Nations International Children's Emergency Research Articles

The Role of Breastfeeding in Acute Respiratory Infections in Infancy.

Acute respiratory infections (ARIs) affect the respiratory tract, are often caused by viruses such as respiratory syncytial virus and rhinovirus, and present symptoms such as coughing, fever, respiratory distress and breathing difficulty. The global adherence to exclusive breastfeeding (BF) for the first 6 months of life has reached 44%, supported by World Health Organization and United Nations International Children's Emergency Fund efforts. BF provides vital nutrients and contributes to infant immune system development, protecting against infections. The role of BF in preventing and reducing complications of ARIs in infants is gaining attention, prompting a review of current data and future research needs. This review aims to summarize the evidence on the role of BF in reducing the risk and severity of ARIs in infants, elucidate the adaptations in breast milk composition during infections and identify relevant research needs. Human milk (HM) is rich in immunoglobulins, antimicrobial peptides, and immunomodulatory factors that protect against various pathogens, including respiratory viruses. Several studies have demonstrated that BF is associated with a significant reduction in hospitalization, oxygen requirements, and mortality in infants with ARIs. The effectiveness of BF varies according to the specific respiratory virus, and a longer duration of exclusive BF appears to enhance its protective effect. It is documented that the composition of HM adjusts dynamically in response to infections, fortifying the infant's immune defenses. Specific immunological components of HM, including leukocytes and immunoglobulins, increase in response to infection in the infant, contributing to the enhancement of the immune defense in infants. Immune-boosting microRNAs enhance immune transfer to the infants and promote early gut maturation, and the HM microbiome along with other factors modifies the the infant's gut microbiome and immune system. BF defends infants from respiratory infections, and the investigation of the microRNAs in HM offers new insights into its antiviral properties. The promotion of BF, especially in vulnerable communities, is of paramount importance in alleviating the global burden of ARIs in infancy.

Youth mental health in a Canadian community sample during COVID-19: Exploring the role of perceived sense of belonging.

Research has linked broad societal changes related to the COVID-19 pandemic and poorer mental health in young people. There remains a pressing need for studies examining the factors that are associated with better mental health and well-being. The current study addresses this gap using a community-based survey called the Waterloo Region Youth Impact Survey. It was designed in partnership with local youth and the Canadian Index of Well-Being in accordance with United Nations International Children's Emergency Fund guidelines. Using a convenience sampling methodology, this survey was developed to explore the domains, rates, and correlates of well-being and mental health among youth during the pandemic (N = 297). Confirmatory factor analysis was used to identify dimensions related to children's social environment (friends, school, family), sense of belonging, mental health, and well-being. Subsequently, a mediation model was tested. The relationship between children's environments and mental health and well-being operated via perceived sense of belonging. Findings shed light on patterns of youth mental health and well-being during the pandemic, illustrating the role of belonging as a promotive factor with public health relevance.

Rule of Law and Human Rights: Analysis of International Standards and Case Law

The EU's human rights policies and actions have two main components: protecting the fundamental rights of EU citizens and promoting human rights around the world. One of the aspects that the UN focuses on is the relationship between democracy and human rights, as the organisation upholds the importance of equal political participation of citizens of its states and full respect for human rights, including the recognition, protection and promotion. As defined by the United Nations International Children's Emergency Fund (UNICEF), human rights are norms that recognise and protect the dignity of all people, meaning they apply to everyone, without distinction of race, gender, education, political opinion, sexual orientation or any other type of moral judgement. The realisation of human rights also obliges states to be responsible for protecting these norms and prohibits certain acts that violate them. Human rights can be said to be one of the greatest achievements of mankind. One of the most important human rights documents is the Universal Declaration of Human Rights, signed in 1948 at the UN General Assembly. Consisting of 30 articles, the Declaration formalises all the theoretical developments made earlier on civil, political, social, economic and cultural rights. Another innovation of the Declaration was the inclusion of human rights in the universal character, becoming the rights of all peoples. Thus, for the UN, human rights "are universal legal guarantees that protect individuals and groups from acts and omissions by governments that violate human dignity"3. Human rights are fundamental and therefore inalienable human rights, i.e. those rights whose violation would lead to an attack on the very essence of humanity. For this reason, it is important that everyone is aware of and knows about human rights, their content and the forms of protection provided for them, as everyone should be able to enjoy their fundamental rights for the sole purpose of living in peace, without distinction. Human rights, democracy and the rule of law create an environment in which countries can promote development, protect people from discrimination and ensure equal access to justice for all.

Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years.

Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.

A STUDY ON COLD CHAIN MAINTENANCE AND VACCINE MANAGEMENT PRACTICES OF URBAN GOVERNMENT HEALTH FACILITIES IN JABALPUR DISTRICT, INDIA

Introduction: Efficient cold chain and vaccine logistics management are made possible by the health system's processes, practices, and policies, which are evaluated by Effective Vaccine Management, a diagnostic tool. A significant number of urban Jabalpur children receive vaccinations from a government health facility.The aim of the study wasto Assessthe cold chain maintenance and vaccine management practices at urban government Cold Chain Points of Jabalpur district.Methods:A cross-sectional study was carried out at all of 13 urban government ColdChain Points across Jabalpur district. Globally validated World Health Organization -United Nations International Children's Emergency Fund Effective Vaccine Management tool was used for this study. Criteria wise and Consolidated Effective Vaccine Management scores were calculated as per World Health Organization guidelines. Results: All the urban service point stores or cold chain points scored more than the target 80% in two criteria: storage capacity and building. The consolidated criteria score of all the cold chain points in urban Jabalpur, criteria like maintenance, stock management, management information system, and supportive functions, were lagging behind the 80% mark. Low scores in maintenance, stock management, and management information system and supportive functions criteria are somehow a setback for all the preparationand hard work done towards optimal vaccine management and supply chain in the area. Conclusion: The overall performance of the urban cold chain points in Jabalpur district was far better as compared to the state-level effective vaccine management assessment done in Madhya Pradesh in 2011 and 2016. Planned preventive maintenance for buildings and equipment needs to be strengthened. Issues like Lack of information for stock management, need for periodic refresher trainings are to be emphasized.

A Risk Assessment and Planning Tool to Prevent Sudden Unexpected Death in Infancy: Development and Evaluation of The Baby Sleep Planner.

Successful national safer sleep campaigns in the United Kingdom have lowered the death rates from sudden unexpected death in infancy (SUDI) over the past 3 decades, but deaths persist in socioeconomically deprived families. The circumstances of current deaths suggest that improvements in support for some families to follow safer sleep advice more consistently could save lives. This study aimed to develop and evaluate a risk assessment and planning tool designed to improve the uptake of safer sleep advice in families with infants at increased risk of SUDI. A co-design approach was used to develop the prototype interface of a web-based tool with 2 parts: an individual SUDI risk assessment at birth and a downloadable plan for safety during times of disruption. The advice contained within the tool is concordant with national guidance from the Lullaby Trust, the United Nations International Children's Emergency Fund (UNICEF), and the National Institute for Health and Care Excellence. User testing of the prototype tool was conducted by inviting health visitors, midwives, and family nurses to use it with families eligible for additional support. Qualitative interviews with health professionals and families allowed for iterative changes to the tool and for insights into its function and influence on parental behavior. A total of 22 health professionals were enrolled in the study, of whom 20 (91%) were interviewed. They reported appreciating the functionality of the tool, which allowed them to identify at-risk families for further support. They felt that the tool improved how they communicated about risks with families. They suggested expanding its use to include relevance in the antenatal period and having versions available in languages other than English. They reported using the tool with 58 families; 20 parents gave consent to be interviewed by the research team about their experiences with the tool. Families were positive about the tool, appreciated the trustworthy information, and felt that it was useful and appropriate and that the plans for specific infant sleeps would be of benefit to them and other family members. Our tool combines risk assessment and safety planning, both of which have the potential to improve the uptake of lifesaving advice. Refinements to the tool based on these findings have ensured that the tool is ready for further evaluation in a larger study before being rolled out to families with infants at increased risk.

