Well-baby Clinics Research Articles

Birth order and socioeconomic disadvantage predict behavioural and emotional problems at age 3 years.

The aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre-schoolers. This was a cross-sectional study including 30,795 children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well-baby clinic at age 3years. Multivariate logistic regression was used to analyse predictors for having a high total SDQ difficulties score. Young parental age and a low level of parental education predicted high total SDQ score in a stepwise pattern. Being a first-born child was associated with a high SDQ score with an adjusted odds ratio of 2.10 (95% C.I. 1.84-2.41), compared with having older siblings. A sole physical custody arrangement predicted a high total SDQ score after parental separation. The percentage of children with a high total SDQ score increased with the Care Need Index (CNI) of the well-baby clinic. This study identified socioeconomic disadvantage and being the first-born child as the main predictors of poor mental health at age 3years. Well-baby clinics with socioeconomically disadvantaged catchment areas should be provided with adequate resources and methods for equitable prevention.

Factors Associated with the Maintenance of Breastfeeding at One Year among Women in Chiang Mai, Thailand.

This study aimed to investigate factors associated with breastfeeding for at least one year among women in Chiang Mai, Thailand. We conducted a cross-sectional study of 451 mothers with children aged between 12 and 24 months who visited the well-baby clinic among women who visited the well-baby clinic in secondary and tertiary hospitals. The data collected included maternal sociodemographic information, employment status, reasons contributing to continued breastfeeding, primary sources of information, and influential people affecting continued breastfeeding. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding at one year. Reporting “easier to bond with baby” as a reason to continue breastfeeding (AOR 3.118, 95% CI: 2.022, 4.809) and multiparous status (AOR 1.588, 95% CI: 1.042, 2.420) were positive predictors of mothers who had breastfeeding at least one year postpartum while mothers with undergraduate education level (AOR 0.635, 95% CI: 0.404, 0.997) were more likely to discontinue breastfeeding. Our study highlighted that working mothers have lower odds of continued breastfeeding than stay-at-home mothers (SAHMs), which was found for work with day shifts (AOR 0.437, 95% CI: 0.261, 0.731), work with rotational shifts (AOR 0.481, 95% CI: 0.247, 0.934), and work from home jobs with a flexible schedule (AOR 0.439, 95% CI: 0.229, 0.838). These findings showed that both employment outside home and work from home were strong risk factors for discontinuing breastfeeding before 12 months. We suggest that a breastfeeding-friendly workplace policy is essential to enhance the continuance of breastfeeding. Additionally, working at home requires more research to explore breastfeeding barriers and establish more support strategies.

Development of a Risk-Factor Questionnaire for the Infant Ear and Hearing Program in Samoa.

Congenital hearing loss is the most common sensory disorder present at birth. While universal newborn hearing screening is the standard for most high-income countries, alternative models are under consideration for most low and middle-income countries. The Pacific Islands have among the highest rates of paediatric ear disease and deafness in the world, and an interim Infant Ear and Hearing Program is currently being developed for the Polynesian nation of Samoa. The inclusion of a routine risk-factor questionnaire for childhood deafness in the Infant Ear and Hearing Program package is a feasible alternative for well-baby clinics in Samoa. The World Health Organisation advocates that all member states should implement newborn and infant hearing screening. This includes a risk-factor questionnaire developed from the joint committee on infant hearing risk-factors, as well as additional risk-factors unique to low and middle income countries. The present paper examines all known risk-factors for childhood deafness to develop an appropriate and evidence-based questionnaire for inclusion in the Samoan Child Health Book and Infant Ear and Hearing Program package. From a starting point of 19 risk-factors, 11 risk-factors were included with no changes; 5 risk-factors were modified to align with current health service availability in Samoa; 2 risk-factors were excluded due to cultural inappropriateness and irrelevance for Samoa; and 1 risk-factor was added for our Samoan and Pacific Island context. There are 17 items on the final risk-factor questionnaire for childhood deafness developed for Samoa. The Infant Ear and Hearing Program package will also include ear examinations and monitoring of hearing developmental milestones. The risk-factor questionnaire will be reviewed again in 5years' time for the next edition of the Samoan Child Health Book.

