Mothers In Slums Research Articles

Caesarean delivery and neonatal mortality: evidence from selected slums in and around Dhaka city, Bangladesh- A prospective cohort study

BackgroundThis study examined the neonatal mortality for newborn of women who delivered by caesarean section or vaginally using a prospective cohort.MethodsA total of 6,989 live births registered from 2016 to 2018, were followed for neonatal survival from the selected slums of Dhaka (North and South) and Gazipur city corporations, where icddr,b maintained the Health and Demographic Surveillance System (HDSS). Neonatal mortality was compared by maternal and newborn characteristics and mode of delivery using z-test. Logistic regression model performed for neonatal mortality by mode of delivery controlling selected covariates and reported adjusted odd ratios (aOR) with 95% confidence interval (CI).ResultsOut of 6,989 live births registered, 27.7% were caesarean and the rest were vaginal delivery; of these births, 265 neonatal deaths occurred during the follow-up. The neonatal mortality rate was 2.7 times higher (46 vs. 17 per 1,000 births) for vaginal than caesarean delivered. Until 3rd day of life, the mortality rate was very high for both vaginal and caesarean delivered newborn; however, the rate was 24.8 for vaginal and 6.3 per 1,000 live births for caesarean delivered on the 1st day of life. After adjusting the covariates, the odds of neonatal mortality were higher for vaginal than caesarean delivered (aOR: 2.63; 95% CI: 1.82, 3.85). Additionally, the odds were higher for adolescent than elderly adult mother (aOR: 1.60; 95% CI: 1.03, 2.48), for multiple than singleton birth (aOR: 5.40; 95% CI: 2.82, 10.33), for very/moderate (aOR: 5.13; 95% CI: 3.68, 7.15), and late preterm birth (aOR: 1.48; 95% CI: 1.05, 2.08) than term birth; while the odds were lower for girl than boy (aOR: 0.74; 95% CI: 0.58, 0.96), and for 5th wealth quintile than 1st quintile (aOR: 0.59, 95% CI: 0.38, 0.91).ConclusionOur study found that caesarean delivered babies had significantly lower neonatal mortality than vaginal delivered. Therefore, a comprehensive delivery and postnatal care for vaginal births needed a special attention for the slum mothers to ensure the reduction of neonatal mortality.

Dhaka Metropolitan Waste Management: Strategies to Ensure Participation of Slum Mothers

Dhaka Metropolitan Waste Management: Strategies to Ensure Participation of Slum Mothers

Self-monitoring improved child feeding among low educated slum mothers in Bangladesh, a pilot study

Abstract Issue Child undernutrition in urban slums is the most serious but least addressed health problem in many LMICs including Bangladesh. Slum children are deprived of adequate feeding as advocated by WHO. Face-to-face contact to monitor adherence to child feeding recommendations is costly. We aimed to identify if a visual aid for self-monitoring, in the form of a pictorial calendar, could assist illiterate slum mothers to self-regulate their child feeding behaviours and increase adherence to recommended child feeding practices. Description of the practice: A mixed method study was conducted (Randomised Controlled Trial + semi-structured qualitative interviews) over four weeks in a slum area of Dhaka city. Thirty-four mothers to child aged 6-23 months having <5 years of education were recruited. Mothers randomized to intervention arm (n = 17) received an hour of complementary feeding education along with a pictorial calendar and color-coded stickers representing food groups. The control arm received the education session only. The primary outcome was Minimum Dietary Diversity (MDD: ≥4 food groups in past 24 hours); the Generalised Estimation Equations (GEE) with a log link and binomial family was used to test treatment by time interactions. Results The proportion of achieving MDD was more common (RR 1.2, 95%CI 0.8, 1.8) among mothers from intervention arm compared to control mothers. Intervention mothers were more likely to identify the appropriate food groups compared to control mothers. More than 80% of the mothers completed the calendar for all 28 days of study duration. During qualitative interviews, most mothers (4/5) stated that the pictorial calendar acted as a reminder for them. Lessons An encouraging tendency towards better complementary feeding and better knowledge was seen among the intervention mothers compared to controls. Future research with a larger sample is needed to establish the significance of effect size. Key messages Pictorial calendar appeared to help sustain knowledge and improve feeding practices. Self-monitoring using a pictorial calendar could be a good visual aid for low-educated mothers from low socio-economic status.

