scholarly journals Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services – a feasibility study

2019 ◽  
pp. 140349481989102
Author(s):  
Mariette Derwig ◽  
Irén Tiberg ◽  
Jonas Björk ◽  
Inger Hallström
Keyword(s):  
Primary Prevention ◽  
Child Health ◽  
Health Services ◽  
Usual Care ◽  
Feasibility Study ◽  
Intervention Group ◽  
Child Health Services ◽  
Small Scale ◽  
Control Group ◽  
Health Dialogue

Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.

scholarly journals Application of "Puerperal Healthy" of Optimization of Postpartum Mother Knowledges that Given Effleurage Relaxation Massage

2020 ◽  
Vol 5 (6) ◽  
pp. 152-155
Author(s):  
Herlina . ◽  
Diyah Fatmasari ◽  
Rr Sri Endang Pujiastuti ◽  
Runjati .
Keyword(s):  
Health Services ◽  
Random Sampling ◽  
Intervention Group ◽  
Simple Random Sampling ◽  
Child Health Services ◽  
Control Group ◽  
Access To Health Services ◽  
Control Group Design ◽  
Access To Health ◽  
Postpartum Mothers

The postpartum period is a critical period for both mother and baby. Every mother must have understanding, ability and access to health services. The application of education uses the application of "Puerperal Healthy" and Effleurage Relaxation Massage as a support system in an effort to improve the quality of maternal and child health services. Experimental research with a pre and posttest with control group design approach. Probability sampling techniques with cluster random sampling and simple random sampling numbered 62 postpartum mothers. Data analysis used paired t-test and mann whitney test. The knowledge of the respondents in the intervention group increased by 7.10 and the control group 4.61, the results of the statistical test were significant with p = 0,000. The application of the "Puerperal Healthy" application and Effleurage Relaxation Massage at each puerperal visit was effective in increasing knowledge of postpartum mothers

scholarly journals Parents’ experiences of a health dialogue in the child health services: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Linda Håkansson ◽  
Mariette Derwig ◽  
Ewy Olander
Keyword(s):  
Child Health ◽  
Health Services ◽  
Eating Habits ◽  
Qualitative Content Analysis ◽  
Child Health Services ◽  
Individual Interviews ◽  
Health Promoting ◽  
Development Evaluation ◽  
Health Dialogue ◽  
Parents Experiences

Abstract Background The Child Health Services in Sweden is a well-attended health promoting setting, and thereby has an important role in promoting healthy living habits in families with young children. Due to lack of national recommendations for health dialogues, a Child Centred Health Dialogue (CCHD) model was developed and tested in two Swedish municipalities. The aim of this study was to explore parents’ experiences of health dialogues based on the CCHD model focusing on food and eating habits during the scheduled child health visit at four years of age. Methods A qualitative design with purposeful sampling was used. Twelve individual interviews with parents were conducted and analysed with qualitative content analysis. Results The analysis resulted in three categories: The health dialogue provides guidance and understanding; Illustrations promote the health dialogue; and Space for children and parents in the health dialogue. In addition, analysis of the latent content resulted in a single theme reflecting the parents’ voice on the importance of having a health dialogue on food and eating habits. The health dialogue, promoted by illustrations, provided guidance and understanding, and gave space for children’s and parents’ involvement. Conclusions The results indicate that health dialogues using the CCHD- model create supportive conditions for family members’ active participation in the visits, which may strengthen empowerment and health literacy. The study provides knowledge and guidance for further development, evaluation and implementation of the model.

scholarly journals A retrospective study of the impact of health worker strikes on maternal and child health care utilization in western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael L. Scanlon ◽  
Lauren Y. Maldonado ◽  
Justus E. Ikemeri ◽  
Anjellah Jumah ◽  
Getrude Anusu ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Control Group ◽  
Western Kenya ◽  
The Impact ◽  
And Child Health ◽  
Risk Ratios

