A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador

Abstract Objectives Chronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador. Methods The study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socio-economic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed. Results The prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89). Conclusions for Practice Findings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.

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Undernutrition and associated factors in orphan children aged 6–59 months in Gambella Southwest, Ethiopia: A community-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-045892 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045892

Author(s):

Solomon Feleke ◽

Gudina Egata ◽

Firehiwot Mesfin ◽

Gizachew Yilak ◽

Abebaw Molla

Keyword(s):

Associated Factors ◽

Wealth Index ◽

Cross Sectional Study ◽

Sectional Study ◽

Access To Health Services ◽

Cross Sectional ◽

Orphaned Children ◽

Access To Health ◽

Study Participants ◽

Children Under 5

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.

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Exploring predictive frameworks for malaria in Burundi

10.1101/2021.07.20.21260697 ◽

2021 ◽

Author(s):

Lionel Divin Mfisimana ◽

Emile Nibayisabe ◽

Kingsley Badu ◽

David Niyukuri

Keyword(s):

Neural Network ◽

Pregnant Women ◽

Generalized Linear Model ◽

Intervention Programs ◽

Health Concern ◽

Access To Health Services ◽

Access To Health ◽

Women And Children ◽

Source Of Information ◽

Children Under 5

Abstract Malaria is a major public health concern in Burundi. The infection has been increasing in the last decade despite efforts to increase access to health services, and the deployment of several intervention programs. The use of different data sources can help to build predictive models of malaria cases in different sub-populations. We built predictive frameworks using generalized linear model (GLM), and artificial neural network to predict malaria cases in four sub-populations (pregnant women and children under 5 years, pregnant women, children between 0 and 11 months, children between 12 and 59 months), and the overall general population. The results showed that almost half malaria infections are observed in pregnant women and children under 5 years, but children between 12 and 59 months carry the highest burden. Neural network model performed better in predicting total cases compared to GLM. But the latter provided information on the e ect of predictors, which is an important source of information to mainstream target interventions. Early prediction of cases can provide timely information needed to be proactive for intervention strategies, and it can help to mitigate the epidemics and reduce its impact on populations and the economy.

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Varzaghan Earthquake Affected Mothers’ and Their Newborns’ Health More Severely, in Socioeconomically Vulnerable Area

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.96 ◽

2018 ◽

Vol 13 (03) ◽

pp. 511-518

Author(s):

Mehdi Esfandyari ◽

Elnaz Vaghef-Mehrabany ◽

Mehrangiz Ebrahimi-Mameghani

Keyword(s):

Socioeconomic Status ◽

Health Services ◽

Pregnant Women ◽

Family Income ◽

First Trimester ◽

Local Health ◽

Access To Health Services ◽

Access To Health ◽

Before And After ◽

Moderate Malnutrition

ABSTRACTObjectiveWe aimed to compare the pregnancy status of the pregnant women and birth status of their newborns, socioeconomic status, and access to health services, between high- and low-damage areas in Heris, affected by the Varzaghan Earthquake, 2012.MethodsThe study was conducted on pregnant women at any trimester of pregnancy (with complete medical profiles in local health centers) in August 2012 (time of the earthquake) who lived in Heris and delivered up to March 2013. Data were obtained on pregnancy- and infant-related variables, housing, socioeconomic status, and access to health services, including food supplies, before and after the earthquake.ResultsFamily income and mothers’ education were lower in highly damaged areas. Among these women, underweight at first trimester of pregnancy was higher, and weight gain during the last trimester was lower, compared with low-damage regions. Preterm delivery was higher in low-damage areas. Birth indices of the infants were not significantly different between the 2 areas; however, in highly damaged areas, moderate malnutrition was more prevalent among children under 1 year (weight-for-age) and under 2 years (height-for-age).ConclusionsSocioeconomic status of mothers was lower in highly damaged areas and might have played a role in their own and newborns’ health status. (Disaster Med Public Health Preparedness. 2019;13: 511-518)

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Equality Analysis of Main Health Indicators among Children under 5 Years in Uganda

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v29i2.8 ◽

1970 ◽

Vol 29 (2) ◽

Author(s):

Adel Hussein Elduma

Keyword(s):