Breastfeeding self-efficacy, social support, and breastfeeding among Chinese mothers with late preterm infants

BackgroundIncidence of late preterm (LPT) infants has increased and become a worldwide issue. There is well-documented evidence that breast milk confers infant health benefits. Therefore, it is necessary to investigate factors that influence breastfeeding among mothers who have LPT infants. AimTo examine the relationship between breastfeeding self-efficacy, social support, and breastfeeding at one month postpartum among mothers with LPT infants. MethodThe descriptive correlation study was conducted with 88 Chinese mothers with LPT infants at one month postpartum visited the well-baby clinic of four tertiary hospitals in Lincang city. ResultsAt one month postpartum, 48.9% of mothers with LPT infants breastfed exclusively. Breastfeeding among these mothers was a significantly positive relationship with breastfeeding self-efficacy (rpb = .555, p < .01) and social support (rpb = .422, p < .01). Conclusionsand Implementation: These findings can help nurse-midwives be aware of breastfeeding self-efficacy and social support related to exclusive breastfeeding.

Collaboration of oral care and well-child care: for better preventive dentistry

The new Dutch clinical practice guideline Oral Care for Children and Young People advises parents to visit the oral care professional before or from the eruption of the first tooth, because oral care starts with the first deciduous tooth. However, this is not yet standard for everyone. Still, almost all parents of newborns (> 95%) visit well-baby clinics with their newborn. This article describes how well-baby clinics and oral care can collaborate and how in the Netherlands, young children and their parents can be contacted earlier for (preventive) dental care. There are a few examples of projects in which well-child clinics and oral care collaborate, such as the Gezonde Peutermonden project (toddlers' healthy mouths project), the GigaGaaf project (giga whole project) and the case of a practice in Haarlem, in the Schalkwijk district. Because these projects are still in progress, it is not yet clear whether a collaboration between well-child clinics and oral care will also have an effect on the caries prevalence in children.

Measuring mothers' representations of their infants: Psychometric properties of the clinical scales of the working model of the child interview in a low- to moderate-risk sample.

The Working Model of the Child Interview (WMCI) is frequently used to measure parents' representations. Beyond the global categories (balanced, disengaged, distorted), the reliability, factor structure, and validity of all the 15 clinical scales have not previously been studied. The WMCI was administered to 152 Norwegian mothers of infants (mean age=7.3 months) recruited from community well-baby clinics. Interrater reliability was adequate for the global categories and moderate for the clinical scales. Exploratory factor analysis and confirmatory factor analysis yielded three factors with evidence of factorial validity: Factor 1 balanced; factor 2 resentful; factor 3 apprehensive. Factor 1 corresponded with the original category balanced, while factor 2 and factor 3 corresponded with the original category distorted. Concurrent validity was supported as mothers with balanced representation (factor 1) were less stressed and the mother-infant interaction was more positive than that of mothers with resentful representation. Mothers with resentful or apprehensive representations (factor 2 and factor 3) reported more stress. The extracted factors and demographic variables correlated weakly or not at all, confirming discriminant validity. Our findings show that the clinical scales of the WMCI can be used in research with low- to moderate-risk samples.

A rare case of metabolic disorder- Alkaptonuria

Alkaptonuria is a rare genetic disorder of tyrosine metabolism, due to deficiency of the enzyme homogentisate 1, 2 dioxygenase. This results in characteristic features like blackish urine discoloration, ochronosis, arthropathy, cardiac valve deterioration. In this paper, the authors presenta case report of a 4-month-old boy who was brought by his mother to the well-baby clinic, with a chief complaint of black staining of nappy, a few hours after voiding. A qualitative examination of urine after an hour of the collection showed dark black discoloration, Quantitative examination reveals the presence of homogentisic acid to the extent of200mg/dl. The Diagnosis of Alkaptonuria was confirmed and the infant was started on Vitamin C and put under regular follow-up.

