Maternal Health Education Research Articles

Socio-Economic Factors Affecting The Maternal Health In Rural Areas Of District Layyah, Pakistan

The present quantitative study was conducted to explore the socio-economic factors affecting on the maternal health in the rural areas of District Layyah. The universe of the present study consisted of the all the fertile women those were able to reproduce. 150 women were selected from the rural areas of the research areas through systematic random sampling. Description of the data and analysis was done through SPSS. It was concluded that the early marriages, low level of education and income, unavailability of the maternal homes and general hospitals, far away of the hospitals, and the absence of doctors and gynecologists in the rural areas and the traditional methods of delivery cases are the major causes of the low level of maternal health in the rural areas of the study area. It was recommended that to improve the maternal health education and income level should be raised and awareness should be given in the study areas.

Maternal health behaviors during pregnancy in rural Northwestern China

BackgroundMaternal health during pregnancy is a key input in fetal health and child development. This study aims to systematically describe the health behaviors of pregnant women in rural China and identify which subgroups of women are more likely to engage in unhealthy behaviors during pregnancy.MethodsWe surveyed 1088 pregnant women in rural northwestern China on exposure to unhealthy substances, nutritional behaviors, the timing and frequency of antenatal care, and demographic characteristics.ResultsPregnant women were active in seeking antenatal care and had low rates of alcohol consumption (5.1%), exposure to toxins (4.8%), and exposure to radiation (2.9%). However, tobacco exposure was widespread (40.3%), as was low dietary diversity (61.8%), unhealthy weight gain (59.7%), unhealthy pre-pregnancy BMI (29.7%), and no folic acid intake (17.1%). Maternal education is closely linked to better health behaviors, whereas experience with a previous pregnancy is not.ConclusionsTobacco exposure and unhealthy nutritional behaviors are common among pregnant women in rural northwestern China. The findings indicate that in the absence of professional health information, relying on experience of previous pregnancies alone may not help rural women avoid unhealthy maternal behaviors. Maternal health education campaigns targeting nutrition and tobacco exposure during pregnancy may improve maternal, fetal, and child health in rural China.

Predictors of Neonatal Sepsis in Hospitals at Wolaita Sodo Town, Southern Ethiopia: Institution-Based Unmatched Case-Control Study, 2019.

Background Neonatal sepsis plays a significant role in neonates' mortality in developing countries accounting for 30-50% of total deaths each year. Gaining insight into neonatal sepsis predictors will provide an opportunity for the stakeholders to reduce the causes of neonatal sepsis. This research is aimed at determining the predictors of neonatal sepsis at Wolaita Sodo University Teaching Referral Hospital and Sodo Christian General Hospital, Ethiopia, April-July 2019. Method This study employed an institution-based unmatched case-control study by selecting neonates in selected hospitals through consecutive sampling technique. The cases of this study are neonates diagnosed with sepsis. The study used a pretested structured questionnaire for a face-to-face interview to collect data from index mothers. Besides, the review of the record was done using checklists. The data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences version 24.0 for analysis. The study used descriptive, bivariate, and multivariate analyses. The odds ratio with 95% confidence interval was used to measure the association's strength. p < 0.05 was the cut-off point for declaration of statistical significance for the multivariate analysis. Results Factors significantly associated with neonatal sepsis among neonates were maternal age of 15-20 years and 21-30 years, mothers with low income/wealth, history of urinary tract infections/sexually transmitted infections, presence of intrapartum infections, antenatal care follow‐up < 3 visits, Apgar (Appearance, Pulse, Grimace, Activity, and Respiration) score < 7, low birth weight, and the time in which breastfeeding started after delivery < 60 minutes. Conclusion Maternal age, wealth/income, maternal urinary tract infections/sexually transmitted infections, intrapartum fever, antenatal care visit ≤ 3 times, Apgar score < 7, low birth weight, and starting time of breastfeeding were independent predictors of neonatal sepsis. Therefore, maternal health education during antenatal care visits, perinatal and newborn care, and early initiation of breastfeeding might decrease neonatal mortality and morbidity due to sepsis.

