MATERNAL AND CHILD HEALTH STATUS RELATED TO NUTRITIONAL STATUS AND DEVELOPMENT OF CHILDREN DURING LACTATION PERIOD: A CROSS-SECTIONAL STUDY AMONG MOTHERS WITH CHILDREN AGE 0 – 6 MONTHS IN AGRICULTURAL AREAS OF INDONESIA

Maternal and child health status (MCHS) plays an essential role in the exclusive breastfeeding practice (EBP), which in turn helps to determine the nutritional status and development of children (NSC & CD) aged 0-6 months. This study aimed to determine the prevalence and factors influencing EBP, NSC, and CD to MCHS in Jember, East Java, Indonesia. A family-based survey was conducted among 470 mothers with children aged 0-6 months, by using a stratified random sampling method. Furthermore, a self-administered questionnaire was used to measure the characteristics of children and mothers, MCHS, EBP, NSC (z score with weight per age= WAZ and height per age= HAZ), and CD (pre-screening developmental questionnaire=PSDQ). The prevalence of EBP was 74.7% (95% CI= 65.5 – 81.2%), with influential factors being education, family income, children's age, and distress to limitations. Also, the Z-score of WAZ and HAZ were 2.99±0.22 and 3.01±0.22, respectively (3% of underweight and 1.7% of stunting). The factors influencing WAZ were children's age, birth weight, approach, and attentional shifting. However, the factors that only influenced the HAZ was the children's age. Also, among children three months old, the score of PSDQ was 8.30±1.33 (0.8% of deviation and 56.5% of suspect development), and their influenced factors were mother's work, infant's age, and the weight of birth. Among those that were 6 months old, the PSDQ score was 8.83±1.42 (7% of deviation and 24.3% of suspect development), and their influenced factors were mainly relationship. The analysis of the result further showed that the EBP, NSC, and CD, are related to MCHS, in rural agricultural areas. Therefore, the relationship of the parent-child should function appropriately, in order to support infant growth and development during lactation.

NUTRITIONAL STATUS OF 1-3 YEAR CHILDREN BELONGING TO RURAL AREA OF SELECTED STATES OF INDIA

Background: One-third out of 151 million children are found to reside in India; making the country an outlier even among the developing nations [1,2,3]. Studies suggested that socio-economic conditions of the household play a major role in determining child health status as higher nancial capabilities are linked with better care, health services, quality of food resulting in positive health outcomes [1,4,5]. Methodology: The data for the study was taken from National Nutrition Monitoring Bureau, Technical Report, Rural survey 2001, India. The data was given in accordance with states Kerala(197), Tamil Nadu(408), Karnataka(286), Andhra Pradesh(338), Maharashtra(332), Gujarat(288), Madhya Pradesh(292), Odisha (261), West Bengal(271). The percent Recommended Dietary Allowances or Recommended Daily Allowances (RDA) for Protein, Total Fat, Energy, Calcium, Iron, Vitamin-A, Thiamin, Riboavin, Niacin, Vitamin-C, Free Folic acid was given in the intervals less than 50 ,50-70,greater than equal to 70.The results and conclusions were made further. Results:Results were revealed in accordance with the highest and lowest values of percentage of RDA. Discussion: After observing the data discussion was made for future prospectus

The Effects of Family Income and Parents’ Educational Status on Child Health Status: Examining the Mediation Effects of Material Deprivation and Parents’ Health

Using the Chinese Family Panel Studies database in the wave of 2012, 2014, and 2016 with a sample of 25,663 children from 0 to 15 years old, this article examines the direct and indirect effects of family income and parents’ educational status on child health outcome. Two mediators include material living conditions and parents’ health. The results show that material living conditions and parents’ health have the greatest influences on children’s health, and parents’ education and family income are the secondary importance. Parents’ education has significant effects on child health through parents’ health and living conditions.

Infant and child health status ahead of implementation of an integrated intervention to improve nutrition and survival: a cross-sectional baseline assessment

Background Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children for every 1000 children will live until their first birthday. In response to this grim statistics, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model to improve child health outcomes. The aim of this study is to measure and report on child health indicator ahead of implementing this model. Methods A cross sectional design was employed, adopting the Demographic Health Survey methodology. We reached out to a sample of 952 households comprising of 2675 birth, in our study area. Mortality data was analysed with R package for mortality computation and other outcomes using SPSS. Principal component analysis was used to classify households into wealth quintiles. Logistic regression was used to assess strength of associations and significance of association was considered at 95% confidence level. Results The incidence of low birth weight (LBW) was 6.4% at the study area compared to 10% at the national level with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2–7.2 p = 0.043). Fever incidence was higher in the study area (50.5%) in comparison to 39.5% nationally. Consumption of minimum acceptable diet was showed a significant protection against fever (OR 0.64 95%CI 0.41–0.94 p = 0.042). Global Acute Malnutrition rate was 7.6% and this significantly reduced with increasing age of child. Under-five mortality rate was 32.1 per 1000 live births and infant mortality was 25.7 per 1000 in the catchment with most deaths happening within the first 28 days of life (57.3%). Conclusion Improving child health status is complex, therefore, investing into an integrated intervention for both mother and child could yield best results. Given that most under-five deaths occurred in the neonatal period, implementing integrated clinical and community newborn care interventions are critical.

Maternal Educational Attainment and Child Health in the United States

Purpose: To identify how child health status differs by mother’s educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017. Design: Repeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS). Setting: United States. Participants: Children aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427). Measures: Reported child health status, mother’s educational attainment, child’s race/ethnicity, and control variables were measured using the NHIS. Analysis: Using logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed. Results: Children whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly ( P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children ( P < .05). Conclusion: Maternal education disparities in child health are wide and have persisted.

Infant and Child health status ahead of implementation of an integrated intervention to improve nutrition and survival: A difference-in-difference quasi-experimental baseline assessment

Background Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children in every 1000 children will not celebrate their first birthday. In response, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model. Ahead of implementation of this initiative, we conduct a baseline assessment using a difference-in-difference design in an effort to measure incremental effects. Methods A quasi-experimental evaluation design (difference-in-difference) was employed. Adopting the methodology of the DHS, a sample of 952 and 990 households comprising of 2675 and 3311 birth histories respectively in the treatment and control areas were reached. Mortality data were analysed with R package for mortality computation, Complex Samples Module of IBM – SPSS for other outcomes and Emergency Nutrition Assessment software for nutrition data. Logistic regression was used to assess strength of associations and cox regression model for assessing risk of mortality Results The incidence of low birth weight (LBW) was 5.7% at the program area compared to 7.2% at the controlled area with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2 – 7.2 p=0.043). Fever incidence was higher in the program area (50.5%) in comparison to 48.4% in the control. Non-consumption of minimum acceptable diet was significantly associated with fever (OR 1.67 95%CI 1.07 – 2.61). Acute and chronic malnutrition was 7.6% and 45.8% respectively with non-receipt of Vitamin A was significantly associated with chronic malnutrition. Under-five mortality rate was 32.1 per 1000 live births in the program area and 33.6 in the control. Infant mortality rate was 25.7 in program area and 20.4 in the control. Risk of under-five mortality was higher in the neonatal period (HR 20.72 95% 8.64 – 49.65 p=0.001). Conclusion Improving child health status is complex and therefore investing into an integrated intervention yields best results. Given that the risk of all under-five was higher at the neonatal period, strengthening the health system to provide quality care is crucial.

Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal

In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.