Is parental satisfaction important in a public hospital NICU

Background: NICU in public hospitals in developing countries face immense challenges in the form of overcrowding, less manpower and lack of equipment. Patient care is the prime responsibility of the health care workers. Parental satisfaction although an important part of health care is not given its due importance. There are very few studies analysing parental satisfaction of NICU babies in the developing countries including India. The objective of this cross-sectional study was to 1. Assess satisfaction regarding medical treatment 2. To assess satisfaction regarding General environment. Take suggestions regarding improvement in services.Methods: A total of four hundred and fifty-nine parents were interviewed. They were parents of babies admitted in NICU, those coming for follow up in the well-baby clinic. Parents of babies who died or left against medical advice were interviewed at the time of leaving the hospital or telephonically later. Results were analysed statistically using the student chi square test.Results: 92.6% of the respondents were satisfied with the medical services and 96.6% were satisfied with the general environment. Reasons for lack of satisfaction were analysed. Nuclear families, urban background, adverse outcome of the baby were the Key factors. Parents gave pertinent suggestions like improvement in cleanliness, more beds, increase in medical staff, better availability of medicines and blood products.Conclusions: There is need to develop standardised protocols to analyse parental satisfaction. This will lead to better understanding of parental expectations and help to improve patient care.

Perceptions on respectful maternity care in Sri Lanka: Study protocol for a mixed-methods study of patients and providers.

Over the past few decades, interest in providing and measuring Respectful Maternity Care (RMC) has increased markedly. Sri Lanka is reportedly shown to have better maternal health statistics and studies on quality improvement are lacking in this unique population. We aim to describe healthcare providers' perceptions and women's expectations, perceptions and their gaps in service provision regarding RMC in Sri Lanka. A descriptive cross-sectional study with a mixed-methods approach comprising of qualitative component followed by a quantitative component will be conducted in Castle Street Hospital for Women (CSHW) and De Soysa Hospital for Women (DSHW), Colombo, Sri Lanka. Healthcare providers (HCP- doctors, nurses and midwives) and vaginally delivered postnatal women (in postnatal wards and postnatal well-baby clinics) will be recruited through convenience sampling. In-depth interviews will be conducted with each of the four categories. Thematic analysis will be adopted to analyze qualitative data and the findings will further be used to improve the quantitative phase questionnaires. Self-administered questionnaire will be administered to a 378 vaginally delivered postnatal women [quota sampling across ten wards], exploring demographic details, and maternal opinion on various aspects of RMC. Locally validated Women's Perceptions of RMC tool (WP-RMC) will also be used to measure the level of RMC among these postnatal women along with the questionnaire 01. Qualitative findings will be used for cognitive validation of the WP-RMC into the Sri Lankan setting. This study will explore HCP's and women's expectations, perceptions and their gaps in service provision regarding RMC in two maternity hospitals in Sri Lanka. Assessment of the quality of care with regards to RMC have not been reported previously in this setting.

Predictive Factors of Growth Among Preterm MigrantChildren in Kanchanaburi Province, Thailand

This research soughtto study the predictive factors of the duration of exclusive breastfeeding, mother’sfeeding behaviors,and health service accessibility onthe growth of preterm migrant children in Kanchanaburi Province, Thailand. The subjects were 156 Burmese migrant mothers with preterm children 18-24 months old who received health check-upsat well-baby clinics in Kanchanaburi Province. The data analysis was performed utilizingdescriptive and multiple logistic regression statistics. The results revealed that although premature infants should reach normal growth the same as full-term children at 2 years old,41%of the child subjects were underweight, and 46.8%had stunted growth. Also, 53.2% of the mothers exclusively breastfed for less than 6 months due to the mothers having to returnto work. Upon performing multiple logistic regression analysis, it was found that exclusive breastfeeding from birth to the age of 6 months old and the feeding behaviors of the mothers were the most significantpredictorsinfluencing the growth of premature migrant children.In comparison, health service accessibility did not affectthe growth of premature migrant childrensince the majority of migrant mothers (88.5%) regularly brought their preterm children forhealth check-ups. Ourfindings strongly suggested that the education of migrant mothers should be continuously promoted to emphasize the importance of exclusive breastfeeding of their preterm children, including in their workplace, and to encourage migrant mothers to recognize the importance of providing complementary foods to suit their migrant Burmese lifestyle.