Abstract Background There have been dozens of strikes by health workers in Kenya in the past decade, but there are few studies of their impact on maternal and child health services and outcomes. We conducted a retrospective survey study to assess the impact of nationwide strikes by health workers in 2017 on utilization of maternal and child health services in western Kenya. Methods We utilized a parent study to enroll women who were pregnant in 2017 when there were prolonged strikes by health workers (“strike group”) and women who were pregnant in 2018 when there were no major strikes (“control group”). Trained research assistants administered a close-ended survey to retrospectively collect demographic and pregnancy-related health utilization and outcomes data. Data were collected between March and July 2019. The primary outcomes of interest were antenatal care (ANC) visits, delivery location, and early child immunizations. Generalized estimating equations were used to estimate risk ratios between the strike and control groups, adjusting for socioeconomic status, health insurance status, and clustering. Adjusted risk ratios (ARR) were calculated with 95% confidence intervals (95%CI). Results Of 1341 women recruited in the parent study in 2017 (strike group), we re-consented 843 women (63%) to participate. Of 924 women recruited in the control arm of the parent study in 2018 (control group), we re-consented 728 women (79%). Women in the strike group were 17% less likely to attend at least four ANC visits during their pregnancy (ARR 0.83, 95%CI 0.74, 0.94) and 16% less likely to deliver in a health facility (ARR 0.84, 95%CI 0.76, 0.92) compared to women in the control group. Whether a child received their first oral polio vaccine did not differ significantly between groups, but children of women in the strike group received their vaccine significantly longer after birth (13 days versus 7 days, p = 0.002). Conclusion We found that women who were pregnant during nationwide strikes by health workers in 2017 were less likely to receive WHO-recommended maternal child health services. Strategies to maintain these services during strikes are urgently needed.

scholarly journals A Retrospective Study of the Impact of Health Worker Strikes on Maternal and Child Health Care Utilization in Western Kenya

2021 ◽  
Author(s):  
Michael L Scanlon ◽  
Lauren Y. Maldonado ◽  
Justus E. Ikemeri ◽  
Anjellah Jumah ◽  
Getrude Anusu ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Workers ◽  
Child Health Services ◽  
Control Group ◽  
Maternal Child Health ◽  
Western Kenya ◽  
The Impact ◽  
Risk Ratios ◽  
Maternal Child

Abstract BackgroundThere have been dozens of strikes by health workers in Kenya in the past decade, but there are few studies on their impact on maternal child health services and outcomes. We conducted a retrospective survey study to assess the impact of nationwide strikes by health workers in 2017 on utilization of maternal child health services in western Kenya. MethodsWe utilized a parent study to enroll women who were pregnant in 2017 when there were prolonged strikes by health workers (“strike group”) and women who were pregnant in 2018 when there were no major strikes (“control group”). Trained research assistants administered a close-ended survey to retrospectively collect demographic and pregnancy-related health utilization and outcomes data. Data were collected between March and July 2019. The primary outcomes of interest were antenatal care (ANC) visits, delivery location, and early child immunizations. Generalized estimating equations were used to estimate risk ratios between the strike and control groups, adjusting for socioeconomic status, health insurance status, and clustering. Adjusted risk ratios (ARR) were calculated with 95% confidence intervals (95%CI). ResultsOf 1,341 women recruited in the parent study in 2017 (strike group), we re-consented 843 women (63%) to participate in close-ended interviews. Of 924 women recruited in the control arm of the parent study in 2018 (control group), we re-consented 728 women (79%). Women in the strike group were 17% less likely to attend at least four ANC visits during their pregnancy (ARR 0.83, 95%CI 0.74, 0.94) and 16% less likely to deliver in a health facility (ARR 0.84, 95%CI 0.76, 0.92) compared to women in the control group. Whether a child received their first oral polio vaccine did not differ significantly between groups, but children of women in the strike group received their vaccine significantly longer after birth (13 days versus 7 days, p=0.002).Conclusion We found that women who were pregnant during nationwide strikes by health workers in 2017 were less likely to receive WHO-recommended maternal child health services. Strategies to maintain these services during strikes are urgently needed.

Health Cadres Commitmentin Child Health Care in Moslem Society of Banyumas District

2016 ◽  
Vol 1 ◽  
pp. 60-65
Author(s):  
Umi Solikhah ◽  
Hari Kusnanto ◽  
Fitri Haryanti
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services ◽  
Group Discussion ◽  
Community Empowerment ◽  
Child Health Services ◽  
Child Health Care ◽  
Minimum Requirements ◽  
Social Esteem ◽  
The Government

Community empowerment with regard to maternal and child health services at the community level carried out by cadre.Cadre is health volunteers, selected by the community.404 number of active cadres in primary health care of South Purwokerto entirely female, although it may be a cadre of men. Active cadre toddler actively providing services every month for child before 5 years age. Interest to know the various reasons committed cadres in performing their duties. The method used is qualitative study,to describe a variety of reasons commitment to perform cadre duties in child health care. Retrieving data using interview techniques through the focus group discussion. Data from 30 cadres.Results of interviews taken until the data saturation, as a reason believed by cadres in the commitment to carry out tasks of serving the Muslim community. Characteristic respondent are mean of age 38 years (the youngest age of 25 years and the oldest 55 years old), a 100% Islamic religion, level of education majority of senior high school(at least primary school). Educational level health cadres in Banyumas has met the minimum requirements by the WHO.Results of the analysis showed thatcommitment includes a cadre of dedicated, caring community, a desire to learn, social esteem, individual satisfaction, togetherness, organization, and spirituality. The spirit of cadre to the community need the attention of the government for development and prosperity in accordance with their duties.Spiritual reasons become one of the motivations in providing health services to the community, albeit to a spirit of dedication and a great desire to learn. Cadres continue to provide services, even to families with different spiritual.

