Mothers described feeding a diverse diet to children aged 6-23 months in addition to continuing to breastfeed. A variety of nutritious foods were mentioned that should be given to IYC, such as milk, egg, leafy vegetables, fish, meat (chicken, beef), potato, eggplant, fruits (apple, grapes, oranges, dates, carrots) and khichuri (dish made with different combinations of rice, lentils, vegetables and spices). Furthermore, if mothers learned that a particular food was beneficial for the child, they reported a willingness to try it. Most complementary foods were prepared from family foods; however, spicy family foods were washed with water before feeding to IYC to remove extra salt and spices. Food was also softened by hand to a consistency appropriate for the child before feeding. Nonetheless, despite demonstrating knowledge about nutritious foods and their preparation, and attributing positive qualities of these foods for children, actual feeding practices demonstrated lack of dietary diversity with about half receiving ASF, and fewer than half receiving vitamin A rich food.
It is well accepted, that any effect on the health of mother is going to affect the health of the fetus. The first two years of life and nine months in utero, the so called “1000 days” to prevent child malnutrition are the critical window period. Appropriate nutritional practices play a pivotal role in determining health and development of children. The Kangaroo Mother Care method is a standardize protocol based care system for preterm or LBW infants and is based on skin to skin contact between baby and mother. Breastfeeding was consistently associated with higher performance in intelligence tests, with a pooled increase of intelligence quotient points. It is every child‟s basic human right to receive a healthy feeding and thereby undergo a normal growth. It is every adult‟s ethical, moral, and legal duty to ensure optimal feeding practices and a normal growth and development for their children. WHA resolutions, endorses the comprehensive implementation plan on maternal, infant and young childnutrition and urges strengthening nutrition policies so that they comprehensively address the double burden of malnutrition. “Protest breastfeeding” seems to be a novel approach or way to promote the breastfeeding and to highlight the Mother and Child right issues in the 21st Century. WHO and UNICEF jointly declared “Where it is not possible for the biological mother to breastfeed, the first alternative, should be the use of human milk from other sources. There is proliferation of sophisticated marketing of unhealthy food to children to continue in the midst of a childhood obesity epidemic.
Intimate partner violence (IPV) is experienced by one in three ever-partnered women globally (Devries et al., 2013). IPV can affect child nutritional outcomes in various ways. Women’s exposure to IPV during pregnancy is associated with decreased birth weight (Aizer, 2011; Shah & Shah, 2010), and pre- term delivery (Shah & Shah, 2010). In children, exposure to maternal experience of IPV has been linked to several health and nutritional outcomes, including developmental delays (Gilbert et al., 2013), asthma (Subramanian et al., 2007; Suglia et al., 2009), elevated total cortisol output (Bair-Merritt et al., 2011; Davies et al.. 2008), under-immunization (Bair-Merritt et al.. 2006), severe acute malnutrition (Rico et al.. 2010; Salazar et al.. 2012), under two mortality (Aisling-Monemi et al.. 2003), decreased growth and stunting (Salazar et al., 2012; Sobkoviak et al., 2012), recent acute respiratory infection (Silverman et al., 2009) and diarrhoea (Silverman et al., 2009; Karamagi et al., 2007). In addition, Yount et al. (2011) posit that children’s exposure to violence in the home may affect early childhood growth and nutrition through biological and behavioural pathways, and their review of the literature
Few papers have dealt with the problem of endogeneity when addressing the relationship between child-rearing practices and child well-being. Kan and Tsai (2005) explore the influence of child-rearing practices, specifically the effect of encouragement (positive reinforcements, e.g., verbal encouragement and awards) and punishment (negative reinforcements, e.g., scolding, physical punishment, or negative pecuniary incentives) in adolescents’ educational expectations and aspirations. In order to deal with the endogeneity problem arising – because encouragement and punishment could be endogenous – the authors use a Generalised Method of Moments (GMM) specification, including the health status of both parents as well as their hours of work and the number of siblings, as variables that may be uncorrelated with the unobservable determinants of education outcomes but correlated with encouragement and punishment. They find that positive reinforcement practices do indeed positively affect children’s educational outcomes, while negative reinforcement practices are harmful to children’s education outcomes. Kan and Tsai (2005) make advances in dealing with potential endogeneity biases. However, given the cross-sectional nature of their sample, their paper is still unable to control for time invariant unobservables that may affect parent’s time allocation, parental practices and child well-being outcomes.