Child Health ◽

Health Services ◽

Rural Areas ◽

Urban Areas ◽

Health Indicators ◽

Great Effort ◽

Access To Health Services ◽

Data Set ◽

Access To Health ◽

Children Under 5

BACKGROUND: Inequality in the access to health services is a major cause of health problemsamong children under five old. The aim of this analysis is to measure the inequality among children under-5 years in relation to main health indicators inUganda.METHOD: Main child health indicators data in Uganda were obtained from WHO inequity data set for the years 1995, 2000, 2001 and 2011. Indicators such as under-5 years mortality rate, underweight prevalence and full vaccination converge and child with infection access to health facilities were included in th analysis. For simple indicators, inequality difference wascalculated, and relative concentration index for complex order indicators was used. Four different inequality dimensions were used to work as stratifies for these indicators.RESULTS: Inequality regarding child health indicators was observed in different dimensions. It was clear that inequality among people living in rural areas were more than urban areas. Femaleshad high inequality than males. Poor and uneducated people are more likely to have inequality than rich and educated people.CONCLUSION: Great effort should be made to decrease inequality among children less than five years through access to health services for all groups in different areas.

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Fatores que influenciam a não adesão ao programa de pré-natal

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2358-3088.2017.7.21.21-29 ◽

2017 ◽

Vol 7 (21) ◽

pp. 21

Author(s):

Ivanilde Marques da Silva Rocha ◽

Vanilda Silva de Souza Barbosa ◽

Anderson Luiz da Silva Lima

Keyword(s):

Pregnant Woman ◽

Prenatal Care ◽

Pregnant Women ◽

Care Program ◽

Access To Health Services ◽

Extrinsic Factors ◽

Care Access ◽

Access To Health ◽

Practical Research ◽

Power Of Choice

Este trabalho constitui uma análise dos fatores que influenciam a não adesão de gestantes ao programa de assistência pré-natal. Para tanto, foi realizada uma revisão com abordagem exploratória e descritiva através da base de dados LILACS. Foram selecionadas 22 referências para a discussão em pauta. Os motivos de influência para a não adesão ao pré-natal foram classificados em duas variáveis: fatores inerentes a gestante e fatores extrínsecos, alheios ao poder de escolha da gestante. Fatores como: desigualdades regionais, sociais e econômicas, dificuldade no acesso aos locais de consultas, idade inferior a 20 anos, pouco estudo, ser solteira, multípara, não aceitar a gestação, possuir tradições familiares de descrença ao pré-natal, bem como falta de acolhimento e apoio também são influências negativas para a adesão ao pré-natal. Estratégias para melhor adesão ainda precisam ser desenvolvidas. Sugere-se a realização de pesquisas práticas que colaborem a essa análise temática.Descritores: Cuidado Pré-natal, Acesso aos Serviços de Saúde, Gestantes. Factors that influence non-adherence to the prenatal programAbstract: This paper is an analysis of the factors that influence the non-adherence of pregnant women to the prenatal care program. For that, a review with an exploratory and descriptive approach was performed through the LILACS database. Twenty-two references were selected for the discussion in question. The reasons for non-adherence to prenatal care were classified into two variables: factors inherent to the pregnant woman and extrinsic factors, unrelated to the power of choice of the pregnant woman. Factors such as: regional, social and economic inequalities, difficulty in accessing places of consultation, age under 20 years, little study, being single, multiparous, not accepting gestation, having family traditions of prenatal disbelief, as well as lack and support are also negative influences for prenatal adherence. Strategies for better adherence still need to be developed. It is suggested to carry out practical research that corroborates this thematic analysis.Descriptors: Prenatal Care, Access to Health Services, Pregnant Women. Los factores que influyen en la no adhesión al programa prenatalResumen: Este trabajo constituye un análisis de los factores que influencian la no adhesión de gestantes al programa de asistencia prenatal. Para ello, se realizó una revisión con enfoque exploratorio y descriptivo a través de la base de datos LILACS. Se seleccionaron 22 referencias para la discusión en pauta. Los motivos de influencia para la no adhesión al prenatal fueron clasificados en dos variables: factores inherentes a la gestante y factores extrínsecos, ajenos al poder de elección de la gestante. Factores como: desigualdades regionales, sociales y económicas, dificultad en el acceso a los lugares de consulta, edad inferior a 20 años, poco estudio, ser soltera, multípara, no aceptar la gestación, poseer tradiciones familiares de incredulidad al prenatal, así como falta de acogida y apoyo también son influencias negativas para la adhesión al prenatal. Las estrategias para una mejor adhesión todavía deben desarrollarse. Se sugiere la realización de investigaciones prácticas que corroboren a ese análisis temático.Descriptores: La Atención Prenatal, Accedo a los Servicios de la Salud, Embarazada.