Early detection of young children at risk of autism spectrum disorder at well-baby clinics in the Netherlands: Perspectives of preventive care physicians.

To improve early detection of autism spectrum disorder in preventive care, a Dutch guideline was developed 5 years ago. The guideline provides preventive care physicians at well-baby clinics action-oriented advice and describes a step-by-step approach for children identified at an increased risk for autism spectrum disorder during general healthcare surveillance. The present qualitative study evaluated adherence to the guideline and studied barriers regarding early detection of autism spectrum disorder at well-baby clinics. Interviews were undertaken with 12 preventive care physicians (one representative per province). It was found that the vast majority of participants did not follow-up general surveillance with an autism spectrum disorder -specific screener as prescribed by the guideline. Six barriers (limited knowledge about autism spectrum disorder symptoms in infant and toddlerhood, professional attitude toward early detection, problems in discussing initial worries with parents, limited use of screening instruments, perceptions toward cultural and language differences and constraints regarding availability of healthcare services) were found. The results of this study highlight the importance of an integrative approach, raising awareness of the benefits regarding early detection of autism spectrum disorder in preventive care, the need of continuous investment in easy and accessible training and active screening, and a closer collaboration between preventive care organizations and autism spectrum disorder experts.

A qualitative study of Norwegian first-time mothers’ information needs in pre-admission early labour

ObjectiveTo explore women's experience with information, and their information needs in pre-admission early labour. DesignA qualitative study with an exploratory and descriptive approach. SettingFive focus group interviews with women attending post-natal care at five different well-baby clinics in South-Eastern Norway in 2019. ParticipantsSixteen first-time mothers who had given birth to a baby 3–17 weeks prior to the focus group interview. All had experience of staying at home in early labour. FindingsThree themes emerged from the analysis. The first and most substantial theme involved information. The women considered it necessary to have easy access to a suitable amount of trustworthy information at the appropriate time. The second theme described that the women were surprised at how early labour manifested, despite having prepared for it. The third theme was about receiving acknowledgement and support, revealing that information did not meet all woman's needs. Key conclusions and implications for practiceThe women found it challenging to prepare for early labour, and no matter how prepared they felt beforehand, unexpected situations arose. Easily accessed online information from reliable sources was useful in early labour, but in order for women to feel safe at home, this should be complemented by telephone conversations with skilled and welcoming midwives in the labour ward. More knowledge about women's information needs in early labour is required, including studies exploring how the information should be provided to help women feel safe when staying at home in early labour.

Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6-24 Months in Hail, Saudi Arabia.

