Reduce Child Mortality Research Articles

The Interplay of Ethnicity, Education, and Employment on Maternal Attitudes Toward Childhood Vaccination in Nigeria

Vaccination is a highly effective public health strategy for reducing child mortality from vaccine-preventable diseases (VPDs) such as measles, polio, tuberculosis, and Haemophilus influenzae. Despite the provision of free routine immunizations for children up to two years old in Nigeria, challenges in vaccine uptake persist, especially for vaccines needed beyond early childhood. These challenges are not merely due to vaccine access but are significantly influenced by maternal attitudes towards immunization. Socio-demographic factors such as ethnicity, education, and employment status are crucial in shaping these attitudes, yet their specific impacts are not well understood. This study aims to explore how these socio-demographic variables affect maternal attitudes towards childhood immunization, with a focus on immunization beyond the age of two in Ughelli North Local Government Area (LGA) of Delta State, Nigeria. A cross-sectional study was conducted with 321 mothers in Ughelli North LGA, utilizing a modified, pre-tested questionnaire to evaluate maternal attitudes towards childhood immunization. Data were collected through an online survey and analysed using descriptive and inferential statistics, with Chi-square tests used to assess the relationships between socio-demographic factors and attitudes. The majority of participants were Urhobo (60.7%), semi-employed (53.6%), and had tertiary education (92.1%). The findings showed that 79.4% of mothers had positive attitudes towards childhood immunization. Significant associations were found between maternal attitudes and ethnicity (p = 0.026), employment status (p = 0.016), and educational level (p < 0.001), indicating that these factors are pivotal in shaping maternal views on the importance and necessity of immunization. Unexpectedly, even mothers with high educational levels showed variability in their attitudes based on ethnic background and employment status, suggesting that public health interventions must consider the complex interplay of these factors. The study's results provide valuable insights into the socio-cultural and economic determinants of maternal attitudes towards immunization in Ughelli, underscoring the need for targeted health promotion strategies that address specific demographic groups. Efforts should focus on community-based interventions and media campaigns that highlight the importance of continuing vaccination beyond infancy. Additionally, enhancing access to immunization services and addressing barriers related to employment and ethnicity will be crucial for improving vaccine uptake in the region.

Nearby armed conflict affects girls' education in Africa.

Female education is a crucial input to women's agency and empowerment, and has wide-ranging impacts, from improved labor market outcomes to reducing child mortality. Existing gender-specific evidence on the effect of armed conflict on education is conflict-specific and mixed. We link granular data on conflict events to georeferenced survey data on educational attainment from 28 countries in Africa, and use a regression-based approach to estimate the local effect of conflict exposure on female years of schooling. We find that conflict events occurring within 25 kilometers during a female child's primary school years reduces years of schooling by 0.4 years by adolescence. We do not find the same effect for males. Exposure to only low intensity conflict events with at most two casualties has persistent negative and significant effects. Consecutive years of conflict, however, can have positive effects in later years, which offset earlier negative effects, suggesting a habituation to violence. In the past two decades, we estimate excess child mortality in Africa associated with the indirect channel of women's education to be similar in magnitude to the number of direct child casualties due to conflict.

Sociodemographic Factors and Maternal Knowledge of Childhood Vaccination in Nigeria