In order to develop a path model that better fits the data, preliminary independent linear regression models to predict maternal mental health and the two child development outcomes were conducted, and only covariates with a statistically significant relationship were included in the analysis. This was done to improve power analysis. In addition to socio-demographic factors associated with maternal depression (child health status, unwanted pregnancy, marital status, maternal health, number of siblings, bad event since pregnancy, place of residence), specific socio-demographic variables associated with child growth (wealth index, child age, place of residence, size at birth) and with child cognitive development (wealth index, child age, child pre-school attendance) have been included. Omission of these factors can strongly bias the estimation of parameters in the model. Covariance paths have been constrained to be zero when non- significant to improve power analysis. The final
In the maternal and child health context, primary data on coverage of interventions is typically created when a woman is booked for antenatal care, and data on her health and the services she receives is subsequently added, re- trieved and reported from her personal file over a con- tinuum of community and facility services. But without eHealth in many settings, paper registers and patient folders make no timely and actionable data available for program management and policy development, and subse- quent extraction of data from paper files results in poor quality data and underutilized health information [16–19]. Information on the individual woman meant to allow personalized care throughout pregnancy and childbirth is often neither easily accessed at follow up visits, nor shared between levels of care, or shared with women themselves to improve self-care. When information is shared, it is often not under robust governance to secure privacy and safety (Myhre et al: eRegistries: Governance for maternal and child health registries, submitted). Most public health data collection strategies are inefficient reporting chores, where care providers are viewed only as data collectors, and women only as data points. Not harvesting the data created and registered at the point-of-care, LMIC spend scarce re- sources on expensive data collection either by duplicate
In this section we will discuss different measures of maternal health, econometric model specifications and estimation procedures used in the analysis. Literature suggests many indicators of mother’s health. For example, presence of one or more diseases, height, weight, body mass index (BMI 9 afterwards), presence of anemia and its level and so on. Adult height has been considered as an indicator of physical strength and general health potential 10 . Adult weight can also be considered as an indicator of health. However, overweight and obesity has been shown to be associated with the risk factors for cardiovascular diseases, hypertension, diabetes, gallstones and orthopaedic impairments (Colditz, 1992; Troiano et al., 1996) and therefore, BMI could be used as a good measure of nutritional status and health of adults. Besides this, BMI is generally related to body fat and higher BMIs usually mean higher body fat and being obese lowers one's life expectancy. Anemia is also considered as important measure of health as it is one of the more common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low. This can lead to health problems because RBCs contain hemoglobin, which carries oxygen to the body's tissues. Anemia can cause a variety of complications, including fatigue and stress on bodily organs. We finally use six indicators such as presence of any disease, anemia, height, weight, BMI and nutritional level to test their effect on the child mortality.
Maternal anthropometric measurements such as post pregnancy weight, height, mid-arm circumference and triceps skin fold thickness were recorded at the time of enrolment following stabilization (within 24 hours of delivery) at hospital using standard technique. Maternal mid-arm circumference was measured using non- stretchable fibre tape. Mother’s triceps skin fold thickness was measured using Lange skin fold calliper and body mass index was calculated using the formula, weight in kg divided by the square of height in meters.
A woman’s behavior, in terms of taking care of her own eating habits during the breastfeeding period is influenced by culture and social context, including be- liefs, feelings, perceptions, values, motivation and attitudes, among other factors. This study identified and characterized beliefs and barriers for maternal eating with the aim of including the socio-cultural aspect both in the design of public health policies and in the contextualized individual dietary-nutritional approach. If tensions between social beliefs and messages from health professionals could be reduced, a higher compliance of recommendations could be attained.
Increasingly, the rapidly advancing epidemic of over- weight / obesity in the developing world, together with its attendant complications of diabetes, hypertension, and other metabolic manifestations of non-communicable dis- ease (NCD), are attracting attention and are of great public health concern. Moreover, ‘thrifty gene’ and ‘developmental origins of health and disease’ (DoHaD) hypotheses have firmly established that fetal growth impairment and associ- ated metabolic adaptations are a common prelude to later overweight / obesity and NCD [2, 3]. Hence, the outstand- ing role of fetal development to successful short and long- term successful pre- and post-natal outcomes continues to gain recognition. Epidemiologically, impaired fetal growth is manifest by low birth weight (LBW) attributable to both preterm birth and small-for-gestational-age (SGA), which is the leading cause of neonatal and early infant mortality in low resource populations . More than 20 million infants in low-middle income countries are born SGA each year with the highest incidence in southwestern India . Im- paired linear growth as well as SGA predict suboptimal post-natal growth including stunting at 2 years of age [6, 7] and will be a focus of this review . Maternal under- nutrition is associated with LBW especially that attributable to SGA  and with impaired fetal linear growth and is high on the global health agenda .