Background The WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Nonadherence to exclusive breastfeeding (EBF) depends largely on the individual, sociocultural context, and institutional factors. The aim of this study is to estimate coverage and factors associated with adherence to EBF among mothers in the urban Hail region, Saudi Arabia. Methods A cross-sectional study was carried out during February–June 2019 among 450 mothers of children aged 6–24 months attending immunization and well-baby clinics in 6 primary healthcare centers in Hail city. A pretested structured questionnaire was used to interview the consented participants. Results The majority of mothers (72.9%) were aware of EBF; 24% reported initiation of breastfeeding within one hour after delivery; however, 71.1% did during the first 24 hours. The majority (76.8%) fed colostrum to their newborn; nevertheless, 50.1% had given a prelacteal feeding. Mothers who reported EBF practice were 50.7% (CI 45.9–55.4). The adjusted logistic regression analysis revealed that mother's awareness about EBF (aOR 3.03; 95% CI 1.78–5.18), antenatal care received at the governmental facility (aOR 2.63; 95% CI 1.28–5.41), breastfeeding a previous child (aOR 2.42; 95% CI 1.46–4.03), counseling received after delivery (aOR 2.47; 95% CI 1.34–4.53), and colostrum feeding given (aOR 4.24; 95% CI 2.31–7.77) were positively associated with EBF practice. On the other hand, mother's education (OR 0.39; 95% CI 0.15–0.99), higher family income (aOR 0.04; 95% CI 0.00–0.31), and practice prelacteal feeding (aOR 0.61; 95% CI 0.38–0.97) were negatively associated with EBF practice. Conclusion EBF rate in urban Hail is still far below WHO recommendations. Efforts to strengthen mothers' counseling/support during antenatal care and immediately after delivery are needed to promote EBF practice, especially in the private sector.

Prevalence of otitis media and risk factors for sensorineural hearing loss among infants attending routine well-baby clinics in urban and rural/remote Samoa: a study protocol

Background The World Health Organization recommends newborn and infant hearing screening programs for all member states to enable early detection and intervention for children with hearing loss. Ear and hearing services are limited in the Pacific Islands, a region with one of the highest global rates of ear disease and hearing loss. Given that a significant proportion of childhood hearing loss is preventable through public health measures, collaboration with existing primary and public health platforms should reduce the prevalence of avoidable ear and hearing disorders among infants and young children. Previous work has investigated an infant ear and hearing program for child welfare clinics in an urban Pacific Island setting. The present study will build on this previous work by investigating the possibility of an Infant Ear and Hearing Program in a different Pacific Island country, and performing comparisons between urban and rural/remote populations. Methods and analysis We propose a cross-sectional study of infants attending well-baby clinics in urban (Apia), rural (Upolu), and remote (Savai’i) Samoa. All participating infants will undergo an ear examination of both ears, and as assessment of risk factors for permanent hearing loss. Ethics and and conclusions We publish these protocols to facilitate similar studies in other low- and middle-Income countries, and especially among our Pacific Island neighbours. We anticipate that 25% of infants will present with ear pathology in at least one ear, and that 25% of infants will present with at least one risk factor for permanent hearing loss. This study was approved by the Government of Samoa Ministry of Health Ethical Research Committee and the University of Queensland Medical Ethics Research Committee.

Factors predicting six-month exclusive breastfeeding among mothers in Ho Chi Minh City, Vietnam

PurposeExclusive breastfeeding (EBF) rates continue to be low in Vietnam. This study aimed to determine the factors predicting 6-month EBF among mothers in Ho Chi Minh City, Vietnam.Design/methodology/approachA cross-sectional study was conducted with 259 mothers of infants aged between six to nine months at well-baby clinics in Ho Chi Minh City. The questionnaires used for data collection included personal background questionnaire, perceived benefits of breastfeeding scale, breastfeeding self-efficacy scale-short form, perceived barriers to breastfeeding scale and the family support of breastfeeding scale. Descriptive statistics, bivariate and multiple logistic regression were used for data analysis.FindingsAbout 32% of the Vietnamese mothers practiced 6-month EBF. By increasing one unit of perceived benefits of breastfeeding, perceived self-efficacy in breastfeeding and family support, the mothers' likelihood to give 6-month EBF would increase 19% (AOR = 1.19, 95% CI = 1.08, 1.31), 12% (AOR = 1.12, 95% CI = 1.04, 1.19) and 10% (AOR = 1.10, 95% CI = 1.04, 1.16), while previous breastfeeding experience, maternal age and maternal education could not significantly contribute to the 6-month EBF.Originality/valueThis is the first study in Vietnam using a nursing model, the health promotion model, as a framework to identify factors predicting 6-month EBF. An effective program for promoting EBF could be developed by manipulating and tailoring the predicting factors to fit the Vietnamese mothers' needs through a mother class, lactation clinic or individual approach.