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Predisposing Factors For Incidence Of Congenital Syphilis

International Archives of Medicine ◽

10.3823/2489 ◽

2017 ◽

Vol 10 ◽

Author(s):

Gracimary Alves Teixeira ◽

Flávia Andréia Pereira Soares dos Santos ◽

Jovanka Bittencourt Leite de Carvalho ◽

Allyne Fortes Vitor ◽

Ana Luisa Brandão de Carvalho Lira ◽

...

Keyword(s):

Health Education ◽

Prenatal Care ◽

Health Services ◽

Early Diagnosis ◽

Congenital Syphilis ◽

Time Frame ◽

Predisposing Factors ◽

Socioeconomic Conditions ◽

Access To Health Services ◽

Access To Health

The study aims to synthesize the knowledge produced in articles about the predisposing factors for the incidence of Congenital Syphilis. An integrative review was conducted in May and June 2014. Three databases were consulted and all publications available at the pre-established time frame were collected. The descriptors congenital syphilis, incidence and causality in Portuguese, English and Spanish were used, resulting in 1723 articles, of which 23 were selected. The results show deficiency in prenatal care; poor diagnosis; inadequante care of the disease; unequal socioeconomic conditions; difficult access to health services; and poor guidelines. The increasing number of new cases of congenital syphilis is due to several factors that can be prevented through quality prenatal care. Therefore, care actions during pregnancy and puerperium need to be redirected so that they are based on early diagnosis, immediate treatment of the couple and health education.

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Institutional Deficiencies and the Rationing of Access to Health Services in Developing Countries: Markers and Challenges (Carences institutionnelles et rationnement de l'acces a la sante dans les pays en developpement: Reperes et enjeux)

SSRN Electronic Journal ◽

10.2139/ssrn.1207211 ◽

2004 ◽

Author(s):

Abdelillah Hamdouch ◽

Marc-Hubert Depret

Keyword(s):

Developing Countries ◽

Health Services ◽

Access To Health Services ◽

Pays En Développement ◽

Access To Health ◽

Pays En Developpement

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Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v1i1.16 ◽

1970 ◽

Vol 1 (1) ◽

pp. 44-49

Author(s):

Beatriz Bertolaccini Martínez ◽

Fernanda Marcelino Da Silva ◽

Vinícius Tavares Veiga ◽

Rodrigo Pereira Custódio ◽

José Vítor Da Silva

Keyword(s):

Social Inequality ◽

Access To Health Care ◽

Young Patients ◽

Cross Sectional Study ◽

Access To Health Services ◽

Access To Treatment ◽

Cross Sectional ◽

Economic Class ◽

Access To Health ◽

Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05. Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist.

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Music to My Ears: A Material-semiotic Analysis of Fetal Heart Sounds in Midwifery Prenatal Care

Science Technology & Human Values ◽

10.1177/01622439211005176 ◽

2021 ◽

pp. 016224392110051

Author(s):

Annekatrin Skeide

Keyword(s):

Social Sciences ◽

Prenatal Care ◽

Fetal Heart ◽

Well Being ◽

Analytical Tool ◽

Semiotic Analysis ◽

Parental Love ◽

The Social ◽

Care Practices ◽

The Aesthetic

Unlike sonographic examinations, sonic fetal heartbeat monitoring has received relatively little attention from scholars in the social sciences. Using the case of fetal heartbeat monitoring as part of midwifery prenatal care in Germany, this contribution introduces music as an analytical tool for exploring the aesthetic dimensions of obstetrical surveillance practices. Based on ethnographic stories, three orchestrations are compared in which three different instruments help audiences to listen to what becomes fetal heartbeat music and to qualify fetal and pregnant lives in relation to each other. In the Doppler-based orchestration, audible heartbeat music is taken as a sign of a child in need of parental love and care cultivated to listen. The Pinard horn makes esoteric fetal music that can be appreciated by the midwife as a skilled instrumentalist alone and helps to enact a child hidden in the belly. The cardiotocograph brings about soothing music and a reassuring relationship with a child but also durable scripts of juridical beauty. This material-semiotic analysis amplifies how well-being is shaped in midwifery prenatal care practices.

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