How well do national and local policies in England relevant to maternal and child health meet the international standard for non-communicable disease prevention? A policy analysis

Objectives(1) To identify national policies for England and local policies for Southampton City that are relevant to maternal and child health. (2) To quantify the extent to which these policies meet the international standards for nutrition and physical activity initiatives set out in the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases (WHO Action Plan).DesignThe policy appraisal process involved three steps: (1) identifying policy documents relevant to maternal and infant health, (2) developing a policy appraisal framework from the WHO Action Plan, and (3) analysing the policies using the framework.SettingEngland and Southampton City.Participants57 national and 10 local policies.ResultsAcross both national and local policies, priority areas supporting public health processes, such as evidence-based practice, were adopted more frequently than the action-oriented areas targeting maternal and child dietary and physical activity behaviours. However, the policy option managing conflicts of interest was rarely considered in the national policies (12%), particularly in white papers or evidence-based guidelines. For the action-oriented priority areas, maternal health policy options were more frequently considered than those related to child health or strengthening health systems. Complementary feeding guidance (9%) and workforce training in empowerment skills (14%) were the least frequent action-oriented policy options adopted among the national policies. The maternal nutrition-focused and workforce development policy options were least frequent among local policies adopted in 10% or fewer. Macroenvironmental policy options tended to have a lower priority than organisational or individual options among national policies (p=0.1) but had higher priority among local policies (p=0.02).ConclusionsFurther action is needed to manage conflicts of interest and adopt policy options that promote a system-wide approach to address non-communicable diseases caused by poor diet and physical inactivity.

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The Effects of National Policies and Laws on the Formation of Conscience: Reflections on Korea’s Family Planning Policy and the Mother and Child Health Law Based on the Evangelium Vitae

Theological Perspective ◽

10.22504/tp.2017.03.196.151 ◽

2017 ◽

Vol 196 ◽

pp. 151

Author(s):

Hae Sook Yu

Keyword(s):

Family Planning ◽

Child Health ◽

Health Law ◽

Family Planning Policy ◽

National Policies ◽

Planning Policy ◽

Mother And Child Health ◽

Mother And Child ◽

And Child Health

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Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

10.21203/rs.2.11585/v2 ◽

2020 ◽

Author(s):

Lauren Yu-Lien Maldonado ◽

Julia J. Songok ◽

John W. Snelgrove ◽

Christian B. Ochieng ◽

Sheilah Chelagat ◽

...

Keyword(s):

Cohort Study ◽

Health Education ◽

Child Health ◽

Health Behaviors ◽

Pregnant Women ◽

Evidence Based ◽

Matched Cohort ◽

Western Kenya ◽

Newborn And Child Health ◽

And Child Health

Abstract Background: We launched Chamas for Change (Chamas), a group-based health education and microfinance program for pregnant women and their infants, to address inequities contributing to high rates of maternal and neonatal mortality in western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and uptake of evidence-based, maternal, newborn and child health (MNCH) behaviors. Methods: We prospectively compared the uptake of MNCH behaviors between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at health facilities in Busia County to participate in Chamas . Women enrolled in Chamas agreed to attend bi-monthly group health education and optional microfinance sessions for 12 months. We collected baseline sociodemographic data at study enrollment for each cohort. We used descriptive analyses and adjusted multivariable logistic regression models to compare outcomes across cohorts at 6-12 months postpartum, with α set to 0.05. Results: Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a facility with a skilled birth attendant (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In our adjusted models, Chamas participants were nearly five times as likely as controls to deliver in a health facility (OR 5.07, 95% CI 2.74-9.36, p<0.001). Though not statistically significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Our sensitivity analyses revealed no significant difference in the odds of facility delivery based on microfinance participation. Conclusions: Chamas participation was associated with increased practice of evidence-based MNCH health behaviors among pregnant women in western Kenya. Our findings demonstrate this program’s potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect.

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Management of Child and Adolescent Obesity: Study Design and Practitioner Characteristics

PEDIATRICS ◽

10.1542/peds.110.s1.205 ◽

2002 ◽

Vol 110 (Supplement_1) ◽

pp. 205-209 ◽

Cited By ~ 1

Author(s):

Frederick L. Trowbridge ◽

Denise Sofka ◽

Katrina Holt ◽

Sarah E. Barlow

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Child Health ◽

Body Mass ◽

Nurse Practitioners ◽

Maternal And Child Health ◽

Pediatric Nurse ◽

Attitudes And Practices ◽

Pediatric Nurse Practitioners ◽

And Child Health

Objective. A study was undertaken to examine the attitudes and practices of health care providers in the assessment and treatment of overweight and obese children and adolescents. This study describes the study design and the practice settings and person characteristics of the practitioners included in this study. Methods. A needs assessment questionnaire was developed by a working group consisting of researchers, clinicians, educators, and representatives of the Maternal and Child Health Bureau, Health Resources and Services Administration (Department of Health and Human Services), National Center for Education in Maternal and Child Health, International Life Sciences Institute, and Harris Interactive, Inc. The questionnaire consisted of 35 questions divided into 3 topic areas and was disseminated to a sample of pediatricians (n = 1088), pediatric nurse practitioners (n = 879), and registered dietitians (n = 1652). Results. Despite a low response rate (33% for pediatric nurse practitioners, 27% for registered dieticians, and 19% for pediatricians), descriptive data were obtained about a variety of practitioner characteristics. Some significant differences were observed across practitioner groups and between genders in regard to years in practice, body mass index, and dietary and physical activity behaviors. Significant relationships were also observed in some practitioner groups between body mass index and compliance with dietary and physical activity guidelines. Conclusions. Our data show there is a wide variance in practitioner characteristics, particularly in regard to gender, years of practice, body mass index, and obesity-related behaviors. It is hoped the analyses presented in this and in the subsequent articles will provide useful information on current attitudes and practices and will contribute to improvements in the treatment of overweight children and adolescents.

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Decision Support System to Develop Evidence-based Policies for Inequity Reduction in Maternal and Child Health Care

Journal of Health Management ◽

10.1177/0972063418821812 ◽

2019 ◽

Vol 21 (1) ◽

pp. 53-84 ◽

Cited By ~ 1

Author(s):

Partha Saha

Keyword(s):

Health Care ◽

Decision Support ◽

Child Health ◽

Support System ◽

High Impact ◽

Evidence Based ◽

Child Health Care ◽

Health Care Interventions ◽

Health Care Indicators ◽

And Child Health

To reduce inequity in maternal and child health care indicators among socio-economically different regions, strategic location-specific policies should be designed. In this research work, a knowledge-discovery-based interactive decision support system has been developed on a web platform which would assist health care policymakers to design evidence-based decisions. Two modules have been prepared under this system to find out key influential Maternal and Child Healthcare (MCH) interventions for socio-economically different regions which had high impact on health care indicators. Data of 284 districts of nine high-focus states of India have been provided into the system to find out the efficiency of the system. Those data have been collected from district- level household survey part three (DLHS-3). The first module of the system has segregated all 284 districts into three segments based on their educational, social and economic conditions, and the second module has found out key influential health care interventions for all three segments separately which had high impact on health care indicators. It has been observed that adolescent health care intervention like female sterilization and childhood health care interventions such as DPT (diphtheria, pertussis, and tetanus) vaccine and measles vaccine were key influential health care interventions. The improvement of coverage of these interventions would help to reduce inequity and improve health care indicators of regions. Further research should be done to understand how the coverage of these interventions can be improved, especially in socio-economically poor regions.

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