Childhood vaccination is globally recognized as one of the most cost-effective public health interventions to reduce child mortality, particularly in regions burdened by vaccine-preventable diseases (VPDs) such as measles, polio, and tuberculosis. Despite the availability of free routine vaccination services in Nigeria, suboptimal vaccination coverage persists, and maternal knowledge plays a critical role in this challenge. While much attention has been focused on the role of attitudes and practices in influencing vaccine uptake, less is known about the specific impact of socio-demographic factors on maternal knowledge of the vaccination schedule, particularly in urban areas like Ughelli, Nigeria. This study seeks to fill this gap by examining the socio-demographic determinants of maternal knowledge about childhood vaccination in Ughelli North Local Government Area (LGA) of Delta, Nigeria. A cross-sectional descriptive study was conducted among 321 mothers residing in Ughelli North LGA, utilizing a structured and pre-tested questionnaire designed to assess maternal knowledge of vaccination schedules and key vaccines for children. The study explored the association between socio-demographic factors such as age, educational level, employment status, ethnicity, and the level of maternal knowledge about childhood vaccination. Data were collected using an online survey and analysed with descriptive and inferential statistics to identify patterns and associations. The study revealed that, despite high levels of educational attainment among participants (88.8% had tertiary education), 87.5% of the respondents demonstrated poor knowledge of the full vaccination schedule, especially concerning vaccines required beyond the age of two. Socio-demographic variables, including ethnicity, employment status, and education, were not significantly associated with vaccination knowledge (p>0.05), indicating that even mothers with higher education levels exhibited gaps in specific vaccination knowledge. These results suggest that maternal education alone is not a sufficient predictor of comprehensive vaccination knowledge in this context. This study makes an original contribution to the body of knowledge by highlighting the disconnect between general education and specific health knowledge regarding childhood vaccination. While many studies have established positive links between socio-demographic factors and overall vaccine attitudes or practices, this research uniquely focuses on knowledge of the vaccination schedule, identifying critical gaps that exist independently of attitudes or socio-economic status. The findings emphasize the need for tailored health education interventions that go beyond general literacy and target the specifics of vaccine schedules and timing, particularly for vaccines administered after infancy.

A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.

Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccination during pregnancy, the issue still exists. This analysis explores the impact of MTT vaccination on neonatal mortality in Bangladesh and identifies associated factors. This research utilizes data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS). The dataset consists of 23,402 cases; among them, 587 cases resulted in infant death. The outcome variable was infant mortality, which was binary. The independent variables identified as potential contributors to the cause of death included tetanus toxoid vaccination status, mode of delivery (cesarean section or not), and mother's education level, among others. The Poisson model was employed to analyze the data. The analyses showed that the neonatal mortality rate was 2.51%. Notably, 45.90% of mothers received the MTT vaccination during pregnancy. Among them, 23.07% received a single dose, and 22.82% took adequate doses (receiving more than two doses) and adhered to WHO guidelines. The adjusted incidence rate ratio (IRR) was 1.36, which indicates that there was a 36% higher risk of neonatal mortality for those children whose mothers did not take TT (IRR = 1.36, p = 0.081). We also found that women from middle-class households (IRR = 1.58, 95% CI = 0.98, 2.54) and women with higher parity (IRR = 1.96, 95% CI = 0.95, 4.03) also had a higher risk of newborn fatalities. A comparable trend has been observed regarding the correlation between the number of tetanus doses administered and neonatal mortality, where it also emphasizes the importance of receiving adequate doses (a minimum of 2 doses of tetanus vaccine) to mitigate neonatal mortality (adjusted IRR = 0.54, 95% CI = 0.29, 1.01) in comparison to no doses received. Administering a minimum of one maternal tetanus dose significantly lowers the risk of neonatal mortality. Other than Maternal Tetanus Toxoid vaccination, the analyses underscore various contributors to neonatal mortality, encompassing maternal healthcare, delivery procedures, socio-economic status, and education. Targeted interventions addressing these factors have the potential to efficiently decrease neonatal mortality rates and improve overall maternal and child health.

Involvement Of Males In Utilization Of Maternal And Child Health Services: A Cross-Sectional Study Of Women’s Perspective