Status of maternal health care services: An assessment study in slums of Kolkata.

Background and Aims:Mothers constitute an important and priority group in any community due to their high pregnancy related morbidities and mortality. The prevention of pregnancy related complications was possible with proper utilisation of maternal health care services. This study was conducted with the aim of assessing the utilisation of maternal health care services among mothers with younger child aged ≤3 years in slums of Kolkata, West Bengal and to find out the factors associated with it.Methodology:It was a community-based, observational study with cross-sectional design conducted in slums of Kolkata from June 2017 to May 2018. 30 slums [under Kolkata municipal corporation] were selected by cluster sampling technique using probability proportionate to size method. 10 mothers were selected from each slum and a total of 300 mothers were selected for the study. A pre-designed, pre-tested, structured schedule was used for data collection.Results:The mean age of the mothers was 23.83 (±3.64) years with the age ranging from 18 to 35 years. 75.7% mothers were registered in 1st trimester of pregnancy and 100% mothers received ≥4 antenatal check-ups. But only 78% mothers consumed ≥100 IFA tablets and only 23.3% mothers consumed ≥360 calcium tablets in antenatal period. 80.3% of the mothers had unsatisfactory utilisation of maternal health care services. Unsatisfactory utilisation of maternal care services was significantly associated with the younger age of the mothers, a smaller number of pregnancies and teenage marriage.Conclusion:Utilisation maternal health care services was not satisfactory among mothers in slums of Kolkata. Awareness generation and behaviour change communication among mothers is necessary for proper utilisation of the services.

Socio-economic status and feeding practices among the mothers of under-five children in an urban slum of Bangladesh: a cross-sectional study

Poor socio-economic conditions and inappropriate feeding practices in slum dwelling mothers can have adverse consequences for the health and nutritional status of their under-five children. The present study was to assess the feeding practices and socio-economic status mothers of under-five children. A cross-sectional study was conducted from January 2015 to December 2015 in four urban slums of Bangladesh. Two hundred and fifty five mother-child pairs were selected by non-random convenience sampling and were interviewed using a pre-tested questionnaire. Anthropometric measurements were taken from under-five children aged 6-59 months. In the present study, boys (54.0%) were predominant over girls (46.0%). The prevalence of initiation of breastfeeding after delivery, prelacteal feeds, exclusive breastfeeding and bottle-feeding were 34.5%, 43.5%, 39.6% and 30.6%, respectively. Out of 255 children studied, more than half (57.6%) of the children received complementary feeds at the appropriate time whereas 45.9% children received with appropriate consistency. Meal frequency was 40.4% and minimum dietary diversity was given to only 39.6% of the children. Minimum dietary diversity means feeding the child food from at least four food groups. Feeding practices improve as mother‟s education levels and household income status increases while maximum slum dwelling mothers are illiterate and primary level completed and household income status are not static. Data showed that overall 14.0% of under-five children were suffering from malnutrition. In terms of severity, 11.3% were moderately malnourished-MAM and 2.7% were severely malnourished-SAM. Various inappropriate feeding practices are more prevalent among urban slum mothers. From this study, it was evident that mothers of low socio-economic group have poor knowledge regarding the feeding practices of their under-five children. There is an urgent need to bridge the “knowledge gap” and “practice gap” of mother‟s from urban slum and lower socio economic strata of the community by further strengthening the on-going breastfeeding programme, breastfeeding knowledge and practice of mothers in urban slum areas.Asian J. Med. Biol. Res. September 2018, 4(3): 307-314

Peer Networking to Improve Knowledge of Child Health and Immunization Services Among Recently Relocated Mothers in Slums of Dhaka, Bangladesh

Peer Networking to Improve Knowledge of Child Health and Immunization Services Among Recently Relocated Mothers in Slums of Dhaka, Bangladesh

Breastfeeding practices among slum mothers: a multivariate statistical analysis

Introduction: The aim of this study was to determine the differential patterns of mean duration of breastfeeding among mothers from slum areas in Rajshahi City, Bangladesh by using the multiple classification analysis (MCA). Materials and Methods: The data for this study was collected from mothers from slum areas of 8 different slums of Rajshahi City Corporation who had had at least one child at the time of interview. Results: We showed that the overall mean duration of breastfeeding was 24.66 months for all women, which may show considerable impact on fertility around slum areas in near future. Conclusion: Of all the selected variables in MCA, it was seen that the current age of the children and the body mass index of the respondents appear as the strongest important determinants of duration of breastfeeding and other variables play relatively less important role on the duration of breastfeeding.

