was very similar between them. Such similarity may result from maternal child care habits (e.g., kissing on the mouth). Further research is required to characterize the development of the oral microbiota early in life and identify environmental factors that affect colonization and the risk of oral and gastrointestinal diseases.

Utilization of Maternal Health Services: A Case Study of South Sudan Juba Teaching Hospital

Introduction: Maternal health service (MHS) is a set of services related to maternity health care. These health services cause a serious concern worldwide. Furthermore, MHS incorporates antenatal care, delivery care and postnatal health service. The aim of this study was to assess Mother-to-Child utilization for MHS at Juba Teaching Hospital (JTH) South Sudan. Methods: A cross-sectional research study was done among 207 women of reproductive age at the time of visits to routine immunization services for receiving free under-five immunization. The interviewers gathered data using the structured questionnaire. The data were analyzed using SPSS Statistics v20. The frequency tables were for describing data and chi-square test and logistic regression were used to determine whether there was statistical association of sociodemographic factors with MHS. Results: Of 207 mothers, 188 (91%) utilized the maternal health. Nearly 20% did not give birth at health facility. Furthermore, there was a significant association of education attainment with place of delivery [OR at 95%CI = 3.06 (1.40 – 6.71), p-value = 0.005] Conclusion: Maternal healthcare services were highly utilized as compared to others in the regions. Moreover, the Level of formal education found to be associated with effective maternity care. An estimated of 20% from women reported delivered at non-health facilities. Therefore, the study recommended specific attention to non-compliance mothers through reinforcement of active health education on safe reproductive and maternal childcare.

Tots and Teens: How Does Child’s Age Influence Maternal Labor Supply and Child Care Response to the Earned Income Tax Credit?

Building on earlier work that shows that the Earned Income Tax Credit (EITC) has a substantial positive effect on maternal labor supply, we show that labor supply effects are concentrated among mot...

Children are important too: juvenile playgroups and maternal childcare in a foraging population, the Agta.

Non-maternal carers (allomothers) are hypothesized to lighten the mother's workload, allowing for the specialized human life history including relatively short interbirth intervals and multiple dependent offspring. Here, using in-depth observational data on childcare provided to 78 Agta children (a foraging population in the northern Philippines; aged 0-6 years), we explore whether allomaternal childcare substitutes and decreases maternal childcare. We found that allomother caregiving was associated with reduced maternal childcare, but the substitutive effect varied depending on the source and type of care. Children-only playgroups consistently predicted a decrease in maternal childcare. While grandmothers were rarely available, their presence was negatively associated with maternal presence and childcare, and grandmothers performed similar childcare activities to mothers. These results underscore the importance of allomothering in reducing maternal childcare in the Agta. Our findings suggest that flexibility in childcare sources, including children-only playgroups, may have been the key to human life-history evolution. Overall, our results reinforce the necessity of a broad conceptualization of social support in human childcare. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Knowledge of and Attitudes Toward Perinatal Home Visiting in Women with High-Risk Pregnancies.

Published research indicates that some perinatal home visiting programs are highly effective. However, there is a dearth of information regarding how these services apply to women experiencing a high-risk pregnancy. The aim of this study was to determine the potential acceptability of home visiting services within this vulnerable population and identify what services women want. Four focus groups (N = 32) were conducted with a population of low-income, pregnant individuals in medically underserved central Georgia (United States). Participants were evaluated based on their current exposure to home visiting, receptiveness to home visiting, and reasons for apprehension regarding home visiting. The results of this study were mixed, with women expressing both interest in and reluctance about home visiting programs. Themes of distrust and fear of judgment or persecution existed. Women also varied with regard to what home visiting services they would like offered. Those discussed included assistance with maternal or infant medical needs, maternal function tasks, household tasks, and child care. Home visiting programs can be effective for improving maternal and child health outcomes. However, not all home visiting programs effectively reach their target population. More research is needed to determine what women who have high-risk conditions during pregnancy want help with and how to increase receptiveness. The results of this study could be informative to health care providers who treat persons with high-risk conditions in identifying adjunctive services for those in need of additional support.

Mother-child separation among women living with HIV and their children in the first four years postpartum in South Africa.

Mother-child pairs may separate during early life, yet the health impacts thereof are unclear. We explored the patterns and impact of separation among women living with HIV (WLHIV) and their children in South Africa. WLHIV who had initiated antiretroviral therapy (ART) during pregnancy received HIV viral load (VL) testing and completed a timeline questionnaire of mother-child separation since delivery at 3-5years post-partum. Health care usage was abstracted from routine medical records. We examined associations between separation and (a) maternal health outcomes (engagement in HIV care and HIV viral suppression, [VS]) and (b) child health outcomes (post-breastfeeding HIV testing and immunisation completion), using logistic regression. Of 346 mother-child pairs (median maternal age at antenatal ART initiation, 28years), 24% were ever separated (median time to first separation 20months, interquartile range [IQR] 9, 31). Most separated children were living with their grandmothers (65/83, 78%). Mothers who ever separated were younger, and more likely to be employed, and to reside in informal housing than those who never separated. Any separation reduced the odds of VS≤50 copies/mL at four years post-partum (odds ratio 0.57; 95% CI 0.34-0.93); associations were similar for VL≤1000 copies/mL and maternal engagement in care. No association was found between separation and child confirmatory HIV testing or immunisation completion. In this setting, mother-child separation is common in the first four years of life and appears associated with suboptimal maternal outcomes. Further research is required to understand the drivers and implications of mother-child separation.