Background: Men in patriarchal societies of developing countries like India are often identified as decision makers in all aspects of life. Men’s supportive stance in MCH services utilization plays crucial role in reduction of maternal and child mortality. Aim: To study the involvement of males in maternal and child healthcare services. Objective: To study sociodemographic profile of study participants and knowledge and practices of their husbands about MCH services. Material and methods: The cross-sectional study was conducted among 130 married women having one living child less than 2 year of attending immunization clinics of Government medical college and hospital, Miraj. Information about socio-demographic and reproductive health characteristics, male participation in reproductive and child health care services was collected entered in MS excel and analyzed. Results: Among the females 70% were below 25 years of age and age of the husbands of 71% participants were less than 30 years. 64% females were belonging to Muslim religion, 84% were residing in urban area, 82% stayed in joint family, 58% educated up to secondary school, 67% belongs to socio-economic class IV. 61% husbands were decision maker in family planning, 78% husbands accompanied for ANC visit,79% husbands knew about the govt. MCH scheme 94% husbands knew about increased need for food & rest by pregnant women, 63% were having knowledge about complications of pregnancy and delivery. But only 22% husbands accompanied for child’s immunization. Only 34% husband help in domestic work, 63% paid attention on diet/food frequency of their wives and 51%encouraged & paid attention on adequate rest of their wives. Conclusion: Men are aware of various aspects of antenatal and intra natal care, their husband’s involvement during antenatal period was found to be good but it decreases during immunization phase of the child. Involvement for helping in domestic work, encouraging for adequate rest & food during ANC was also less. So, creating specific Health education and SBCC activities about maternal & child health among men may enhance their positive involvement.

Strategies to Reduce Maternal and Child Mortality Rates through "Buaian Services" in East Java

Strategies to Reduce Maternal and Child Mortality Rates through "Buaian Services" in East Java

Effects of Carbon Dioxide Emissions on Child Mortality in Nepal

The rising levels of carbon dioxide (CO₂) emissions have intensified concerns about public health impacts, especially in developing countries where economic growth often increases environmental strain. This study aims to examine the relationship between CO₂ emissions and child mortality in Nepal, incorporating factors such as economic growth, health expenditure, and educational attainment. Using time-series data from 2001 to 2021, Fully Modified Ordinary Least Squares (FMOLS) and Canonical Cointegrating Regression (CCR) models were employed to assess the long-term relationships between these variables. Results indicate that a 1% increase in CO₂ emissions is associated with an approximate 0.11% rise in child mortality, underscoring the detrimental effects of environmental degradation. Additionally, economic growth and health expenditure were found to significantly lower child mortality, with a 1% increase in GDP per capita reducing child mortality by 0.69% and a similar increase in health expenditure decreasing it by 0.22%. Higher educational attainment also significantly decreased child mortality rates by 0.19%. These findings suggest that policies addressing both environmental and socioeconomic factors are essential to improving child health outcomes. Overall, the study highlights the importance of integrated policy approaches in mitigating child mortality through environmental protection, economic development, and social investment.

Contextual challenges experienced by CHVs in the informal use of mobile phones within integrated community case management (ICCM) in Nyaguda sub-location, Western Kenya

Since the 1990s, Kenya has made substantial progress towards reducing child mortality. However, Kenya still lags behind regional and global averages in child mortality rates. Developing countries like Kenya face constraints in health system performance and access to services, especially in hard-to-reach areas such as Nyaguda sub-location calling for integrated care. Yet, it faces challenges that the everyday use of mobile phones could potentially address. In Nyaguda sub-location, mobile phones were used informally since they were not part of the integrated Community Case Management feasibility study. Several contextual challenges existed despite the benefits of using mobile phones within iCCM. This paper explores the contextual challenges to the informal use of mobile phones within iCCM in Nyaguda sub-location. The study employed an ethnographic research design. The data collection methods included informal conversations, Focus group discussions (FGDs)and in-depth interviews. This paper found several challenges to the informal use of mobile phones within iCCM, including physical challenges, high expectations on the Community Health Volunteers, cultural obligations, trust issues, and work/family conflict. The article concludes that physical follow-ups providing deeper connections among the various health stakeholders are still vital despite using mobile phones to avert child morbidity and mortality in hard-to-reach areas.