Cost of mate choice: Changing patterns of global age disparity in marriage and their consequences to women's health including maternal mortality and menopause.

Consistent across cultures and throughout time is the male preference for younger females. Given its prevalence, the mate choice theory proposes that age-disparate relationships may have contributed to the evolution of maternal mortality and menopause. The objective is to document evidence for age disparity in marriage from past and present populations and evaluate their relevance to maternal mortality and menopause. Cross-sectional data were collected from various regions and time points, ranging from the Roman era to the current decade. To analyze both the age disparity in marriage and age at marriage, data were collected from Ancestry.ca for Quebec, Massachusetts, India, South Africa, and England and Wales. Additional data were taken from the United Nations as a more recent and comprehensive source. To analyze the relationships between age disparity in marriage and different social factors, data on gross domestic product, maternal mortality rates, fertility, primary school enrollment, child marriage rates, and percentage of women in the total labor force were collected from the World Health Organization, World Bank, and United Nations International Children's Emergency Fund. The results showed that males were significantly older than females at first marriage in all populations and time frames sampled, supporting the assumption underlying the mate choice theory. Maternal mortality rates were strongly associated with age-disparate relationships, increasing by 275 per 100,000 live births for each additional year in the age disparity. The results from this study provide support for the assumption underlying the mate choice theory of maternal mortality and menopause.

Implementation of WASH (Water, Sanitation, and Hygiene) with Stunting Incidents in Pujer District, Bondowoso Regency

The Government of Indonesia is working with the United Nations International Children's Emergency Fund (UNICEF) to support a development program for the Water, Sanitation, and Hygiene (WASH) sector. Globally, access to WASH is still inadequate, and diseases resulting from poor WASH contribute to 13% of under-five deaths. Poor sanitation can cause various diseases, including nutritional problems such as stunting. In 2021, Bondowoso will become one of the 10 regencies or cities with the most considerable prevalence of stunting under five in East Java. Therefore, it is essential to research and examine the link between the success of WASH implementation and the stunting rate in Pujer District, Bondowoso Regency. This quantitative descriptive study was conducted in the Pujer District with 67 respondents using a simple random sampling technique. The study used several variables, including the hygiene behaviour of mothers under five, the ownership of access to family sanitation, the physical quality of family drinking water, the incidence of infectious diseases (diarrhoea) in children, and the nutritional status of children based on height and age (TB/U). The analyses were univariate, crosstab, and scoring. There were 16 families (24.4%) with an unsuccessful WASH assessment but no stunting below five, and 33 families (49.25%) with a successful WASH assessment but no stunting below five. It was concluded that the better the WASH was applied, the better the nutritional status of the toddlers; conversely, the worse the WASH was implemented, the worse the nutritional status of the toddlers.

Child well-being in Vietnam: The roles of household welfare and early childbearing

Children are important resources for nations' long-term and sustainable development; therefore, they have the right to have their well-being ensured from birth. Although multidimensional methods for researching child well-being in Vietnam have made some progress, most studies still focus on single aspects of child well-being. This paper analyzes the correlations between household welfare (measured by the asset index - an effective alternative tool to income and expenditure), early childbearing, and child well-being (in six constitutive dimensions) to provide a broad picture of the above relationships in the Vietnamese context. Using secondary data from the Vietnam Sustainable Development Goal Indicators for Children and Women (SDGCW) survey by the General Statistics Office (GSO) of Vietnam and the United Nations International Children's Emergency Fund (UNICEF) in the period 2020–2021, and applying Tobit and OLS regression models, the research results show that a high level of household welfare not only directly increases child well-being but also has an indirect positive effect on this indicator by reducing the early childbearing rate. Based on the research findings, several suggestions are made to improve household welfare; therefore, this paper can support the government in managing early childbearing rates and improving child well-being throughout the country.

