Health-related quality of life and children’s happiness with their childcare

Background Almost without exception, research into the range and quality of childcare provision, and its correlates with children’s development, comes from the perspective of adults. Parents, childcare workers, teachers and the general public have all been asked for their views on childcare. In contrast, there is a dearth of information on attitudes to childcare provision and its correlates from the perspective of the children themselves.

Methods A total of 3657 Primary 7 children, who are 10 or 11 years of age, completed the KIDSCREEN-27 health-related quality of life (HRQoL) measure along with questions on their childcare provision as part of an online survey carried out in schools.

Results Most children receiving childcare from people other than their parents were completely happy with their care. Childcare was related to poorer HRQoL for girls on four of the ?ve KIDSCREEN domains, although the effect sizes were small. For both boys and girls, there were statistically signi?cant, although modest, correlations between happiness with childcare and scores on all ?ve domains of the KIDSCREEN-27.

Conclusions Overall, the ?ndings suggest that most children are happy with their care and that any differences between the HRQoL of those who are cared for by their parents and those who are not are small to moderate.

The Millennium child with autism: Early childhood trajectories for health, education and economic wellbeing

Objective: Most of what we know about children with autism spectrum disorder (ASD) is based on post-diagnostic, retrospective, self-select studies. Oftentimes, there is no direct comparison between trajectories of children with ASD and children without ASD.

Methods: To circumvent both of these problems, the present secondary data analysis utilised a large-scale longitudinal general population survey of children born in the year 2000 (i.e. the Millennium Cohort Study; MCS; n=18522). Bi-annual MCS data were available from five data sweeps (children aged 9 months to 11 years of age).

Results: Pre-diagnostic data showed early health problems differentiated children later diagnosed with autism from non-diagnosed peers. Prevalence was much higher than previously estimated (3.5% for 11-year olds). Post-diagnosis, trajectories deteriorated significantly for the children with ASD and their families in relation to education, health and economic wellbeing.

Conclusion: These findings raise many issues for service delivery and the rights of persons with disabilities and their families.

An evaluation of Primary health care system in Kerala

The thesis entitled An Evaluation of Primary Health Care System in Kerala. The present study is intended to examine the working of primary health care system and its impact on the health status of people. The hypothesis tested in the thesis includes, a. The changes in the health profile require reallocation of resources of primary health care system, b. Rate of utilization depends on the quality of services provided by primary health centers, and c. There is a significant decline in the operational efficiency of the primary health care system. The major elements of primary health care stated in the report of AlmaAta International Conference on Primary Health Care (WHO, 1994)” is studied on the basis of the classification of the elements in to three: Preventive, Promotive, and Curative measures. Preventive measures include Maternal and Child Health Care including family Planning. Provision of water and sanitation is reviewed under promotive measures. Curative measures are studied using the disease profile of the study area. Collection of primary data was done through a sample survey, using pre-tested interview schedule of households of the study area. Multi stage random sampling design was used for selecting the sample. The design of the present study is both descriptive and analytical in nature. As far as the analytical tools are concerned, growth index, percentages, ratios, rates, time series analysis, analysis of variance, chi square test, Z test were used for analyzing the data. Present study revealed that no one in these areas was covered under any type of health insurance. Conclusion states that considering the present changes in the health profile, traditional pattern of resource allocation should be altered to meet the urgent health care needs of the people. Preventive and promotive measures like health education for giving awareness among people to change health habits, diet pattern, life style etc. are to be developed. Proper diagnosis and treatment of the disease at the beginning of the stage itself may help to cure majority of disease. For that, Public health policy must ensure the primary health care as enunciated at Alma- Ata international Conference. At the same time Public health is not to be treated as the sole responsibility of the government. Active community participation is an essential means to attain the goals.

Intergenerational persistence in health in developing countries : the penalty of gender inequality?