IMPROVING MATERNAL AWARENESS AND CHILDHOOD VACCINATION UPTAKE IN DELTA STATE, NIGERIA

Background:- Vaccination is globally recognized as one of the most effective public health interventions for reducing child mortality by preventing vaccine-preventable diseases (VPDs) such as measles, polio, tuberculosis, and Haemophilus influenzae. However, in countries like Nigeria, inadequate knowledge about vaccination remains a major barrier to achieving optimal vaccine coverage. Despite the Nigerian government’s provision of free routine vaccination for children up to the age of two, many mothers are unaware of the need to complete the full vaccination schedule, which leads to missed vaccination opportunities in later childhood. This study aimed to assess the level of maternal knowledge regarding childhood vaccination in Ughelli North Local Government Area of Delta State, Nigeria. Methods:- This cross-sectional descriptive study was conducted among 321 mothers in Ughelli, Delta State, Nigeria. Data were collected using a pre-tested, self-administered questionnaire designed to assess knowledge about childhood vaccination. The survey was administered online, and the data were analysed using descriptive and inferential statistics to examine associations between socio-demographic factors and vaccination knowledge. Participants' socio-demographic characteristics, including ethnicity, employment status, and educational background, were recorded and analysed. Results:- The study sample was predominantly Urhobo (68.9%), with a majority of participants being semi-employed (50.2%) and having attained tertiary education (88.8%). Despite the high educational levels, 87.5% of the respondents demonstrated poor knowledge of the full vaccination schedule, particularly regarding vaccines required after the age of two. The study found no statistically significant association between socio-demographic factors such as ethnicity, employment status, and educational level and maternal knowledge of vaccination (p > 0.05). Discussion:- Although previous studies have shown a positive relationship between maternal education and vaccine uptake, this study revealed that socio-demographic variables had no significant impact on knowledge about vaccination schedules. Despite general awareness of the importance of vaccines, the study identified significant gaps in specific knowledge, particularly concerning vaccines required beyond the second year of life. These gaps highlight the need for improved communication strategies to ensure mothers understand the full vaccination process. Conclusion:- The findings underscore the critical need for targeted health promotion efforts to enhance maternal knowledge of childhood vaccination, particularly regarding vaccines beyond infancy. Comprehensive educational campaigns using mass media, social media, and community platforms are recommended to bridge these knowledge gaps. Healthcare workers should also be trained to deliver clear and consistent information on vaccination during routine maternal and child health visits to ensure timely and complete vaccination coverage.

Cause-Specific Mortality among Infants in a Randomized Controlled Trial of Azithromycin Compared to Placebo for Prevention of Mortality.

Although community randomized trials have found a reduction in all-cause child mortality in communities receiving mass azithromycin distribution compared with placebo, individually randomized trials have not found similar protective effects. If a direct effect of azithromycin for prevention of child mortality exists, it is likely due to reduction in infectious mortality. Here, we assessed cause-specific mortality in a large randomized controlled trial of azithromycin administered during well-infant visits in Burkina Faso for prevention of mortality. Among 32,877 enrolled infants, the most common causes of death by 6 months of age were malaria, acute respiratory infections, and diarrheal disease. We found no evidence of a difference in the distribution of cause of death by randomized treatment assignment (P = 0.42) or in any infectious-specific cause of death. The results of this analysis are consistent with no direct effect of azithromycin on infant mortality when administered during well-infant visits.

Changes in the epidemiology of under-5 mortality in China from 2016 to 2022: an observational analysis of population-based surveillance data