scholarly journals OP0198-HPR A STRUCTURED MODEL FOR OA CARE IN PRIMARY HEALTHCARE IS A COST-EFFECTIVE ALTERNATIVE COMPARED TO USUAL CARE FOR PEOPLE WITH HIP AND KNEE OA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 119-120
Author(s):  
N. Østerås ◽  
E. Aas ◽  
T. Moseng ◽  
L. Van Bodegom-Vos ◽  
K. Dziedzic ◽  
...  
Keyword(s):  
Usual Care ◽  
Primary Healthcare ◽  
Intervention Group ◽  
Cost Effective ◽  
Cost Utility ◽  
Control Group ◽  
Structured Model ◽  
Knee Oa ◽  
Cost Effective Alternative ◽  
The Cost

Background:To improve quality of care for patients with hip and knee osteoarthritis (OA), a structured model for integrated OA care was developed based on international treatment recommendations. A previous analysis of a cluster RCT (cRCT) showed that compared to usual care, the intervention group reported higher quality of care and greater satisfaction with care. Also, more patients were treated according to international guidelines and fulfilled recommendations for physical activity at the 6-month follow-up.Objectives:To assess the cost-utility of a structured model for hip or knee OA care.Methods:A cRCT with stepped-wedge cohort design was conducted in 6 Norwegian municipalities (clusters) in 2015-17. The OA care model was implemented in one cluster at the time by switching from “usual care” to the structured model. The implementation of the model was facilitated by interactive workshops for general practitioners (GPs) and physiotherapists (PTs) with an update on OA treatment recommendations. The GPs explained the OA diagnosis and treatment alternatives, provided pharmacological treatment when appropriate, and suggested referral to physiotherapy. The PT-led patient OA education programme was group-based and lasted 3 hours followed by an 8–12-week individually tailored resistance exercise programme with twice weekly 1-hour supervised group sessions (5–10 patients per PT). An optional 10-hours Healthy Eating Program was available. Participants were ≥45 years with symptomatic hip or knee OA.Costs were measured from the healthcare perspective and collected from several sources. Patients self-reported visits in primary healthcare at 3, 6, 9 and 12 months. Secondary healthcare visits and joint surgery data were extracted from the Norwegian Patient Register. The health outcome, quality-adjusted life-year (QALY), was estimated based on the EQ-5D-5L scores at baseline, 3, 6, 9 and 12 months. The result of the cost-utility analysis was reported using the incremental cost-effectiveness ratio (ICER), defined as the incremental costs relative to incremental QALYs (QALYs gained). Based on Norwegian guidelines, the threshold is €27500. Sensitivity analyses were performed using bootstrapping to assess the robustness of reported results and presented in a cost-effectiveness plane (Figure 1).Results:The 393 patients’ mean age was 63 years (SD 9.6) and 74% were women. 109 patients were recruited during control periods (control group), and 284 patients were recruited during interventions periods (intervention group). Only the intervention group had a significant increase in EQ-5D-5L utility scores from baseline to 12 months follow-up (mean change 0.03; 95% CI 0.01, 0.05) with QALYs gained: 0.02 (95% CI -0.08, 0.12). The structured OA model cost approx. €301 p.p. with an additional €50 for the Healthy Eating Program. Total 12 months healthcare cost p.p. was €1281 in the intervention and €3147 in the control group, resulting in an incremental cost of -€1866 (95% CI -3147, -584) p.p. Costs related to surgical procedures had the largest impact on total healthcare costs in both groups. During the 12-months follow-up period, 5% (n=14) in the intervention compared to 12% (n=13) in the control group underwent joint surgery; resulting in a mean surgical procedure cost of €553 p.p. in the intervention as compared to €1624 p.p. in the control group. The ICER was -€93300, indicating that the OA care model resulted in QALYs gained and cost-savings. At a threshold of €27500, it is 99% likely that the OA care model is a cost-effective alternative.Conclusion:The results of the cost-utility analysis show that implementing a structured model for OA care in primary healthcare based on international guidelines is highly likely a cost-effective alternative compared to usual care for people with hip and knee OA. More studies are needed to confirm this finding, but this study results indicate that implementing structured OA care models in primary healthcare may be beneficial for the individual as well as for the society.Disclosure of Interests:None declared

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