Maternal Child Health Research Articles

Women’s Perspectives on the Role of Community Health Workers in Planning Family-Community Based Study in a Rural, Remote Region

Background: Community health workers (CHWs) are believed to play pivotal role in enhancing rural health, including guidance, assistance to couples in planning family. In India, Accredited Social Health Activists (ASHAs), special cadre of CHWs, program was introduced to bolster maternal child health, though their roles got extended to broader health initiatives. However, ASHAs’ contribution to planning family does not seem to be to their full potential. Need to harness this special cadre of CHWs to promote planned families in rural communities is evident. Methodology: Community based study was conducted over two years in a remote hilly region, in 140 villages with health care facility, (Study Center) in one of them. Study sample comprised of 4500 women aged 20 to 49 Yrs. from diverse educational backgrounds, professions, economic status, and parity. Data was collected through interviews using predesigned structured questionnaire. Results: Study revealed varied perceptions of CHWs roles in planning family among rural tribal women. Most respondents said that CWHs need to motivate health facility births and bring children to immunization clinics, 56%. However, their role in encouraging planning family was less acknowledged 12to 33%. Sterilization was most widely recognized method of planned family, where CWHs were expected to be facilitators, upto 75% Age, education. economic status, jobs, number of child births affected their perceptions and expectations. However most Women did expect CHWs to arrange family planning programs. Conclusion: Present study underscores need for more robust awareness amongst communities about role of CHWs in promoting planned families in rural tribal communities. Strengthening ASHAs involvement in comprehensive fam

Assessment of Nutrition Knowledge in Pregnant Women of Lahore: An Interview Based Study at Major Hospitals of Lahore During Prenatal Visits

Background: The intentions of the following study were to assess women knowledge regarding dietary practices during pregnancy. The study expresses the nutrition related knowledge of pregnant females and its correlation with associated factors of these women. The study also shows the sources of dietary guidance for these women during pregnancy. Method: The study members visited different hospitals of Lahore, interviewed pregnant women and filled questionnaire regarding their knowledge of dietary practices during pregnancy. The statistical tests applied were frequency, percentage, mean, standard deviation, Regression, Kolmogorov-Smirnov test and Spearman’s correlation. Results: 364 questionnaires were finished and analysed using software. Pregnancy related nutrition knowledge was positively correlated with level of education (rs= 0.46, p<0.05) and monthly income (rs=0.27, p<0.05). Only 4.3% of women attained pregnancy scores related to nutrition knowledge above 50%. They mostly get information from their mothers and doctors. Majority of the women recommended increasing intake of supplies from all food groups and fluid. The result indicated that nutritional behaviour of women was characterized by many ill practices. Conclusion: Women interviewed for this research had restricted nutrition knowledge and proper nutrition guidelines were not provided to pregnant women at health care facilities. Women followed insufficient food routines in pregnancies that were mostly directed by mothers of women. The diet of a female during pregnancy has a direct effect on fitness outcomes of mother and child. Many women lacked this information and thus ended with micro-nutrient deficiencies. So there is an alarming need to train women to enhance their knowledge for appropriate dietary patterns to avoid severe outcomes in the form of compromised maternal-child health

Promoting Institutionalization of Research-Evidence Use in Maternal, Newborn and Child-Health Policymaking in Nigeria

The implementation of policies informed by research evidence in maternal newborn and child health (MNCH) is known to improve health outcomes. In this study we describe the process of the establishment of MNCH Research Days Event as a mechanism for the promotion of institutionalization of evidence-to-policy-to practice in MNCH in Nigeria. We also describe the current status of research evidence use in policymaking, level of policymakers-researchers interaction as well as identify the individual and organizational roles to promote evidence-informed policymaking in MNCH in Nigeria. The study was a cross-sectional survey carried out during a 3-day National MNCH stakeholders’ engagement meeting on Nigeria Research Days for MNCH, as part of the Implementation of Moving MNCH Evidence into Policy (MEP) Project. Data on the stakeholders’ perception regarding the study objective was collected using a semi-structured questionnaire administered in person. A total of 51 participants completed the questionnaire. Result showed low mean ratings (MNRs) for both research evidence use in MNCH policymaking (ranging from 2.23-3.14 in a 5-point scale) and policymakers-researchers interaction (2.98-3.43). Creating research capacity development platforms for individuals and institutions involved in policymaking (MNR 4.69) were among strategies that can enhance the evidence-to-policy process in MNCH. Sustainable interaction between policymakers and researchers can be achieved through the institutionalization of mechanisms such as ‘Research Day Event’ that will provide platform to consider issues around evidence-to-policy-to-practice. Urgent sustainable capacity development among stakeholders in the MNCH sector is highly recommended.