Sustainable Development Goal (SDG) 3.2 aims to end preventable deaths of newborns and children younger than 5 years. China's progress towards SDG 3.2 has not been evaluated on multiple dimensions. We aimed to assess mortality rates in children younger than 5 years (hereafter referred to as under-5 mortality) and to quantify preventable child mortality and geospatial and temporal trends in child mortality in China from 2016 to 2022. In this observational analysis, we used data from the Chinese National Maternal and Child Health Surveillance System (MCHSS) for the period Jan 1, 2016, to Dec 31, 2022 and conducted all-cause mortality and cause-specific mortality analyses for different age groups (age 0-6 days, 7-27 days, 0-27 days, 1-5 months, 6-11 months, 12-23 months, 24-59 months, and birth to 59 months) separately at the national, residential (rural vs urban), and regional (eastern vs central vs western China) levels. All mortality rates were adjusted by age group, type of residency, region, and region-residency strata using a 3-year moving average of the under-reporting rates. National deaths were estimated using the number of livebirths from 2016 to 2022 from the Health Statistics Yearbook of China. Estimated national-level and regional-level mortality rates were weighted by the proportion of the population living in urban and rural areas from the 2010 national census. Optimal survival metrics for neonates and children younger than 5 years were calculated by cause of death in 2020-22 (termed the national optimum), on the basis of the lowest mortality observed among the six region-residency strata. In 2022, approximately 65 700 (95% CI 62 700-68 800) children younger than 5 years died in China, with 45·1% (42·7-47·4) of these deaths occurring in the neonatal period (age <28 days). China's under-5 mortality rate decreased from 10·2 deaths (9·9-10·5) per 1000 livebirths in 2016 to 6·8 deaths (6·5-7·2) per 1000 livebirths in 2022; the neonatal mortality rate decreased from 4·9 deaths (4·7-5·1) per 1000 livebirths in 2016 to 3·1 deaths (2·9-3·3) per 1000 livebirths in 2022. The relative risk of death in children younger than 5 years in rural areas compared with urban areas decreased from 2·4 (2·2-2·6) in 2016 to 1·9 (1·7-2·1) in 2022, and in the western region compared with the eastern region decreased from 3·4 (3·0-3·9) in 2016 to 2·3 (1·9-2·8) in 2022. The leading causes of under-5 mortality in 2022 were injuries (23·1% [21·1-25·1] of all-cause deaths), congenital malformations (14·8% [13·1-16·4]), preterm birth complications (14·1% [12·5-15·7]), intrapartum-related events (10·1% [8·7-11·5]), and acute respiratory infections (9·5% [8·2-10·9]). The leading cause of death in the neonatal period was preterm birth complications (12·8% [11·4-14·2] of deaths in children younger than 5 years). Under-5 mortality in China declined between 2016 and 2022. Disparities across regions and in urban versus rural areas narrowed over time, but they still exist. Therefore, efforts should be made to further reduce child mortality in China, including consistent investments and implementing of policies, programmes, and interventions, especially for the western rural areas. None. For the Chinese translation of the abstract see Supplementary Materials section.

Wealth Effects of Change in Infant Mortality Rate in India and its major states: A Decomposition Analysis

A newborn's first 28 days of life and their survival for a year present a crucial window of opportunity for management and prevention of the condition, which could otherwise be fatal. Eventhough, India has made great strides towards reducing child death (UN-IGME-child mortality report, 2015), the country is still far from reaching the SDG goal of reducing child mortality. In India, a household's financial situation may have a significant impact on infant mortality rates. The National Family Health Survey rounds-3 and 5 are taken into account for the analysis in this study. Further, decomposition analysis has been implemented in the present study. According to the decomposition analysis, there are four reasons why the infant mortality rate changes: (1) because of the change in the infant mortality rate; (2) because of the change in married couples' fertility women; (3) as a result of changes in the proportion of married women now and (4) in other variables influencing the rates of infant mortality rates in various wealth indices between NFHS-3 and NFHS-5. . KEYWORDS :Infant mortality rate, Wealth-indices, Decomposition analysis, National family health survey (NFHS).