Breastfeeding beliefs and practices among migrant mothers in slums of Diyarbakir, Turkey, 2001

A qualitative investigation and a population survey were conducted to explore the breastfeeding beliefs and practices of mothers who were forced to migrate from their original villages and were currently living in the slums of Diyarbakir in Turkey. Qualitative data collection on breastfeeding beliefs was conducted using in-depth interviews. In-depth interviews were tape-recorded. Quantitative data on breastfeeding practices were collected using a structured questionnaire. Mothers generally have a positive attitude towards breastfeeding, but colostrum is usually perceived negatively. No woman was found to feed her infant exclusively by breastfeeding. Only 9.9% of mothers initiated breastfeeding within the first hour of birth. Forty per cent of mothers started solid foods before 4 months. Mother's education appeared as a significant factor influencing the introduction of colostrum to the newborn. Mothers with lower education generally believed that the colostrum should not be fed to the infant and that a pregnant woman's milk is unhealthy for the baby. There was also a belief that 'working under the sun' decreased the quality of milk of a mother. Cultural beliefs have a significant influence on breastfeeding practices. Some of these practices are potentially harmful to newborns. Health education programmes should address these beliefs and practices in culture sensitive ways.

Early child health in Lahore, Pakistan: V. Feeding patterns.

The feeding practices of children (n = 1476) from birth to 24 months, as determined in a longitudinal study, in Lahore, Pakistan, are presented. Four socioeconomic groups at various levels of urbanization were included; a village, periurban slum, urban slum and an upper middle class. Initiation of breastfeeding was delayed in all the neonates. Sixty-five percent of the periurban slum mothers and 45% of the village mothers had not started breastfeeding at 48 hours after the birth of the infant. Prelacteal feedings, especially of herb water and honey, were the norm. Breastfeeding was highly prevalent. Eighty-seven to 98% of the infants in all the areas were breastfed at one month of age. Exclusive breastfeeding was rare, with 9% at one month, declining rapidly with age and being highly influenced by season. Partial breastfeeding was the most common mode of feeding. Water in addition to human milk was given by 45-73% of the mothers living in the urban slum, village and periurban slum at one month of age. Fresh animal milk and/or commercial formula was already being given at 1 month by 22-64% of the mothers in all areas. Commercial formula was the preferred food in the upper middle class, while in the other three areas it was rare and fresh animal milk was mainly used. More than 50% of the mothers in the village and in the periurban slum gave diluted animal milk even beyond the age of 10-15 months. In the upper middle class 50% of the infants were fed semisolids at the age of four months, while in the village, the periurban and the urban slum at 6 months of age only 10%, 12% and 47% of the infants received semisolids. The results of this study indicate that breastfeeding was highly prevalent in the three poorest areas. However, in all the areas initiation of breastfeeding was delayed and prelacteal feeding was the norm. Exclusive breastfeeding was rare, feeding bottles were used by 82-100% of the mothers to feed supplements and human milk substitutes, in the four areas.

Transferring a Simple Technology for Reducing the Dietary Bulk of Weaning Gruels by an Amylase-Rich Food from Laboratory to Urban Slum

This paper describes the transfer of a simple technology for the reduction of the dietary bulk of weaning gruels toy an amylase-rich food (ARF). Since the germination of pulses and the preparation of wheat gruel were culturally familiar, 188 slum mothers mastered these skills easily from graduate trainers. More than 90% of the mothers and their infants or toddlers liked the low-bulk consistency of the gruel with ARF and continued to use a gift packet of ARF powder as long it lasted. However, in a follow-up survey three months later, only 28% of them were making ARF regularly, although 83% continued to make the gruel regularly. Most of the mothers (89%) indicated they would buy ready-to-use ARF powder at prices of Rs 0.5 to Rs 2; so there appears to be good potential for the commercial manufacture of ARF.