This paper is motivated to investigate the often neglected payoff to investments in the health of girls and women in terms of next generation outcomes. This paper investigates the intergenerational persistence of health across time and region as well as across the distribution of maternal health. It uses comparable microdata on as many as 2.24 million children born of about 0.6 million mothers in 38 developing countries in the 31 year period, 1970–2000. Mother's health is indicated by her height, BMI and anemia status. Child health is indicated by mortality risk and anthropometric failure. We find a positive relationship between maternal and child health across indicators and highlight non-linearities in these relationships. The results suggest that both contemporary and childhood health of the mother matter and that the benefits to the next generation are likely to be persistent. Averaging across the sample, persistence shows a considerable decline over time. Disaggregation shows that the decline is only significant in Latin America. Persistence has remained largely constant in Asia and has risen in Africa. The paper provides the first cross-country estimates of the intergenerational persistence in health and the first estimates of trends.

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

BACKGROUND: In northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members. METHODS: Four focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis. RESULTS: Four themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators' lack of health knowledge was regarded as a deficit for assisting the groups' assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups. CONCLUSIONS: This qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.

Validity of recall absent schoolchildren to free eye health projects

Purpose: To analyze the results of recall absent schoolchildren to eye health projects. Methods: Cross-sectional study. Visual screening was performed in schoolchildren attending 1st to 4th grades at public schools, from 7 to 10 years-old, to select and forward to complete ophthalmic evaluation. The projects were performed during weekends, at a public school, in the same municipality. Free transportation, food and eyeglasses were offered. A second opportunity of examination was offered to the students who were absent from the first call, with the same facilities. Results: 51,509 schoolchildren had their vision tested, 14,651 (28.4%) were referred for ophthalmic examination. Of these, 8,683 (59.3%) attended the first call, 2,228 (37.3%) attended the recall and 25.5% of parents did not take their children to ophthalmic examination. The need for eyeglasses for children who attended the examination was 23.8% and 32.0% in the first opportunity and recall, respectively. The recall increased the coverage in 15.2% (59.3% to 74.5%). Conclusion: An expressive number of parents (25.5%) did not bring their children to be examined, even at a second opportunity of exam. The facilities offered: access, free examination, transportation and glasses. Children who were absent in the first opportunity and appeared at recall had a greater need for eyeglasses. Recall increased the coverage in 15.2% (59.3% to 74.5%) and it is not recommended when financial resources are limited.

CATCH across Texas: Building a model for the diffusion of effective school-based health promotion programs

The impact of health promotion programs is related to both program effectiveness and the extent to which the program is implemented among the target population. The purpose of this dissertation was to describe the development and evaluation of a school-based program diffusion intervention designed to increase the rate of dissemination and adoption of the Child and Adolescent Trial for Cardiovascular Health, or CATCH program (recently renamed the Coordinated Approach to Child Health). ^ The first study described the process by which schools across the state of Texas spontaneously began to adopt the CATCH program after it was tested and proven effective in a multi-site randomized efficacy trial. A survey of teachers and administrator representatives of all schools on record that purchased the CATCH program, but were not involved in the efficacy trial, was used to find out who brought CATCH into the schools, how they garnered support for its adoption, why they decided to adopt the program, and what was involved in deciding to adopt. ^ The second study described how the Intervention Mapping framework guided the planning, development and implementation of a program for the diffusion of CATCH. An iterative process was used to integrate theory, literature, the experience of project staff and data from the target population into a meaningful set of program determinants and performance objectives. Proximal program objectives were specified and translated into both media and interpersonal communication strategies for program diffusion. ^ The third study assessed the effectiveness of the diffusion program in a case-comparison design. Three of the twenty Education Service Center regions in Texas were chosen, selected based on similar demographic criteria, and were followed for adoption of the CATCH curriculum. One of these regions received the full media and interpersonal channel intervention; a second received a reduced media-only intervention, and a third received no intervention. Results suggested the use of the interpersonal channels with media follow-up is an effective means to facilitate program dissemination and adoption. The media-alone condition was not effective in facilitating program adoption. ^

Household risk factors and the health and nutritional status of children in rural Honduras