Breastfeeding Support for All: Narrowing Inequalities for Nurturing a Future That Is Fair and Sustainable

Early initiation of breastfeeding, duration, and exclusivity are internationally recommended practices to maximize impact in preventing and reducing the double burden of malnutrition, reducing child mortality and other morbidities, improving child development, and reducing health costs. The protection, promotion, and support of breastfeeding are also central to countries' commitments to the 2030 Agenda for Sustainable Development. Global progress in breastfeeding rates has been reported in past years. However, many children are still left behind and are not receiving the numerous benefits of breastfeeding. There are also relevant inequities in breastfeeding rates across global regions and countries and between groups from different socioeconomic statuses and cultural backgrounds within countries. These inequities are also extended to the frequency and availability of comparable standardized indicators worldwide. In 2023, globally, only 39% of the countries provided information on exclusive breastfeeding rates to the age of six months, and 7% assessed their overall breastfeeding support programs in the past five years. The increase in the coverage and frequency of monitoring globally agreed breastfeeding targets and the assessment of the impact of breastfeeding programs are imperative to providing breastfeeding support for all and increasing breastfeeding prevalence equitably. Breastfeeding can be an equalizer in society; no one should be left behind. Only this way can breastfeeding mums be celebrated in all their diversity and journeys, attending the 2024 World Breastfeeding Week call.

Growth monitoring and promotion service utilization and its associated factors among children less than two years in Ethiopia: A systematic review and meta-analysis.

Growth monitoring and promotion services are strategies to promote child health and reduce child mortality. Even though Ethiopia is attempting different strategies to cope with the low rate of GMP utilization, the problem is still unresolved. Determine the pooled proportion of GMP utilization and its contributing factors among children less than two years in Ethiopia. The review protocol was registered with PROSPERO, number CRD42023472746. The PRISMA-2020 statement guided the conduct of this review. Electronic databases and grey literature were used. Heterogeneity was evaluated using I2. Subgroup analysis was conducted. The random effect model was used to summarize the pooled effect sizes with their respective 95% CI with STATA version 17. To test the small study effect, the funnel plot and Egger's test were applied. A total of seven (7) studies with 4027 participants were considered in this meta-analysis. The pooled proportion of GMP utilization reported by seven studies was 25.71% (95%CI: 24.39, 27.04). ANC follow-up (AOR = 2.11; 95% CI: 1.47, 2.76), PNC follow-up (AOR = 1.96; 95% CI: 1.44, 2.49), counseling (AOR = 2.88; 95% CI: 2.09, 3.68), maternal education (AOR = 2.89; 95% CI: 1.66, 4.13), paternal education (AOR = 3.78; 95% CI: 2.25, 5.32), family health card (AOR = 2.31; 95% CI: 1.67, 2.96), and mothers good knowledge towards GMP (AOR = 2.90; 95% CI: 1.72, 4.07) variables were positively associated with GMP service utilization. The pooled proportion of GMP remains low in Ethiopia. ANC and PNC follow-up, counseling, maternal and paternal education, family health cards, maternal knowledge towards GMP were significantly associated. Findings are essential for evidence-based policy making, intervention, and input for ongoing research.

Peningkatan Kapasitas Ibu Hamil Melalui Buku KIA Kelas Ibu Hamil Tahun 2024

Health development programs in Indonesia are currently prioritized towards improving the health status of mothers and children, particularly in the most vulnerable groups such as pregnant women, mothers giving birth, perinatal infants, toddlers, and women of reproductive age. In response to this, a community service activity titled "Enhancing the Capacity of Pregnant Women through the Maternal and Child Health (MCH) Handbook in Pregnant Women's Classes in the Working Area of Puskesmas Cempaka, Banjarbaru City, in 2024" was conducted. This initiative aims to reduce child mortality rates and improve maternal health. The use of the MCH Handbook is considered a strategic step to enhance community independence. The target of this community service activity was 12 pregnant women attending the Pregnant Women's Class facilitated by Midwife Maulida. The implementation methods included preparation and execution of activities in June 2024 in Bangkal, Cempaka Subdistrict, Banjarbaru City. Evaluations were conducted through pre-test and post-test assessments of the mothers' knowledge about the MCH Handbook. The results showed that 83% of the participants always brought the MCH Handbook during antenatal visits, 41.6% had read the handbook in its entirety, and 58.3% only read the sections related to examinations. Therefore, further evaluations of pregnant women's knowledge about pregnancy through the MCH Handbook are needed to broaden their insights and enable effective implementation.