Maternal knowledge of effective breastfeeding and its benefits, as potential determinant of attitudes to infant feeding: A survey in Calabar, Nigeria.

Appropriate breastfeeding is a cost-effective child survival strategy. This study assessed relationship between knowledge of breastfeeding and attitude towards infant feeding among pregnant women in Calabar, Nigeria. By convenience sampling, consenting antenatal clinic attendees were recruited from secondary health centers in Calabar. Pre-tested questionnaire was used to assess knowledge of different aspects of breastfeeding, while the Iowa Infant Feeding Attitude Scale (IIFAS) was used to assess attitude towards infant feeding. Data was analyzed using SPSS version 21.0, with p-value of less than 0.05 considered statistically significant. Two hundred and fifty (250) pregnant women were surveyed with mean age of 29.7 ± 6.1 years. One hundred and eight respondents (43.2%) had unsatisfactory levels of knowledge. Common areas of misconception were oral thrush effect of breastfeeding (47.2%), frequency of breast milk expression (47.6%), and effects of inverted nipples (45.6%). Most respondents (92.0%) had neutral attitude to infant feeding, and there was no significant relationship between overall knowledge of breastfeeding and infant feeding attitude (p <0.05). Of all the knowledge areas assessed, only benefits to mothers (r=0.11, p=0.08) and effective breastfeeding (r=0.17, p=0.01), had knowledge scores that correlated positively with infant feeding attitude scores. These findings contribute to existing literature required for improvement in policies and strategies, for breastfeeding education and child survival, especially in resource-poor settings. There is need for further research towards improving priority content of maternal health education during the time-constrained ANC visits.

Sociocultural, political, and health system-related determinants of perinatal deaths in Jordan from the perspectives of health care providers: a qualitative study

Background Perinatal mortality is a fundamental indicator of the quality of the healthcare provided to women during pregnancy and childbirth, as well as the healthcare provided to neonates in the first week of life. At the national level, determining the direct and indirect causes of these deaths is vital, as it will assist in tracking the quality of antenatal, natal and postnatal care and help to detect the areas for avoidance. This study aimed to identify the main determinants of perinatal deaths in Jordan from the perspectives of health care providers (HCPs). Methods A descriptive qualitative approach using focus group discussion was used. Four focus groups were conducted in each of the four hospitals where the approached HCPs are employed. An average of 5 HCPs were interviewed in each focus group with a total of 80 HCPs participating in the 16 focus groups. Thematic analysis was carried out to analyze the data. Results The HCPs provided a detailed description of the determinants of perinatal and neonatal death from their points of view. Four main themes with multiple subthemes emerged, namely maternal factors (ignorance, concealment of medical condition, and husbands’ negligence), sociocultural factors (socioeconomic status, tribal and consanguineous marriage, and harmful cultural practices), political factors (early marriage driven by displacement and war consequences on maternal health), and health system-related factors (services management including capabilities and logistics, overcrowding of emergency rooms, discharge against medical advice, and unskilled general practitioners in private maternity clinics). Conclusions As perceived by HCPs, maternal factors, sociocultural factors, political factors, and health system-related factors are the main determinants of perinatal deaths in Jordan. Improvement in the quality of maternal and neonatal health care services, maternal health education, and maternity staff training are strongly recommended.

Relationship Between Pregnant Women's Participation in Pregnant Women's Class With Ready to Face Delivery in Practice of Nurmala Midwives, Talawi District, Batu Bara Regency 2020

Maternal and fetal deaths often result not from technical incompetence or negligence, but also from a lack of maternal health education about childbirth. The limited knowledge of primigravida mothers about childbirth affects mothers in facing childbirth. This research is an analytic survey research with a cross sectional design approach. The study was conducted in the practice of midwife Nurmala, Talawi sub-district, Batubara district in 2020. The research population was 78 people, with a total sample of 44 respondents. The sampling technique used was non-probability sampling with purposive sampling. Data analysis used univariate analysis, bivariate analysis with chi-square. The results of statistical tests using the chi square test, obtained the calculation results of p value = 0.000 less than 0.05, then Ha is accepted. In conclusion, there is a relationship between the participation of pregnant women in the class of pregnant women and readiness to face childbirth in the practice of midwives, Nurmala, Talawi sub-district, Batubara district in 2020. It is recommended that health workers improve health services, especially for pregnant women to participate in mother class activities by activating maternal class services by midwives. village and cooperation with cadres, village officials, improve the quality of the implementation of maternal classes with the addition of mother classes in the village and can be used as one of the information materials in the context of preparing planning for handling anxiety for pregnant women, in particular in preparation for childbirth.