During this cross-sectional study, both quantitative and qualitative research methods were used to elucidate the role that household environment and sanitation play in the nutritional status of children in a rural Honduran community. Anthropometric measurements were taken as measures of nutritional status among children under five years of age, while interviews regarding the household environment were conducted with their primary caregivers. Community participatory activities were conducted with primary caregivers, and results from water quality testing were analyzed for E. coli contamination. Anthropometric results were compared using the 1977 NCHS Growth Charts and the 2006 WHO Child Growth Standard to examine the implications of using the new WHO standard. The references showed generally good or excellent agreement between z-score categories, except among height-for-age classifications for males 24-35.9 months and weight-for-age classifications for males older than 24 months. Comparing the proportion of stunted, underweight, and wasted children, using the WHO standard generally resulted in higher proportions of stunting, lower underweight proportions, and higher overweight proportions. Logistic regression was used to determine which household and sanitation factors most influenced the growth of children. Results suggest only having water from a spring, stream, or other type of surface water as the primary source of drinking water is a significant risk factor for stunting. A protective association was seen between the household wealth index and stunting. Through participatory activities, the community provided insight on health issues important for improving child health. These activities yielded findings to be harnessed as a powerful resource to unify efforts for change. The qualitative findings were triangulated with the quantitative interview and water testing results to provide intervention recommendations for the community and its primary health care clinic. Recommendations include educating the community on best water consumption practices and encouraging the completion of at least some primary education for primary caregivers to improve child health. It is recommended that a community health worker program be developed to support and implement community interventions to improve water use and household sanitation behaviors and to encourage the involvement of the community in targeting and guiding successful interventions. ^

The interorganizational implementation of state health policy: A network approach

This is an implementation analysis of three consecutive state health policies whose goal was to improve access to maternal and child health services in Texas from 1983 to 1986. Of particular interest is the choice of the unit of analysis, the policy subsystem, and the network approach to analysis. The network approach analyzes and compares the structure and decision process of six policy subsystems in order to explain program performance. Both changes in state health policy as well as differences in implementation contexts explain evolution of the program administrative and service unit, the policy subsystem. And, in turn, the evolution of the policy subsystem explains changes in program performance. ^

Water to Thrive health needs assessment for Robit, Ethiopia

Developing countries suffer from an array of diseases, of which the developed world is unfamiliar. In order to facilitate the development of community interventions and streamline NGO partnership, needs assessments in targeted areas are conducted. The purpose of this assessment was to attain baseline descriptive data to further understand the needs of the village of Robit, Ethiopia. A trained team collected data from Austin based non-profit Water to Thrive (W2T) on June 1st and 2nd, 2011 through focus groups, key informant interviews, and individual surveys. Qualitative and quantitative data were paired to affirm the results of one another through triangulation. The results identified an apparent need for health intervention and education. Malaria, water-borne disease, respiratory issues (asthma, Upper respiratory tract infections), and maternal and child health were among the evident problems in Robit. There was a clear need for midwife training as well as water sanitation, latrine building, and general illness treatment. Poor road conditions and annual flooding of Robit plays an important role in the poor health and lack of food security of the village. While some evidence of social desirability and recall bias was found in the interview and survey data, the triangulation of findings provided important insights and validity to the needs assessment. ^

U.S. teens in our world : understanding the health of U.S. youth in comparison to youth in other countries /

"This chartbook is the product of the efforts of many authors and editors, including Mary Overpeck ... [et al.]"--P. 16.

Barriers to health care/children's health [microform] : hearing before the Committee on Labor and Human Resources, United States Senate, Ninety-ninth Congress, second session, on review of access to health care for the poor and uninsured and improved health for America's children, July 16, 1986.

CIS Microfiche Accession Numbers: CIS 87 S541-16

Children's primary care and chronic health care issues [microform] : hearings before the Committee on Finance, United States Senate, One Hundredth Congress, second session, May 24 and 26, 1988.

CIS Microfiche Accession Numbers: CIS 89 S361-26

Economics of reproductive and infant health : an annotated bibliography from 1980 to 1993 /

Includes indexes.