Factors Influencing Parental Practices Regarding Childhood Immunization in Lahore, Pakistan

Background: Childhood immunization is a key strategy of the World Health Organization (WHO) to reduce child mortality. The vaccine is intended to protect about 2 million and 3 million survivors per year. Despite this, Pakistan continues to struggle with vaccine-preventable diseases due to a significant number of unvaccinated children and is one of two states where the prevalence of poliovirus persists. This study aims to investigate the factors influencing parents’ decisions regarding childhood immunization in Pakistan, with a focus on understanding parental practices and perceptions surrounding vaccination Methods: A cross-sectional study was conducted to assess parent’s practices toward vaccination of their children in Lahore, Pakistan. Validated questionnaires was used to evaluate parent’s practices of childhood vaccination. The research population was 353 parents living in urban and rural areas of Lahore with children of different ages. The data collected through a questionnaire entered and analyzed by using SPSS program v21, IBM. P-values less than 0.05 were considered as statistically significant values. Results: Out of 353 parents surveyed, majority of the study subject were mothers (56.1%) with age 25-29 years with percentage 30.0%, stating that majority of the parents have poor practice (75.4%) and a few presented good practices i.e., 24.6%. Variables like occupation, number of children, residency, living class and health care providers in respondent family shows highly significant statistical association (p&lt;0.001) with patient’s practice regarding their child immunization. Conclusion: The poor practice towards child immunization indicates a concerning gap in immunization adherence. The study revealed that a significant majority of parents demonstrated poor practices highlighting critical public health issues despite awareness campaigns. Factors such as limited access to healthcare facilities, socioeconomics challenges and cultural beliefs contribute to poor practice. The findings emphasize the need for improved support system and educational initiatives to bridge the gap between knowledge and practice, to enhance vaccination rates and improving public health outcomes.

THE IMPACT OF PAEDIATRIC EMERGENCY MANAGEMENT SKILLS ON PATIENT OUTCOMES IN ZARIA

Paediatric emergencies represent a critical challenge in Nigeria, where approximately 2,300 children under the age of five die daily, predominantly from preventable and treatable conditions such as pneumonia, malaria, and diarrheal diseases. Mortality rates are disproportionately higher in rural areas, where primary health care (PHC) centers often serve as the only point of access to medical services. The effectiveness of these centers is largely dependent on the emergency management skills of their healthcare workers. Despite their importance, there has been limited research on how the skills of PHC workers in managing paediatric emergencies impact patient outcomes. This study aimed to assess the proficiency of healthcare workers in primary healthcare centers in Zaria in managing common paediatric emergencies. A cross-sectional descriptive study was conducted among 139 health workers selected through a multi-stage sampling technique in Sabon Gari and Zaria Local Government Areas. Data collection was carried out using a pre-tested semi-structured self-administered questionnaire. The data were analyzed using SPSS version 21, and associations were tested using the chi-square test, with results presented in tables and charts. The findings revealed a significant deficiency in the emergency management skills of healthcare workers. A majority of respondents demonstrated inadequate skills in handling paediatric emergencies, with 66 (48.5%) exhibiting very poor competency in the management of common paediatric emergencies, and 32 (23.5%) displaying poor competency. Only a small fraction, 4 (2.9%) of respondents, demonstrated excellent skills in emergency management. Similarly, 46.7% of the respondents had very poor skills in the treatment of common paediatric emergencies, while only 3.0% exhibited excellent treatment skills. A statistically significant relationship was observed between the level of academic qualification and emergency management skills (p &lt; 0.05). The results underscore the critical need to enhance the skill levels of healthcare workers in PHCs through continuous professional development. This could be achieved through collaborative efforts between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Primary Health Care Departments of Zaria and Sabon Gari local governments, focusing on regular training and workshops. Improving the skills of healthcare workers in managing paediatric emergencies is essential for reducing child mortality and improving health outcomes in the region.