The natural infection rates of vaccine-preventable diseases among children: A literature review

Background: Indonesia currently faces a triple burden of various disease problems, outbreaks of infectious diseases, and an increase in long-standing infectious diseases, new infectious diseases, and non-communicable diseases (NCDs). A report released in 2020 by the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) indicated that during the Covid-19 pandemic, the postponement of routine vaccinations resulted in approximately 80 million children aged less than or equal to 12 months being susceptible to diphtheria, measles, and polio.Purpose: To review previous research in analyzing the relationship between incomplete basic vaccination and the occurrence of vaccine-preventable disease (VPD) cases.Method: This study employed a literature review design, conducting a systematic review by selecting relevant articles pertaining to the research objective. The literature study selection process was adapted from the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Inclusion criteria for this research encompassed originality, usage of both English and Indonesian languages, keywords covering basic vaccination, adverse events following vaccination, Integrated Healthcare Centervisits, education, and the role of Integrated Healthcare Centercadres.Results: Generally, community knowledge, attitudes, family support, and the role of cadres correlated with vaccination coverage achievement. However, some studies indicated no correlation between specific variables and the infants' basic vaccination status. To enhance vaccination coverage and client satisfaction, improving community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, as well as increasing vaccine availability and vaccination guidelines, are necessary.Conclusion: To improve vaccination coverage and client satisfaction, enhancements in community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, alongside increased vaccine availability and vaccination guidelines, are essential.Suggestion: It is advisable for the community to enhance knowledge, attitudes, and support for vaccination, especially among mothers and families. The active involvement of cadres in vaccination programs and public dialogue regarding the moral ethics of vaccination also need improvement.

Mitigating and preventing food insecurity: a scoping review of the current EU policies

Abstract Background Food insecurity (FI) is a major public health concern, due to its association with a variety of adverse health outcomes. The aim of this study is to provide a picture of the EU policy response and adherence to the international recommendations in terms of FI mitigation and prevention. Methods A scoping review was carried out based on PRISMA Extension for scoping reviews method. By using specific queries/keywords, Pubmed and Scopus were searched and also institutional databases: EUR-Lex, WHO Global Database on the Implementation of Nutrition. The search was supplemented by a review of a list of organizations’ official websites, including Cordis, Food and Agriculture Organization of the United Nations, United Nations International Children's Emergency Fund and World Food Programme. Results The search on PubMed and Scopus produced a list of 8 articles, 3 concerning agriculture policies in EU, 4 related to intervention on the school lunch and 1 focused on the introduction of a tax on unhealthy drinks. Based on the search on EUR-Lex and WHO Global Database on the Implementation of Nutrition, 4 EU-wide statutory policies were collected covering school meals, food loss reduction, food waste prevention and food crisis and humanitarian aid operations. The institutional website's review returned 18 documents in the form of ‘soft law’ measures, including action plans, action tools and projects. Conclusions Preliminary findings suggest that currently, at EU level, a coherent specific policy framework on FI is lacking. The policy fragmentation is mainly due to the multidimensional nature of FI, which has interconnections with multiple and different areas of food system-food availability, food accessibility, food safety and food quality and healthiness. The outputs also show that to date EU has failed to adhere to the international recommendations (above all, WHO recommendations) on FI mitigation and prevention. This has significant implications in terms of public health. Key messages • Policies design and implementation have the potential to create living environments conducive to good health and to lead to concrete health gains. • Health gains resulting from strategies and policies implementation against FI reduce healthcare costs associated with the treatment of the FI-related diseases.

Handle with Care: A Narrative Review of Infant Safe Sleep Practices across Clinical Guidelines and Social Media to Reduce SIDS.