Maternal Health Education (Pregnant, Childbirth and Puerperal Periods) COVID19 Pandemic Period: Literature Review

Maternal Health Education (Pregnant, Childbirth and Puerperal Periods) COVID19 Pandemic Period: Literature Review

Perceived Influence of Family Planning Education on Maternal Health among Reproductive-Aged Women in Ijebu Zone of Ogun State Nigeria

The health of women during pregnancy, childbirth and the postpartum period is maternal health. This study examined the influence of family planning and maternal health education on reproductive-aged women’s health in Ijebu zone of Ogun state, Nigeria. The population of the study includes all reproductive-aged women who have accessed and used family planning and maternal health care services in Ijebu zone of Ogun State. This study was a descriptive survey. The instrument used was self-structured. Four health centres were randomly selected for the study, while 300 participants were purposively selected for the study. Chi-square (X2) was the main statistical tool used for the analysis. All hypotheses formulated were rejected at 0.05 alpha level of significance. The findings of this study show that the influence of family planning and maternal health care /education on reproductive-aged women’s health in Ijebu zone of Ogun state include lengthening the interval between pregnancies, reduce the number of high-risk pregnancies, promotes efficiency and cost-effectiveness of health services, and improve women’s lives and satisfaction with health services. Based on the findings of this study, it is therefore concluded that family planning and maternal health education will influence maternal mortality as well as promote maternal health and child care among married people in Ijebu zone of Ogun state if integrated. It is therefore recommended that maternal health education services should be carried out in the public through the media by both governmental and non-governmental organizations. Maternal healthcare and family planning should be integrated in the health centres.

Influence of cultural and traditional beliefs on maternal and child health practices in rural and urban communities in Cross River State, Nigeria

Objective: The influence of cultural and traditional beliefs on key maternal and child health practices in the developing nations cannot be overemphasized. This study was carried out to determine the influence of cultural and traditional beliefs on key maternal and child health practices among rural and urban mothers in Cross River State. Materials and Methods: The study design was a comparative analytical cross-sectional study among mothers with under-five children in rural and urban households in Cross River State and the study populations comprised mothers of under-five children and traditional birth attendants in Cross River State. Sampling technique used to select respondents in the rural and urban sites was multistage sampling method and the sample size was determined using standard method of comparing two independent groups. For focus group discussion (FGD), the purposive sampling method was employed in both study sites. The study instrument was a semi-structured questionnaire and data obtained were analyzed using SPSS version 21.0. Results: Statistical analysis showed that the age of mother, husband, and marriage of women from the rural communities were significantly higher (P &gt; 0.05) than that of women from the urban communities. Knowledge of the cultural beliefs of their people concerning maternal and child health is significantly higher in the rural communities than in the urban communities (P &lt; 0.0001). Similarly, there was significant difference in the cultural dispositions of the rural and urban communities to maternal and child health practices (P &lt; 0.05). The results of this study suggest that traditional beliefs influence maternal and child health-care practices in Cross River State, Nigeria. Conclusions: It is therefore concluded that cultural and traditional influences on maternal and child health practices are predominant in rural settings, with positive or indifferent cultural disposition to recommended practice being commonly associated with such practice. Maternal health education as well as education and engagement of traditional leaders are highly recommended. This should be focused at corrective reorientation toward the preference of recommended best practices that they currently do not support while sustaining the effort at encouraging other best practices.

Assessing the newborn screening education needs of families living in medically underserved areas.