The impact of conditional cash transfer (CCT) on health and education in a coastal community: A randomized control trial (RCT) and regression discontinuity design (RDD)

This study evaluates the impact of the Pantawid Pamilyang Pilipino Program (4Ps), a national conditional cash transfer (CCT) on the health and education of beneficiaries in the coastal community of Maangas, Presentacion, Camarines Sur. It compares households receiving 4Ps benefits to a control group of non-recipients with similar sociodemographic characteristics to establish counterfactuals. Using a Randomized Control Trial (RCT) approach, data were collected from 157 participants in each treatment and control group through structured questionnaires. Descriptive statistics were utilized to analyze the economic profiles of respondents, revealing diverse representations. Logistic regression models unveiled significant correlations between attendance, dropout rates, and various predictor variables, notably the 4Ps program and eligibility, location, household size, and perceptions. Regarding health outcomes, the analysis demonstrates the positive impact of 4Ps membership on reducing child mortality, improving child growth, and promoting healthcare-seeking behaviors. Factors such as clinic visits, health insurance, and health beliefs also significantly influence health outcomes. RDD underscores the effectiveness of the 4Ps program in poverty alleviation, with eligibility playing a key role in enhancing income outcomes among beneficiaries. Prioritizing access to healthcare services, reinforcing the importance of regular clinic visits, and optimizing child health outcomes are crucial steps towards sustainability of the program. Tailored interventions based on enrollment status and academic performance can help prevent student attrition. Providing aid to coastal communities and embedding livelihood support programs in 4Ps can break the cycle of poverty by integrating these initiatives into the current structure of the program.

The Impact of Integrated Community-Based Management of Respiratory Infections in Reducing Child Mortality

Pneumonia alone is reported to be the leading reason for child death especially within developing countries which have inadequate health care facilities. So, it is necessary to assess the effect of Integrated Community Based Management interventions in reducing the child mortality rate caused by respiratory diseases. Objectives: To assess the effectiveness of early intervention to raise public awareness, ensure that individuals adhere to their treatments and use community health workers to decrease mortality in Low- and middle-income countries and to identify the key factors that contribute to success. Methods: The articles which are purely research articles were retrieved from databases including PubMed, Science Direct, Nature Journal and Google Scholar from January 2013 to April 2024. Peer-reviewed papers published on the management of respiratory diseases in the communities including youngsters below the age of 5 years were included from Africa, South Asia, America and Europe. Only those studies that met the identified criteria for methodological quality, and reporting on the outcomes of interventions and decrease in mortality were considered for inclusion. Results: The findings showed that community health workers played a significant role in the early diagnosis and prevention of respiratory tract disorders and other harmful diseases. There was a significant reduction of 30% in mortalities of infants and preschoolers in communities where the implementation of interventions was made necessary. Conclusions: It was concluded that the implementation of integrated community-based management of respiratory infection is a viable approach used to address child mortality in low-income areas and raise public awareness.

Waterborne Gastrointestinal Diseases and Child Mortality: A Study of Socioeconomic Inequality in Mexico.

In Mexico, 1.9% of child mortality among children aged 3 to 15 years is attributed to waterborne gastrointestinal diseases (WGD). This study employs a generalized bivariate logit econometric model to simulate the relationships between mortality risks and seven explanatory variables. Based on the model results and sensitivity analysis of the estimated parameters, a set of policies was designed to reduce the likelihood of child mortality. The proposed strategy involves implementing the following public policies, primarily targeting communities with extreme and high marginalization: increasing access to drinking water, improving housing conditions, expanding parental basic education coverage, and providing nutrition and healthcare to children from an early age. The findings reveal that children who speak an indigenous language face a mortality risk from WGD that is three times higher than those who do not, while children who receive medical services have a 29% lower risk of mortality compared to those who do not have access to them. It is recommended to offer free medical care in indigenous languages within high-marginalization communities. The combined impact of these policies is expected to significantly reduce child mortality due to WGD.