Sudden Infant Death Syndrome (SIDS) is a leading cause of infant mortality across the United States and the world. There are multiple environmental and behavioral determinants of sudden infant death which are modifiable risk factors and potential targets for intervention. In this increasingly digital era, health education and communication on SIDS have taken many forms, which extend to social media. Current published studies on coverage of infant safe sleep practices are scant and were published well before the newly revised guidelines of the American Academy of Pediatrics that review ways to prevent infant sleep-related deaths based on evidence-based SIDS-reduction measures. In this Perspective: Review of a Pediatric Field, the current state of published knowledge and coverage on a range of infant safe sleep considerations across social media are reviewed. We delineate gaps in the knowledge and practice as well as the central differences between the 2016 and 2022 AAP Safe Sleep guidelines. We also present recommendations for further research and practice which support coverage of future content on the revised guidelines across social media as the basis to present the most up-to-date and evidence-based information for reducing sudden infant death from sleep-related causes. Tapping into the potential of social media as a learning modality in health promotion also contributes towards the larger goal of the World Health Organization, United Nations International Children's Emergency Fund (UNICEF), and Healthy People 2030 to reduce infant mortality on both global and national levels.

Revolutionizing pediatric HIV therapy: The latest breakthroughs in drug delivery techniques

Human Immunodeficiency Virus (HIV) is the root cause of acquired immunodeficiency syndrome (AIDS), which destroys the body's immune cells, thereby rendering the body unable to fight any infections. It is a sexually transmitted disease (STD) in adults but in children, it is passed on from an HIV-positive mother in the womb or through the birth canal, or via breastfeeding. According to a report by United Nations International Children's Emergency Fund (UNICEF) 2021, 2.73 million children have been infected with this virus globally. Current statistics for 2022–23 would be updated by July 2023. Many antiretroviral drugs (ARVs) are available in the market for preventing the vertical transmission of HIV which are not 100% effective. The regimen for treating HIV in children is of long duration and requires drug administration multiple times daily which makes it less compliant for the children as well as their parents. As a result, the children are unable to complete the regimen. Multiple new dosage forms such as microarray patches, buccal films, 3D-printed mini tablets, polymeric micelles, and food-based nanoparticles have been developed to overcome these problems. This article aims to discuss the problems with existing therapy and recent advances that have been made in HIV therapy for children along with the various clinical trials that are currently underway.

Seeding Resilience-Building CROPs: Understanding the Impact of Connection and Relationship-Oriented Practices on Educator Intention to Leave

According to United Nations International Children's Emergency Fund (UNICEF), the devastation caused by the global COVID-19 pandemic has elevated the teacher turnover crisis to one of the most harrowing issues facing our society. Stress and burnout among school professionals have reached new highs, resulting in a need to better understand the individual and contextual factors that can ameliorate stress and improve well-being and resilience. Using a relationship-based framework of resilience, this study shifts our gaze from burnout toward understanding the resilience factors associated with lower stress to inform the field’s pathway toward addressing the workforce crisis while better supporting the resilience of educators, students, families, professionals, and educational systems during the pandemic and beyond. Findings from a logistic regression model show a significant decrease in the likelihood of intention to leave as relationship-based resilience factors increased. Implications discuss the importance of opportunities that increase family–school–community support, social-emotional well-being and safety, and other strategies that build relationships, foster resilience, and improve retention of the school-based workforce.

The Relevance of Human Security Approach in Assessing The Causes and Solutions to Food Insecurity in South Sudan (Case Study: South Sudan 2017 Famine)

The Relevance of Human Security Approach in Assessing The Causes and Solutions to Food Insecurity in South Sudan (Case Study: South Sudan 2017 Famine)

Menstrual Hygiene Problems and Challenges Faced by Adolescent Females in Rural Areas: A Narrative Review.