Relationship of sociodemographic factors and low birth weight in toddlers

Abstract Objective This study analyzes the relationship between sociodemographic factors and low birth weight (LBW) in toddlers. Methods The research design uses a correlational method. The population is 303 mothers with toddlers aged 12–60 months in Lojejer Wuluhan Jember Village, East Java, Indonesia. The cluster sampling took 172 samples in total. The sociodemographic variables measured included the father’s and the mother’s age, the father’s and mother’s education, family income, the father’s occupation, the mother’s occupation, and the child’s gender. Data collection techniques used questionnaires and document studies in the Maternal Child Health (MCH) handbook. Data were analyzed using logistic regression. Results The results showed that the variable age of the father and mother ≥20 years was a protective factor for the incidence of LBW. Family income <IDR 3,000,000 per month, fathers with farm workers and fishermen as occupation, male sex, and low father’s education were predictor factors for LBW. Conclusions This study concluded that the variable sociodemographic factors related to LBW in toddlers in Lojejer Wuluhan Village, Jember district, East Java Province, Indonesia. Therefore, the government needs to establish stricter policies in terms of maturing the age of marriage to reduce the incidence of LBW.

Virtual simulation-based educational training enhances nursing students’ preparedness to conduct perinatal intimate partner violence screenings

Intimate partner violence (IPV) is an unfortunately prevalent experience during the perinatal period and significantly impacts both maternal and fetal health. Ensuring nursing students are adequately prepared to conduct IPV screening and respond to patients’ disclosure of IPV upon graduation is essential to promoting enhanced maternal-child health outcomes. Seventy-eight undergraduate nursing students in their third semester of nursing school participated in the simulated scenario and provided complete data. Students engaged in a virtual simulation-based educational training (SBET) and completed a preposttest assessing their knowledge, skills, and attitudes related to IPV screening and response. Students’ knowledge and skills significantly improved as a result of the virtual SBET (t = −5.99, p < .001, d = −0.67 and t = −4.33, p < .001, d = −0.48, respectively). A relatively low-cost, low-burden virtual SBET can significantly improve nursing students’ perceived knowledge and skills in identifying and caring for pregnant patients experiencing IPV.

Association between maternal and child health care and neonatal death in Angola: a secondary analysis of Angola Demographic Health Survey 2015–16

BackgroundNeonatal mortality has decreased in Angola; however, it remains high. Quality maternal and child health (MCH) care is key to improving neonatal survival. In Angola, however, the association between neonatal mortality and MCH care has not yet been investigated. Therefore, this study aimed to identify the association between neonatal mortality and MCH services in Angola.MethodsWe used the Angola Demographic Health Survey 2015–16, which is the latest nationally representative dataset of Angola. The associations between early/late neonatal death and MCH care utilization were identified by a multivariable logistic regression analysis, adjusted by the sex of the child, type of residence, wealth index, caesarian section, size of the child at birth and delivery assisted by skilled birth attendant. The individual sample weight, sample strata for sampling errors/design, and cluster number were incorporated in a descriptive and logistic regression analysis to account for the unequal probability sampling in different strata.ResultsThe early and late neonatal mortality rates were 22 and 2 per 1000 live births, respectively. We found that having none, one, two or three tetanus injections before the last pregnancy compared to five or more injections, and no postnatal health check for children before discharge were associated with the occurrence of late neonatal death. During the first 2 days after childbirth, no observation of breastfeeding, no counseling on breastfeeding, no counseling on newborn danger signs, no measurement of child body temperature, and no examination of the cord as well as not checking child health before discharge were associated with early neonatal death.ConclusionsDoses of maternal tetanus vaccination and postnatal child health check before discharge were modifiable factors associated to late neonatal death. Further studies to improve MCH care coverage are needed.