Child feeding habits in the People's Democratic Republic of Yemen. II. Supplementary foods and weaning patterns.

86 urban 132 slum 747 rural children under age 2 years in the Peoples Democratic Republic of Yemen (PDR Yemen) were surveyed as to the use of supplementary foods. An experienced Yemeni nurse-midwife who had been specially trained in interview techniques and on matters pertaining to nutrition visited each family. The mothers were questioned about whether or not regular supplementation had been initiated and if so at what age which persons had influenced their decision when to start and what supplements were used. Supplementary food is defined to mean any food given to the child on a regular basis in addition to breast milk cows milk powder and/or fresh mammalian milk. Supplements were classified into biscuits commercial baby foods foods specially cooked for the infants and family food. The tiny amounts given for a few days as special prelacteal feeds were not considered as supplementary food. Mothers in the urban and slum areas stated that the appropriate time to give foods supplementary to breast or bottle milk was 4 months of age; rural mothers started at 8 months. All mothers in the urban and slum areas found supplementary feeding necessary considerably before age 2. No fewer than 20% of rural mothers stated 2 years as the ideal age for its introduction. Biscuits were the 1st supplementary food introduced and were widely used. The only commercial baby food used was a cereal-based precooked enriched powder. It was given regularly to 23% of children below age 2 in the urban area and to 14 and 3% in the slum and rural areas respectively with a maximum use between 9-12 months of age. The introduction of family food before 6 months was observed only in the slum area. At age 1 80% of the urban 79% of the slum and 60% of the rural children regularly were taking a portion of the familys diet. The mothers held the opinion that their children mostly were thriving normally; this was the case particularly among the slum mothers. The growth development of infants in PDR Yemen begins to falter around age 6 months reaching a maximum deviation at 12-12 months of age. Slum children are the most wasted and a nutritional component as a reason for this seems clear. The greater concern among urban mothers may reflect greater awareness that food is related to growth and health.

Child feeding habits in the People's Democratic Republic of Yemen. I. Breast and bottle feeding.

Breast and bottle-feeding among 86 urban 132 slum and 747 rural children below 2 years of age in the Peoples Democratic Republic of Yemen were studied in 1982-83 using current status method. Most mothers began by breastfeeding but a rapid decline was seen especially in the urban and slum populations with a concomitant high prevalence of bottle feeding. The median duration of breastfeeding was 6.5 10 and 14 months among urban slum and rural mothers respectively. The prevalence of exclusive breastfeeding of infants below 3 months of age was significantly higher (P<0.05) in the rural setting compared to both the slum and urban areas and prolonged exclusive breastfeeding was only found though rarely in rural areas. Rural and slum mothers with suckling infants below 6 months of age tended to state 12 months as the optimal length of breastfeeding whereas mothers with older infants more often stated 2 years. Few mothers used cows milk formula in the proper concentration and amount. (authors modified)

A history of infant feeding. IV. Nineteenth century continued.

The care and especially the feeding of infants improved during the 19th century in England. There was special exhortation to raise the standards of infant care among the poor. Conditions of infants both inside and outside workhouses improved during the century and the value of infant life increased. The 2 main obstacles to progress in this direction were the general ignorance of slum mothers regarding hygiene and correct methods of artificial feeding and the lack of standards of cleanliness of cows milk. Cows were maintained in unsanitary conditions milk was watered and water was often contaminated. The consequences of good and bad methods of infant feeding and of good and bad social conditions were reflected in the levels of infant mortality. These levels fell by 50% from 1731-1791; the decline was slower in the 19th century. Infant mortality statistics illustrate the importance of breast feeding. Mortality levels in a study in 1863 were found to be lower among breast fed infants. The popularity of wet nurses peaked at the end of the 18th century. By 1863 the safety of artificial feeding was such that wet nurses could be eliminated. Feeding bottles have been known and used throughout history since the Roman times. The 1st step toward dehydrated milk for use as an artificial infant food was made in 1835. Supplemental infant foods were developed simultaneously.