Perception of food allergy among mothers of allergic children in Southwestern Saudi Arabia

Background: Food allergy (FA) is increasingly recognized with the highest prevalence in preschool children; there has been a significant increase in hospital admissions for systemic allergic diseases with anaphylaxis and food allergies. Hospital admissions for food allergy were noticed to rise from 6 to 41 per million between 1990 and 2000 worldwide . The prevalence of food allergy is increasing over time with significant geographic variations. It is estimated to affect 6% of children in the United States (USA); according to a study conducted in Makkah, by AL Mokarmah, the prevalence of FA among children attending the well-baby clinic was 22.5% and in Riyadh is 6% among children who visit the allergy clinic at King Khalid University Hospital. FA in children is usually caused by milk (2.5%), egg (1.3%), peanut (0.8%), tree nuts (0.2%), fish (0.1%), as well as shellfish (0.1%), with an overall prevalence of 6%. Methods: In this cross-sectional study, a self-administered questionnaire was used in the data collection. After data were collected, they were entered in the Statistical Software IBM SPSS version 22. Descriptive and inferential statistics were obtained. Results: Out of 980 mothers, 49% were suffering from food allergy, while 28.6% of their children were suffering from food allergy. Shellfish was the most common cause of food allergy (38%). Conclusion: The management of FA in children is improving through the acquisition of new knowledge in diagnosis and treatment. Education of physicians and food-allergic patients about FA and its treatment is becoming recognized as an unmet need. Key words: Food allergy, mother, children, knowledge, prevalence, factors

Awareness and Perception of Parents Regarding Well Baby Clinic in Primary Health Care Centres in Abha City, Southwestern Saudi Arabia.

Background:Well-baby clinic (WBC) service is implemented in all primary health care centers and is provided based on international standards to all children under 5 years in Saudi Arabia. It is a comprehensive package of health promotion and curative care to improve and maintain the health status and well-being of this age group.Aim:The main aim is to assess parents’ awareness and perception regarding WBC in primary health care centers in Abha sector, Kingdom of Saudi Arabia (KSA).Methodology:A descriptive cross-sectional approach was used in the current study. The study targeted all babies’ caregivers attending WBCs in primary health care centers in Abha city. The children's parents were included using three stages cluster sample technique. The questionnaire included participants’ demographic data such as age, gender, relation to the baby, educational level, work, and monthly income. Awareness regarding the WBC was assessed using two main items covering hearing about the clinic provided services.Results:The study included 1593 participants whose ages ranged from 19 to 55 years old with a mean age of 34.6 ± 11.8 years. About 64% of the respondents knew about the WBC, which was significantly higher among the females than males (P = .003). Also, 71.2% of respondents aged 25–34 years knew about well-baby clinic (WBC) compared to 35% of parents aged less than 25 years (P = .001). Exact 57.1% of the respondents went to the nearest governmental health office at vaccination times. About 46% of the respondents reported that the clinic nurse was the main person who dealt with them. Regarding services provided by a nurse at the vaccination clinic, registering child vaccination was the most reported (66.2%), followed by helping the mother make the child calm (56.8%).Conclusions:In conclusion, the study revealed that proper care is vital for a child's survival as well as optimal physical and mental development. Adequately cared child has proper well-being and happiness. Mothers and children caregivers had adequate awareness and acceptable attitude towards WBCs and provided services. Some barriers were declared including lack of available WBCs within the residence range, not all WBCs usually working, and more information should be provided about WBCs.

Limited Reduction in Anemia in Children in a Low-Income Community Offered Iron Treatment Despite a Quality Improvement Initiative.