Evaluation of family planning services: A district example in Istanbul

Aim: The aim of family planning services is to provide individuals with the information and support they need to make informed, safe and healthy reproductive decisions. Furthermore, it provides women with the option to space out their pregnancies and offers protection from unplanned pregnancies. It is thought that family planning services could play a role in protecting maternal and child health, as well as improving the overall health level of society. The objective of this study was to gain insight into the family planning services provided to applicants at the Maternal Child Health and Family Planning Centre in a district of XXXXX between 2018 and 2020. Methods: The study population comprised individuals who had applied to the XXXXX AÇSAP Centre between 2018 and 2020. We are grateful to have had the opportunity to retrospectively analyse the data of 1,444 individuals. Results: The study group had an average age of 33.95 years, with 45.2% of participants having completed primary education or below. It may be of interest to note that among the women who applied, 46.2% were in the age group of 35 years and above. It is worth noting that a significant proportion of the women who applied, namely 75.9%, were seeking to use a family planning method for the first time. It would seem that the age groups 29-34 and 35-40 saw the highest number of applications. It is notable that a relatively high proportion of women (49.4%) had not used any family planning method in the previous three months, compared to those who had employed other methods. It would seem that the intrauterine device is the most preferred family planning method across all age groups and education levels (p

Maternal intimate partner violence and child health outcomes

Maternal intimate partner violence and child health outcomes

Health Implications of Black Identity Among Latinos: A Call for Afro-Latina Representation in Maternal Child Health Research.

Health Implications of Black Identity Among Latinos: A Call for Afro-Latina Representation in Maternal Child Health Research.

Collaboration to Reduce Sudden Unexpected Infant Death With Child Fatality Review and Outreach.

Sudden unexpected infant death (SUID) is the leading cause of postneonatal infant mortality in the United States, with disproportionately high rates in Baltimore City and Baltimore County in Maryland. This Advocacy Case Study describes the collaboration between the City and County Child Fatality Review teams to decrease infant mortality. B'more for Healthy Babies, formed in 2009 by the Bureau of Maternal Child Health in Baltimore City with the goal of reducing infant mortality through policy change, service improvements, community mobilization, and behavior change has had a sustained effort to respond to SUID. Recognizing that infants born in Baltimore City often reside in Baltimore County (and vice versa), collaboration with Baltimore County has been essential to increasing B'more for Healthy Babies' scope, reach, and effectiveness. Public health messaging campaigns, creation, and dissemination of a "SLEEP SAFE" testimonial video, and Safe Sleep Summits have involved caregivers, healthcare providers, and community partners. Outcomes of this ongoing collaboration demonstrate a decrease in sleep-related infant mortality rates. Our findings also highlight the need for continued, real time monitoring of sleep-related infant mortality trends with a coordinated, multidisciplinary, and crossjurisdictional response. This initiative can serve as a model of cross-sector communication that can be replicated in other similar geographic locations to further reduce SUID.

Education of the "SusCatinTing" application on changes in knowledge, attitudes, and behavior of brides-to-be.

The "SusCatinTing" application is a digital health intervention designed to enhance the knowledge, attitudes, and practices (KAP) of brides-to-be regarding stunting prevention during the critical first 1000 days of life. This study aimed to evaluate the effectiveness of this application in improving stunting prevention efforts among brides-to-be in Bengkulu Province, Indonesia. The application provides educational content on healthy pregnancy, maternal nutrition, and stunting prevention strategies, incorporating both text and audio explanations to ensure accessibility for illiterate and visually impaired users. A quantitative research design was employed, utilizing a single-group pretest-posttest approach involving 50 pairs of brides-to-be with internet-connected Android smartphones. Data collection was conducted through structured questionnaires administered by trained enumerators, focusing on KAP related to stunting prevention. The results indicated a significant improvement in KAP scores post-intervention (knowledge score increase: 42.59, p < 0.001). The application's unique features, including interactive quizzes and a certification process for marriage registration at the Office of Religious Affairs, contributed to its effectiveness. The study concludes that the "SusCatinTing" application is a promising tool for enhancing health education and promoting preventive behaviors among brides-to-be. Further research is recommended to explore the long-term impact of such digital interventions on stunting rates and maternal-child health outcomes.