The estimates of DLHS-4 (2012-13) indicate that nearly 86 per cent of villages in Telangana have a HSC within three kilometers (kms.) distance and about two-thirds (64.6%) of villages in the state have PHC within 10 kms. distance. Although most of the PHCs and CHCs are reportedly facilitating 24x7 services, availing such services from these centres seems to be poor. As per DLHS-4 estimates only little above one-thirds (39%) of PHCs in the state conducted at least 10 deliveries during last one month on 24x7 hours basis (throughout the day and week). One must understand this as shortage of skilled human resources in the public facilities (see Motkuri et al., 2017). Going by the estimates of DLHS-4 (2012-13) a less than half (43%) of PHCs in the Telangana state have a lady medical officer and only 21 per cent of PHCs have residential quarter for medical officers. Against such odds, the usage of private health facilities has been increasing in the state. Besides, certain other things are also at work in facilitating their access to private services. As we have observed above less than one-third of institutional deliveries in the state have taken place in public facility, and the rest of them are private hospitals. Similarly, for the other healthcare needs of mother and child, private healthcare facilities are more preferred than the public ones in the state.
Here prim iparas and breastr-f eeding mothers saw the h e a lth v is it o r as .most .helpful.. The most in te re s tin g c la s s -re la te d trend was a good i n i t i a l attendance and apparent . i n i t i a l s a tis fa c tio n ’ by. mothers: in Lower ...socioeconomic, groups, w ith a subsequent f a ilu r e to re tu rn and a drop in s a tis fa c tio n .le v e ls a fte r ..the f i r s t few postnatal months. I t seems that-m o thers both attended and appreciated the c lin ijc i f : (a) they saw. i t as both re le v a n t and im portant, and (b) they perceived i t s r o le as not e a s ily f u l f i l l e d elsewhere. A c r it ic a l question would, th e re fo re , concern maternal perceptions of th e h e alth v is it o r 's r o le and of her re la tio n s h ip to o th er sources of h ealth education and advice. Mothers saw a wide range of fu n ctio n s fo r the c h ild h e alth c lin ic s , eg weighing c h ild re n , discussing baby's progress, discussing problems,, meeting other mothers, buying m ilk and baby foods. Regarding maternal a ttitu d e s to h e a lth v is ito r s , the psychological and p ra c tic a l importance of th e ir work was acknowledged by many mothers. Those who n e ith e r attended nor 'a p p re c ia te d ' the h ealth v is it o r had doubts about these fu n c tio n s . They saw c lin ic ro le s as b e tte r performed elsewhere, eg they weighed th e ir babies a t the c h em ist's, discussed progress and problems w ith th e ir own doctor, and saw th e ir frie n d s as a b e tte r so cial o u tle t than casual c lin ic acquaintances. Another very s ig n ific a n t fa c to r a ffe c tin g uptake and s a tis fa c tio n was th e experience of one or more 'd is tre s s in g ' in c id e n ts . These in c id e n ts were in v a ria b ly ones, in which the mother was m a d e .to .fe e l g u ilt y , inadequate or embarrassed because of her apparent i n a b ilit y to care fo r her. baby.
All models included the frequency- matching variables of maternal age and child ’ s year of birth, and non- Indigenous and Indigenous data were analyzed separately. The Indigenous status of the mother is self-reported and recorded in the MNS. Multivariate models were adjusted for other maternal and child characteristics associated with adverse child outcomes. These covariates included the mother’s marital status at the time of birth, maternal mental health or illicit drug record, socioeconomic status, health region (metropolitan or rural), child ’ s sex, and parity. To produce the most parsimonious model, covariates were eliminated from the
Engle, P.L., Black, M.M., Behrman, J.R., Cabral de Mello, M., Gertler, P.J., Kapiriri, L., Reynaldo Martorell, Mary Eming Young, and the International Child Development Steering Group. (2007).Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. The Lancet, 369, 229-42
The Enhanced Maternal and Child Health Service focuses on children, mothers and families at risk of poor health and wellbeing outcomes, in particular where multiple risk factors for poor outcomes are present. The Enhanced Maternal and Child Health Service is provided in addition to the suite of services offered through the Universal Maternal and Child Health Service. The Enhanced Maternal and Child Health Service provides a more intensive level of support, including short-term case management in some circumstances. Support may be provided in a variety of settings, including the family home, the maternal and child health centre, or other locations within the community.
If the association between maternal drinking and child emotional and behavior outcomes remains after adequately accounting for confounding, this suggests that policies and interventions aimed at reducing parental drinking would be useful in reducing the risk of these child problems. If the associations are confounded, and maternal drinking is just a risk indicator, then such interventions or policies are less likely to be effective. This is important because strategies implemented on the basis of the currently limited knowledge base may be misguided and waste resources that would have had a better impact if applied elsewhere. 30
The role of state CSHCN programs has changed over time, moving from payment for medical care to the development of a comprehensive, coordinated, family-centered system of care for these children and their families, a role closely aligned with the core functions 7 of public health. In many states, CSHCN programs are exploring the life course approach 8 and considering ways to better integrate CSHCN services with the rest of Title V. Better coordination between IDPH and DSCC will be required for Illinois to be in the vanguard in this approach as the two main components of Illinois’ Maternal and Child Health system are in two separate agencies.