Menstruation is a vital sign of reproductive health and development. Menstrual hygiene practices are consequently a significant public health issue. However, menstrual practices are still tainted by taboos and other sociocultural constraints, which adversely affect health since adolescent females in rural areas are unaware of the scientific facts regarding menstrual hygiene practices. The Indian government has recognized the significance of menstrual hygiene and developed and implemented several programs and schemes for menstrual hygiene management (MHM). But due to a lack of, little, or inaccurate knowledge and cultural practices and socio-economic status, adolescent females face many obstacles and suffer from health issues. A comprehensive literature and datasearch was done using key databases such as PubMed and Google Scholarand other sources such as the Ministry of Health and Family Welfare (MoHFW), the United Nations International Children's Emergency Fund (UNICEF), the World Health Organization (WHO), and Google to identify the relevant articles and reviewed publications using full-text search. A total of 40 articles out of 1,461 were selected for review after the screening and elimination of repeated articles. The objective of this literature review is to assess the awareness and knowledge of the importance of menstruation, the understanding of safe menstruation practices, the significance of properly disposing of menstrual products, and the knowledge of how to guard against reproductive system infection and its consequences and also to identify the problems and challenges faced by adolescent females during their menstrual hygiene practices or management. The core of many health issues is misinformation, myths, erroneous beliefs, lack of awareness, and incomplete or incorrect knowledge about menstruation. Therefore, it is essential to teach adolescent females about hygienic behavior and safe menstrual practices.

Efficacy of Ayurveda Interventions in Protein Energy Malnutrition in Children: A Systematic Review and Meta-Analysis

According to United Nations International Children's Emergency Fund (UNICEF), in India, around 46 percent of all children below the age of three are too small, and 35.7% are underweight and come under MAM (Moderate Acute Malnutrition). Protein Energy Malnutrition (PEM) can be correlated with Karshya, Balashosha, Phakka, Parigarbhika, Sushka Revati, and Apatarpanjanya Vyadhi based on similar clinical features. Multiple evidencebased clinical studies are conducted in this sector, but no comparative conclusion of results or systemic review is accomplished. The study aims to evaluate and compare Ayurveda interventions' efficacy in managing children's protein energy malnutrition and to assess the effect of Ayurveda Interventions on weight gain and serum protein values in children suffering from PEM. This systemic review was conducted according to the guidelines of the Cochrane Handbook of Systemic review of interventions and is reported following the Preferred Reporting Guideline for Systemic review and meta-analysis guidelines (PRISMA). All study groups showed significant p values within the group and insignificant p values in the fixed random effect model. Though the p-value is insignificant between the groups, one group among the four shows better results in the fixed effect model. In the primary outcome of weight, group 3, i.e., the category of drugs having Bruhana and Pachana combination, shows better results than other groups in the fixed effect model. In the outcome of serum protein values, BMI, and Head circumference, group 4, i.e., drugs with only Bruhana properties, show better results than other groups. Based on this review, few policies or treatment protocols can be hypothesized for managing PEM at the national level. The Ayurveda intervention combinations have worked better because they work on multiple aetiological factors and biological variations in PEM in Children.

Humanitarian Action of United Nations International Children’s Emergency Fund (UNICEF) in Jayapura During the Covid-19 Pandemic

The issue of humanitarianism in international relations is a vital topic to probe deeper. Activist groups, individuals, and institutionalized groups or organizations, such as the United Nations International Children's Emergency Fund (UNICEF), have been carrying out humanitarian actions in Papua. UNICEF has been around for a long time in Papua, running several programs, including children's education program in Papua. However, education in Papua remains relatively low due to high rates of illiteracy and school dropouts, and poor literacy. This research explains that international organizations working in the humanitarian field can carry out the basic principles of humanitarianism, specifically, how UNICEF's programs adhere to these principles during the Covid-19 era. Direct interviews and secondary data collection were conducted in this qualitative descriptive research. The results show that UNICEF, as an international humanitarian organization, managed to uphold four basic principles in carrying out its role, particularly in improving the quality of education in Jayapura City. However, the Covid-19 pandemic has posed such obstacles to UNICEF related to donors, program implementation, and personnel that the practiced humanitarian principles became blurred and somewhat questionable. While the best practice promotes faithful adherence to the basic principles of humanity, it is undeniable that almost all organizations cannot exist without assistance from third parties which would ignore the principle of impartiality.
 Keywords: Covid-19, education, humanitarianism, Jayapura, UNICEF