Newborn screening (NBS) is a public health service available to all babies born in the United States (US). NBS is one of the first experiences families have in the US healthcare system with a new baby. A positive experience with NBS can give families a strong start to their child's health care and build trusting relationships with providers. A lack of easily accessible NBS education for families can exacerbate health inequalities through negative interactions with the healthcare system. Expecting Health, a maternal and child health education and advocacy initiative of Genetic Alliance, partnered with RTI International to implement an online survey assessing needs and preferences around NBS-related health education, with a particular interest in those of families living within medically underserved areas (MUAs). A total of 500 participants completed the survey, including 200 participants living in MUAs. The results of the survey showed that, compared with US families living outside of MUAs, families living in MUAs are generally less aware of NBS and do not receive NBS education at the optimal time (i.e., before birth), which could indicate they experience inequities in NBS education. While families across different geographic areas seem to have similar preferences in terms of content for NBS education, the results show that somedistinct communication methods are needed to reach families living in MUAs. To bridge the gap in NBS education to families living in MUAs, the Expecting Health team built an online NBS educational module, using preferred communication methods-specified through the survey-for families living in MUAs.

Gender inequality in early initiation of breastfeeding in Bangladesh: a trend analysis

BackgroundEarly initiation of breastfeeding within 1 hour after birth is essential for newborns, because it reduces risk of neonatal mortality and hypothermia to a great extent and also helps in preventing the long-term chronic diseases and in increasing energy and immunity to newborn. In order to reach the ‘very good state’ of timely or early initiation of breastfeeding recommended by WHO, Bangladesh needs to increase the current rate of 51.24 to 100%. An attempt has been made in this study to examine how the early breastfeeding practice changes among male and female children with time controlling the factors associated with this practice.MethodsData from last four consecutive Bangladesh Demographic and Health Surveys (BDHS) have been used in the study. The participants were included whose child born within the last 5 years preceding the surveys of 2004, 2007 and 2011, and within the last 3 years preceding the survey of 2014 in the study and the respective selected participants were 5145, 4765, 7099 and 4370. To conduct the trend analysis, the descriptive statistics of selected variables along with prevalence of early initiation of breastfeeding have been computed by different years and a multiple logistic regression model has been fitted to the pooled dataset of 2004–2014 considering survey years as time.ResultsRate of early initiation of breastfeeding increased as time progressed and it was faster for female child compared to male child. For example, female children were significantly 10 and 6% less likely to be initiated early than their counterparts in 2004 and 2007, respectively; whereas after 2007 both male and female children were equally treated for breastfeeding practice. It was also found that rate of early initiation significantly increased for one unit increased in survey year and this increasing rate was higher for female child compared to male child. For example, for one unit of increased in survey year, the early initiation of breastfeeding increased by 60% for male child and by 67% for female child. Besides, survey time, gender, education of parents, wanted index child, mode of delivery, antenatal care visits, wealth index, exposure to media and division were found to have potential influence on early initiation of breastfeeding.ConclusionDemographic and health surveys conducted in Bangladesh since 2011 have shown no evidence of gender discrimination regarding timely initiation of breastfeeding. In order to achieve the target rate of early initiation of breastfeeding recommended by WHO, it requires to take effective intervention regarding maternal and child health education.

The association between social support through contacts with Accredited Social Health Activists (ASHAs) and antenatal anxiety among women in Mysore, India: a cross-sectional study.

In India, antenatal anxiety prevalence estimates range from 6 to 48%. Social support is strongly associated with mental wellbeing, yet most studies have examined the impact of support from partners and family members rather than peers, community members, or health care providers. This study explores the supportive role of Accredited Social Health Activists (ASHA) contacts for antenatal anxiety. Data were analyzed from the Saving Children, Improving Lives project, a quasi-experimental study conducted among rural, pregnant women in India. Regression models were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals for the relationship frequency of ASHA contacts and antenatal anxiety. Antenatal anxiety was measured using a subscale of the Edinburgh Postnatal Depression Scale. The sample consisted of 480 pregnant women. Reported antenatal anxiety prevalence was 27% (95% CI 23%, 31%). Participants who were more frequently visited by ASHAs at home (aPR: 0.90; 95% CI 0.76, 0.98) and more frequently accompanied by ASHAs to their antenatal care visits (aPR: 0.86, 95% CI 0.78, 0.95) were less likely to report antenatal anxiety. ASHA home visits were protective for the most vulnerable women (primigravida and those experiencing domestic violence) and ASHA accompaniment to antenatal care visits was equally protective for all women. ASHAs are valued for their contribution towards maternal health education and linking women of reproductive age to healthcare services. Our findings additionally suggest the important role ASHAs play in providing social support to pregnant women, particularly those who are most vulnerable to experiencing antenatal anxiety.