Mental Health in Early Pregnancy and Spontaneous Abortion Risk: A Prospective Cohort Study.

This study aims to explore the relationship between maternal mental health during early pregnancy and the risk of spontaneous abortion (SA), especially in the context of the Coronavirus disease 2019 pandemic. We conducted a prospective cohort study involving 4088 pregnant women at a maternal-child health hospital in China from January to December 2022. During the first trimester, we assessed depression, anxiety, and stress levels using the Depression, Anxiety, and Stress Scale (DASS-21). Pregnancy outcomes were monitored, and univariate and multiple logistic analyses were performed to identify the risk factors. These factors were then used to develop a nomogram model. Significant differences were found in maternal age, number of embryonic arrests, history of abortion, assisted reproduction, and environmental exposure between the SA group (n = 302) and the normal pregnancy group (n = 3786). After adjusting for potential confounders, higher scores on the DASS-21 subscales were independently associated with an increased risk of SA: Depression (OR [Odds Ratio] = 1.54, 95% CI [Confidence Interval]: 1.39-1.71, P < .001), Anxiety (OR = 1.61, 95% CI: 1.44-1.80, P < .001), and Stress (OR = 1.69, 95% CI: 1.31-2.20, P < .001). The model achieved a concordance index of 0.87 (95% CI: 0.86-0.90) and demonstrated a well-fitted calibration curve, indicating its good clinical applicability. Our findings indicate that mental health conditions are significantly associated with an increased risk of SA. The nomogram model also demonstrated strong predictive accuracy, indicating its potential usefulness in clinical settings.

Vicki L. Clifton: Stress, sex, and the placenta: its role in fetal and child development

Professor Vicki Clifton, PhD, GAICD, Dip Manag, Dip Counselling, FRSM, is a Mater Research Institute-University of Queensland Amplify Fellow specializing in obstetrics research through clinical trials and basic biology. With 327 publications, h-Index: 61, and over 14,000 citations, her research focuses on stress and maternal asthma during pregnancy, examining their effects on maternal health, placental function, fetal growth, and child health. She is notably recognized for her work on sex-specific placental function and stress responses influencing fetal growth and pregnancy outcomes. Professor Clifton has led her institution's asthma and pregnancy research program, establishing multi-disciplinary, end-user-engaged research programs in Australia and overseas. Her innovative research has advanced our understanding of factors affecting asthma during pregnancy, leading to new models of care and improved fetal outcomes. Her work has influenced national and international asthma management guidelines, identified sex-specific mechanisms affecting maternal-fetal health, and expanded the frontiers of existing knowledge on fetal-neonatal physiology. Through preclinical studies and clinical partnerships, she has rapidly translated findings into practice guidelines and consumer information. She currently leads the Queensland Family Cohort study, a state-wide longitudinal study linking parental and child health outcomes to biological mechanisms. A Fellow of the Royal Society of Medicine, she pioneered women's leadership as the first female President of the Endocrine Society of Australia and the first female Editor of Placenta (Elsevier). As an NHMRC Research Fellow (2000–2023), she has secured over $25 million in category 1 grants. We are privileged to have Professor Clifton share her personal and professional insights with our readers in this Genomic Press Interview.

Association between maternal perinatal stress and depression and infant DNA methylation in the first year of life