Impacts of Social Assistance on Child Well-Being in Vietnam: The Mediating Role of Household Welfare

As individuals’ living standards increase, the needs for the well-being of individuals are becoming more complicated, especially among children. Even though multidimensional methods for researching child well-being in Vietnam have made some progress, analyses of single dimensions of child well-being remain common. The research analyzes the relationship between social assistance, household welfare and child well-being on both objective and subjective aspects by applying Structural Equation Modeling (SEM) through the secondary data collected from the Vietnam Sustainable Development Goal Indicators for Children and Women survey in the period 2020-2021 by the General Statistics Office (GSO) and the United Nations International Children's Emergency Fund (UNICEF) of Vietnam. The research results emphasize the mediating role of household welfare as high social assistance increases household welfare, thereby improving child well-being in Vietnam. Based on the research results, the research proposes several recommendations for the management and improvement of social assistance programs, thereby improving child well-being in Vietnam.

Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study.

Introduction Kangaroo mother care (KMC) is an evidence-based, simple, time-tested, low-cost, and high-impact intervention for neonatal survival in hospitals and the community, particularly in resource-constrained areas. This has many beneficial effects on sick and stable low-birth-weight babies, lactating mothers, families, society, and the government. However, despite the World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) recommendations for KMC, there is no satisfactory implementation of it in the community as well as in facilities. This study aimed to improve the duration of home-based kangaroo mother care (HBKMC). Material and methods We conducted a before-and-after intervention hospital-based, single-centerstudy in a level III neonatal intensive care unit (NICU) to improve the duration of HBKMC. The KMC duration was classified into four categories: short, extended, long, and continuous where KMC was provided for 4 hours/day, 5-8 hours/day, 9-12 hours/day, and more than 12 hours/day, respectively. All neonates with birth weight < 2.0 kg and their mothers/alternate KMC providers at a tertiary care hospital in India in the time periodof five months from April 2021 to July 2021 were considered eligible for the study. We tested three sets of interventions by using the plan-do-study-act cycle (PDSA cycle). The first set of interventions was the sensitization of parents and healthcare workers regarding the benefits of KMC by comprehensive counseling to mothers and other family members using educational lectures, videos, charts, and posters. The second set of interventions was to reduce maternal anxiety/stress while maintaining maternal privacy by providing more female staff and teaching proper gown-wearing techniques. The third set of interventions was to solve lactation and environment temperature issues by providing antenatal and postnatal lactation counseling and warming of the nursery. The paired T-test and one-way analysis of variance (ANOVA) were used for statistical analysis, and p<0.05 was taken as significant. Results One hundred and eighty neonates were enrolled along with their mothers/alternate KMC providers in four phases, and three PDSA cycles were implemented. Out of 180 LBW infants, 21 (11.67%) infants received KMC < 4 hours/day.According to the KMC classification, 31% have continuous KMC in the institution, followed by 24% long KMC, 26% extended KMC, and 18% short KMC. After three PDSA cycles, HBKMC was 38.88% continuous KMC, followed by 24.22%long KMC, 20.55% extended KMC, and 16.11% short KMC. Continuous KMC was improved from 21% to 46% at the institute and 16% to 50% at home from phase 1 to phase 4 of the study after the implementation of three sets of interventions in three PDSA cycles.The phase-by-phase KMC rate and duration were improved after the application of the PDSA cycles, and this was maintained in HBKMC as well, but it was statistically not significant. Conclusion Sets of intervention packages based on needs analysis using the PDSA cyclewere able to improve the rate and duration of KMC in the hospital and at home.