This study aimed to determine whether better hematological outcomes were attained in young anemic (hemoglobin &lt;11.0g/dl) children following a quality improvements initiative (QII) of a basic anemia screening and iron treatment approach in a low-income community. Pre-post changes in two anemic cohorts, one before (cohort A, n=115) and one after (Cohort B, n=106) a QII, were determined using data from a well-baby clinic in the Dominican Republic. More anemic children in Cohort B had documented anemia resolution than Cohort A, 16.0 versus 7.0%, respectively. For the subgroups with post treatment hemoglobin results, Cohort B (n=65) had a larger pre-post hemoglobin increase than Cohort A (n=62), 0.88 (SD 1.04) versus 0.43 (SD 0.96) g/dl, respectively. However, not all the parameters were significantly better for Cohort B and most children remained anemic in both cohorts post treatment. Determination of more effective service interventions to address childhood anemia in low-resource settings is needed.

Child Development Monitoring in Well-baby Clinics in Kenya.

Background:Maternal and child health (MCH) clinics represent an integrated approach for providing healthcare to pregnant women and children 0-59 months of age. Although MCH clinics are also charged with monitoring child development, which involves tracking developmental milestones, it is unclear how these services are provided or perceived within the clinic. This study aimed to describe self-reported knowledge, perceptions, and practice of developmental monitoring in selected MCH clinics in western Kenya.Methods:This cross-sectional descriptive study was conducted within six clinics. We administered a descriptive survey to measure caregiver and healthcare staff attitudes towards and awareness of developmental monitoring; we also reviewed MCH booklets to identify services received at the clinic. Data collection occurred over a period of one day at each of the six clinic sites. The data were analyzed using descriptive statistics.Results:During the study period, 78 caregiver-child pairs presented to the clinics and had their MCH booklets reviewed. The median child age was three months (interquartile range [IQR]: 1-8 months). Most caregivers were aware of weight monitoring and immunization services; however, when asked specifically about developmental monitoring, only 2.6% of caregivers were aware this service was available at the clinics. Nearly 80% of caregivers reported that they would be very interested in developmental monitoring services. Thirty-three MCH healthcare staff were interviewed about services provided and goals of clinical care. Fewer healthcare staff (60.6%) identified their roles in developmental monitoring compared to their roles in growth (90.9%) and nutritional monitoring (84.8%). Developmental milestones had not been recorded in any of the 78 MCH booklets. However, 78.1% of healthcare staff indicated support for developmental screening.Conclusion and Global Health Implications:While developmental monitoring was valued by healthcare providers, it was not consistently performed at the six clinics in our study. We recommend further work to raise awareness about developmental monitoring and to measure the implications of increased caregiver knowledge and perceptions on developmental monitoring practice.

Knowledge, Attitude and Utilization of Family Planning Methods among Postpartum Women in A Selected Tertiary Care Facility in India

Background & aim: Utilization of family planning services among married women in India, especially postpartum family planning, is poor, with only around one fifth of currently married women using a spacing method. Womenâ��s awareness about PPFP methods in India is also limited. This study aimed to assess the knowledge, attitude and utilization of family planning methods among postpartum women in India. Methods: A cross-sectional survey of 284 postpartum mothers was conducted in a well-baby clinic of a tertiary care facility using convenience sampling. Respondents were interviewed using self-developed, pretested and validated tools. Data was analyzed with STATA software version 31.1 using descriptive statistical methods. Results: Almost two third of the mothers did not receive family planning counseling in the antenatal period (66.1) and over half did not receive it in the immediate postpartum period (53.5). The majority (66.6) did not use any contraceptive method. The mean knowledge score was 7.82i�±3.90 out of a total score of 16 points, and the mean attitude score was 33.53i�±3.90 out of a total score of 50 points. Knowledge of postpartum mothers related to the family planning methods was significantly associated with their educational status, number of antenatal visits, and use of contraceptives, while the use of contraceptive methods was significantly associated with resumed sexual activity.  Conclusion: Lower scores on knowledge about PPFP compared to attitudes to PPFP emphasize the need for innovative approaches to make postpartum women aware about healthy reproductive practices including adoption of FP methods of their choice.