Maternal stress and depression during pregnancy and the first year of the infant’s life affect a large percentage of mothers. Maternal stress and depression have been associated with adverse fetal and childhood outcomes as well as differential child DNA methylation (DNAm). However, the biological mechanisms connecting maternal stress and depression to poor health outcomes in children are still largely unknown. Here we aim to determine whether prenatal stress and depression are associated with differences in cord blood mononuclear cell DNAm (CBMC-DNAm) in newborns (n = 119) and whether postnatal stress and depression are associated with differences in peripheral blood mononuclear cell DNAm (PBMC-DNAm) in children of 12 months of age (n = 113) from the Canadian Healthy Infant Longitudinal Development (CHILD) cohort. Stress was measured using the 10-item Perceived Stress Scale (PSS) and depression was measured using the 20-item Center for Epidemiologic Studies Depression Questionnaire (CESD). Both stress and depression were measured longitudinally at 18 weeks and 36 weeks of pregnancy and six months and 12 months postpartum. We conducted epigenome-wide association studies (EWAS) using robust linear regression followed by a sensitivity analysis in which we bias-adjusted for inflation and unmeasured confounding using the bacon and cate methods. To quantify the cumulative effect of maternal stress and depression, we created composite prenatal and postnatal adversity scores. We identified a significant association between prenatal stress and differential CBMC-DNAm at 8 CpG sites and between prenatal depression and differential CBMC-DNAm at 2 CpG sites. Additionally, we identified a significant association between postnatal stress and differential PBMC-DNAm at 8 CpG sites and between postnatal depression and differential PBMC-DNAm at 11 CpG sites. Using our composite scores, we further identified 2 CpG sites significantly associated with prenatal adversity and 7 CpG sites significantly associated with postnatal adversity. Several of the associated genes, including PLAGL1, HYMAI, BRD2, and ERC2 have been implicated in adverse fetal outcomes and neuropsychiatric disorders. These data further support the finding that differential DNAm may play a role in the relationship between maternal mental health and child health.

Phenome-wide association study in 25,639 pregnant Chinese women reveals loci associated with maternal comorbidities and child health

Phenome-wide association studies (PheWAS) have been less focused on maternal diseases and maternal-newborn comorbidities, especially in the Chinese population. To enhance our understanding of the genetic basis of these related diseases, we conducted a PheWAS on 25,639 pregnant women and 14,151 newborns in the Chinese Han population using ultra-low-coverage whole-genome sequence (ulcWGS). We identified 2,883 maternal trait-associated SNPs associated with 26 phenotypes, among which 99.5% were near established genome-wide association study (GWAS) loci. Further refinement delineated these SNPs to 442 unique trait-associated loci (TALs) predicated on linkage disequilibrium R2>0.8, revealing that 75.6% demonstrated pleiotropy and 50.9% were located in genes implicated in analogous phenotypes. Notably, we discovered 21 maternal SNPs associated with 35 neonatal phenotypes, including two SNPs associated with identical complications in both mothers and children. These findings underscore the importance of integrating ulcWGS data to enrich the discoveries derived from traditional PheWAS approaches.

Comparison of the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among ante-natal mothers in rural field practice area of a medical college

ABSTRACT Background: Anaemia in pregnancy is defined by the World Health Organisation (WHO) as a haemoglobin concentration of less than 11 g/dl in venous blood. The prevalence of anaemia among ante-natal mothers in India is 50.3%[3]. The government of India supplies ferrous sulphate for prophylaxis and treatment of anaemia among ante-natal mothers for free through the reproductive maternal neonatal and child health + adolescent (RMNCH+A) programme. However, patient compliance is poor due to gastrointestinal disturbances (of all registered pregnancies, less than 1/3 consumed a full course of ferrous sulphate). Previous studies in different settings have shown increased compliance and higher mean haemoglobin levels with ferrous ascorbate, which is more affordable than other commercially available compounds. Objective: Hence, the current study was done to compare the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among ante-natal mothers in a rural field practice area of a medical college. Methods: An interventional community-based study was conducted in the rural field practice area of Andhra Medical College. The study was done among 76 registered (registered at Rural Primary Health Centre Simhachalam) ante-natal mothers in gestational age 13–17 weeks with haemoglobin concentration of 7–10.9 g/dl (mild to moderate anaemia) after taking informed consent. The study was performed for two years. Ante-natal mothers who were registered but unavailable during the study period, with a medical history of haematological disorders, chronic cardiac and kidney diseases, known or suspected to have sensitivity to iron compounds, with known thyroid dysfunction or mental illness were excluded from the study. Results: There was a rise in haemoglobin among the entire study population, which was statistically significant (P &lt; 0.0001). There was a higher rise in haemoglobin among the antenatal women who took ferrous ascorbate than among those who took ferrous sulphate (mean difference = 0.344 gm/dl) after 12 weeks of follow-up, which was statistically significant (P = 0.014). Conclusion: The study compared the effectiveness of ferrous ascorbate with ferrous sulphate in improving haemoglobin percentage among antenatal mothers in a medical college’s rural field practice area. There was a significant rise in haemoglobin percentage among the study group, which was on ferrous ascorbate with better compliance and fewer gastrointestinal side effects.