Ghana's national health insurance, free maternal healthcare and facility‐based delivery services

AbstractGhana implemented the National Health Insurance Scheme (NHIS) in 2005 and introduced free maternal healthcare (FMH) into the scheme in 2008. These reforms aimed at improving the utilization of healthcare, especially for expectant mothers. Using data from the 2008 and 2014 Ghana Demographic and Health Surveys (GDHS) with a sample of 8,081, this study employed multivariate probit and conditional mixed process (CMP) estimators to analyze the NHIS enrolment and the use of facility‐based delivery services among expectant mothers within the context of Sustainable Development Goal 3 in Ghana. The influence of birth order on these policies has also been explored. Before and after analysis was used for the effect of the FMH on NHIS enrolment and the use of delivery services while CMP was used for the effect of NHIS on delivery services. It is concluded that higher birth order reduces the likelihood of NHIS enrolment and health facility delivery. Moreover, the FMH policy has improved both NHIS enrolment and facility‐based delivery. Finally, the NHIS policy proves to be a reliable factor to induce utilization of facility‐based delivery services. It is recommended that maternal health education at antenatal care visits should be enriched with potential consequences and complications associated with multiple births. The National Health Insurance Authority (NHIA) should provide registration desks for expectant mothers at health facilities.

Influence of health decision making on maternal complications among women delivered at a general hospital, North-Western Nigeria.

Low status of women and lack of decision making in utilization of maternal healthcare services are important factors influencing maternal complications. Antenatal care services and delivery in a health facility under the supervision of a skilled birth attendant are important ways of mitigating maternal complications. The objective of this study was to examine the influence of responsibility of health decision-making on maternal complications. A cross-sectional study involving 206 women who delivered between February and April 2014 at the Yusuf Dantsoho Memorial General Hospital in Kaduna, Northwestern Nigeria. Consenting participants were recruited consecutively irrespective of their booking status. Data analyzed included the sociodemographic characteristics of the women, responsibility for health decision making, and pattern of obstetric complications. Majority of the participants were Hausa ethnic group Muslims with no formal education. Most (54%) were unbooked. Healthcare decisions were made by the husbands in nearly 90% of the participants. Decision-making significantly influences the occurrence of maternal complications. The study showed a significant relationship between health decision-making and maternal complications. Women empowerment and partner participation in decision-making should be emphasized in maternal health education.

Role of public health literacy during COVID-19 pandemic, its implications and future recommendations- An analysis from India

The term “Health literacy” was coined by Ratzan et al. in 1970s stating for the littlest health education in schools. But still this term is almost new and is in its early phase of development. Though many attempts have been made in the past to define health literacy. WHO construed it as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health”. Health Literacy not only focuses on the individual behaviour-oriented communication but also on the various determinants of health like environmental, social, political etc., thus it is ahead of the cramped concept of health education. If health education methods go beyond the bounds of “information diffusion” and bring about interaction, participation and critical analysis, such kind of approach will lead to health literacy, personal aid and social benefit by enabling adequate community action and will contribute to the advancement of social capital. We believe that nowadays, health literacy is limited to the non-communicable diseases, Maternal and Child Health care and health education is provided to the citizens which is more of kind a bureaucratic formality rather than serving its real purpose. However, this COVID-19 pandemic has become an eye opener for us and revealed that health literacy as a part of health education, is equally important for communicable diseases as well and not only system preparedness, but individual preparedness is also the key to deal with the actual life problems during crises situations.

Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen

BackgroundToxoplasmosis is a common and serious parasitic infection caused by the ubiquitous obligatory intracellular protozoan organism, Toxoplasma gondii. Although infection with T. gondii is usually asymptomatic in healthy individuals, it can lead to severe pathological effects in congenital cases and immunocompromised patients. This study aimed to determine the seroprevalence of T. gondii and its predictors among pregnant women seeking prenatal and medical care at the general maternal and child health facility in Dhamar district of Dhamar governorate, Yemen.MethodsA total of 420 pregnant women were randomly selected for this cross-sectional study. Participants were screened for anti-T. gondii antibodies (i.e. immunoglobulin M; IgM and immunoglobulin G; IgG) using electrochemiluminescence immunoassay. Demographic, socioeconomic, obstetric and behavioural data were collected using a pretested questionnaire via face-to-face interview. Univariate and multivariate analyses were used to identify the independent predictors of T. gondii seroprevalence.ResultsThe overall seroprevalence of anti-T. gondii antibodies (IgG and/or IgM) among the participants was 21.2% (89/420; 95% CI = 17.3–25.1). Anti-T. gondii IgG antibodies were detected in 20.0% (84/420) of the women of which 12.9% (54/420) were positive for only IgG and 7.1% (30/420) were positive for both IgG and IgM antibodies. Moreover, 5 women (1.2%) were reactive only for IgM antibodies. Significant associations between T. gondii seroprevalence and history of spontaneous abortion (P < 0.001), raw vegetables consumption (P = 0.036), and presence of cats in household (P = 0.049) were reported. Multivariate analysis confirmed that history of spontaneous abortion (AOR = 4.04; 95% CI = [2.46, 6.63]) and presence of cats in household (AOR = 1.77; 95% CI = [1.02, 3.07]) are significant predictors of T. gondii seroprevalence among the studied participants.ConclusionThe study found a high seroprevalence (21.2%) of T. gondii infection during pregnancy in Dhamar district, which is significantly associated with adverse pregnancy outcomes. The provision of adequate maternal healthcare and health education pertaining to the prevention of T. gondii infection is therefore imperative to curtail the prevalence of infection among the studied population.

Barriers to the Use of Mobile Health in Improving Health Outcomes in Developing Countries: Systematic Review.

BackgroundThe use of mobile health (mHealth) technologies to improve population-level health outcomes around the world has surged in the last decade. Research supports the use of mHealth apps to improve health outcomes such as maternal and infant mortality, treatment adherence, immunization rates, and prevention of communicable diseases. However, developing countries face significant barriers to successfully implement, sustain, and expand mHealth initiatives to improve the health of vulnerable populations.ObjectiveWe aimed to identify and synthesize barriers to the use of mHealth technologies such as text messaging (short message service [SMS]), calls, and apps to change and, where possible, improve the health behaviors and health outcomes of populations in developing countries.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Deriving search criteria from the review’s primary objective, we searched PubMed and CINAHL using an exhaustive terms search (eg, mHealth, text messaging, and developing countries, with their respective Medical Subject Headings) limited by publication date, English language, and full text. At least two authors thoroughly reviewed each article’s abstract to verify the articles were germane to our objective. We then applied filters and conducted consensus meetings to confirm that the articles met the study criteria.ResultsReview of 2224 studies resulted in a final group of 30 articles for analysis. mHealth initiatives were used extensively worldwide for applications such as maternal health, prenatal care, infant care, HIV/AIDS prevention, treatment adherence, cardiovascular disease, diabetes, and health education. Studies were conducted in several developing countries in Africa, Asia, and Latin America. From each article, we recorded the specific health outcome that was improved, mHealth technology used, and barriers to the successful implementation of the intervention in a developing country. The most prominent health outcomes improved with mHealth were infectious diseases and maternal health, accounting for a combined 20/30 (67%) of the total studies in the analysis. The most frequent mHealth technology used was SMS, accounting for 18/30 (60%) of the studies. We identified 73 individual barriers and grouped them into 14 main categories. The top 3 barrier categories were infrastructure, lack of equipment, and technology gap, which together accounted for 28 individual barriers.ConclusionsThis systematic review shed light on the most prominent health outcomes that can be improved using mHealth technology interventions in developing countries. The barriers identified will provide leaders of future intervention projects a solid foundation for their design, thus increasing the chances for long-term success. We suggest that, to overcome the top three barriers, project leaders who wish to implement mHealth interventions must establish partnerships with local governments and nongovernmental organizations to secure funding, leadership, and the required infrastructure.

The effect of a maternal training programme on early childhood development in Egypt.

The initial years of life, particularly the first two years, are considered the most important for brain development and timely interventions profoundly affect the health of the child and families. This study aimed to determine the effect of maternal health education on motor, social and cognitive development in infants less than two years old, and to identify the factors that could affect normal development. Two hundred and ten mothers and their infants (109 interventions, 101 controls) were recruited from maternal and child health centres in Assiut Governorate, Egypt, in 2017. The maternal training programme has been taught to mothers of infants in intervention groups twice per month and up to five months' duration; however, routine services are provided to control groups only. Bivariate and multivariable analyses were performed to identify the most important predictors of normal development. There were significant improvements in early childhood developmental domains for the intervention groups after five months comparable to the base line assessment. Percent of normal development among intervention groups in communication subscale increased from 46.8% to 76% to 97.9% compared to 50.5% to 46.8% to 57.4% in the control groups (baseline, after two month and after five months assessment respectively). The intervention was a significant predictor in normal development. There was an improvement in early childhood developmental domains for the intervention groups after applying maternal training programme. Designing educational interventions for routine health care services that reach all children will provide mothers with the opportunity for improvement in early childhood developmental.

ANALISIS FAKTOR-FAKTOR KEMISKINAN KABUPATEN DI SUMATERA

Poverty is one Fundamental issues serious concern which become from the government. An important aspect of supporting poverty tackling strategies is the provision of accurate and targeted poverty data. BPS presents data set and poverty information (data mining) and indicators related to poverty issues in level regency/city and province. The island of Sumatra is the region with the densest population after Java with the distribution of poverty of 21.6%. The purpose of this research was to analyze the poverty factors of regencies/cities in Sumatera. The research consist of 6.468 cell data covering 154 regencies/cities in Sumatera and 42 poverty indicators which are processed with factor analysis. The research results showed that the factors of poverty of the Regency and City in Sumatera are: 1) economic factors, employment and housing facilities, 2) under-five health factors, 3) factors of labor and clean water facilities, 4) social factors and assistance of raskin, 5 ) Maternal health factors, education and government facilities.There fore, the government shoul dpayattentito the ways of poverty alleviation by looking at various factors that exist in each region.

Effect of religiosity on maternal and child health practices in Cross River State, Nigeria

Background: Maternal and child health care is very important and crucial in the monitoring and evaluation of various developmental agenda especially in developing nations.Aim/Objective: This study was carried out to ascertain the effects of religiosity on maternal and child health practices in rural and urban Cross River State, Nigeria.Method: The study design was a comparative analytical cross-sectional study amongst mothers with under-five children in rural and urban households in Cross River State and the study populations comprise mothers of under-five children, traditional and traditional birth attendants in Cross River State. Sampling technique used to select respondents in the rural and urban sites was multistage sampling method and the sample size was determined using standard method of comparing two independent groups. For Focus Group Discussions (FGD), purposive sampling method was employed in both study sites. Religiosity was assessed using the ORA dimension of the Duke University Religion Index (DUREL), which is usually measured as frequency of attendance of organized religious activities. The study instrument was a semistructured questionnaire and data obtained was analyzed using SPSS version 21.0.Results: Statistical analysis showed that the age of mother, husband and marriage of women from the rural communities was significantly higher (P< 0.05) than that of women from the urban communities. Religious practices to have safe pregnancy did not significantly predict women having complications in last pregnancy in both study settings while in the rural and urban communities (P<0.05), religious practices significantly influenced family planning methods (P<0.05). In child health practices, religious practices significantly influenced the rural communities practice of breastfeeding child (P= 0.001) and giving child colostrum (P= 0.048) while in the urban communities, it significantly influenced giving child colostrum (P= 0.002).Conclusions: This study therefore concludes that religiosity significantly affects maternal and child health care practices in rural and urban communities of Cross River State, Nigeria and also serve as useful baseline for better understanding of the dynamics of influence of religiosity on maternal and child health practices in Cross River State of Nigeria.Recommendation: Maternal health education as well as education and engagement of spiritual leaders are highly recommended.