Happiness and harmony through health culture diplomacy as integrative maternal–child health nursing

Happiness and harmony through health culture diplomacy as integrative maternal–child health nursing

Clinical Study of Cutaneous Manifestations in Neonates in A Tertiary Care Center in Eastern Nepal: A Descriptive Cross-sectional Study

Introduction: In the neonatal period, a variety of cutaneous symptoms are frequent. To minimize unneeded therapy and to reduce parents' stress, it's important to distinguish between transient and pathological newborn dermatoses. The purpose of this study is to describe the clinical pattern of cutaneous lesions in neonates. Methods: In this cross-sectional descriptive(IRC/1885/020) study , we enrolled 512 neonates born and admitted in maternal child health care ward and Post Natal ward of a tertiary health care cener irrespective of cutaneous manifestations. Convenience sampling technique was used. They were examined till their stay in hospital and followed up weekly via telephone for development of dermatological manifestations. Results: Out of 512 neonates examined, 415 (81.05%) of neonate had at least one cutaneous manifestation.393 (94.69%) had physiological skin lesions, 22 (5.31%) had pathological skin lesions. The most common physiological skin manifestations were sebaceous gland hyperplasia, mongolian spot, ETN, milia and epstein pearl. The pathological cutaneous manifestations though least common comprised of cradle cap, napkin dermatitis and bacterial infections. Most of the lesions were present within 24 hours of birth and many of them were physiological transient lesion. Conclusions: In conclusion, our study highlights the high prevalence of cutaneous manifestations in neonates, with the majority being physiological in nature. Medical personnel must be well versed in the skin changes of neonates which will further help prevent unnecessary treatment and identify life threatening situations that require additional attention.

Dr Bonté Elgood (1874-1960): First woman doctor in Egypt and pioneer of maternal and child care.

Bonté Elgood, née Amos, was one of the early women doctors who qualified from the progressive London School of Medicine for Women, established in 1874. She chose to practice in Egypt which was then under British administration. When she arrived in 1900, Egyptian medical provision for mothers and children was rudimentary where it existed at all. For over 50 years, Bonté Elgood played an important role in setting up maternity care and child health services, first in Cairo and later in the whole country. For her work, she was awarded the OBE and CBE by the British government, and she also received decorations from the French and Egyptian governments.

Building Collective Power to Advance Maternal and Child Health Equity: Lessons from the New Orleans Maternal and Child Health Coalition

ObjectivesThe New Orleans Maternal Child Health Coalition convenes to support and amplify the work of New Orleans-based individuals and organizations working to reduce disparities and protect the health of birthing families in the New Orleans area. The objectives of this qualitative study were to identify successes, challenges, and areas of growth for the Coalition and develop broadly generalizable recommendations for similar groups seeking to mobilize and advance health equity in their own communities.MethodsUsing purposive sampling, we conducted semi-structured interviews with 12 key informants from within and outside of the Coalition. Interviews were transcribed verbatim, and data was analyzed using inductive and deductive coding approaches.ResultsWe identified themes relating to the barriers and facilitators to the maintenance of the Coalition, as well as opportunities to advance the mission of the Coalition. Some themes included structural- and systemic-level barriers to achieving the mission, varying perspectives on the effectiveness of the Coalition, opportunities to enhance the operations of the Coalition’s work, and opportunities to involve other individuals, particularly those with lived experience, and non-MCH related sectors in Coalition’s work.Conclusions for PracticeAs the maternal health crisis continues, coalitions like the New Orleans MCH Coalition provide a vehicle to amplify the mission-driven work of people and organizations. Recommendations put forth by the Coalition can also be utilized by coalitions in other jurisdictions.