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PubMed2001

[Study on the optimal perinatal health care and child health care surveillance systems].

OBJECTIVES: To study the establish an optimal perinatal health care (PHC) surveillance system and an child health care (CHC) surveillance system in China, that can provide better health care services for women and children. METHODS: All women receiving marital check-ups are issued PHC booklets and then their menstrual dates are recorded regularly. If a woman is confirmed to be pregnant, she will receive her first prenatal exam. Subsequent prenatal exams and visits will be followed and recorded accordingly. CHC data will be collected regularly during the provision of routine child health care services. RESULTS: Surveillance systems have been set up in 32 project counties/cities in China, comprising more than 20 million people. The surveillance systems have smoothly been conducted for eight years since 1993. CONCLUSION: The surveillance systems have been proved to be adaptable under China's context. Both PHC and CHC systems seemed to be helpful in improving the health care services as well as the health condition of mothers and children in the areas.

Adult↗
PubMed1991

Evaluation of information on dental health care at child health centers. Differences in educational level, attitudes, and knowledge among parents of preschool children with different caries experience.

The aim of this study was to interpret the manner in which information on dental health care, systematically offered at child health centers, is assimilated among parents of preschool children with different caries experience. The material comprised children who, on the basis of defined criteria were classified as 'healthy' or 'diseased' with regard to caries and restorations. The investigation was mainly performed as telephone interviews with the parents. The results showed no difference between the groups with regard to diet, oral hygiene, and use of fluorides. However, parents of healthy children had a statistically significantly higher level of education than parents of diseased children. The level of education did not influence the knowledge as such but rather the ability to put the knowledge into practice. Parents of healthy children claimed to a greater extent than parents of diseased children to have received a combination of verbal and written information. This could be because the first group had a greater interest in assimilating new information and in creating a two-way communication with the informer. This is probably an effect of the level of education and confirms that it is essential to make people aware of the information's importance rather than merely teaching facts.

Attitude to Health↗
PubMed1997

Oral health component of child health services research.

The June 11 JAMA article outlines a rationale for developing a focus on child health services research and offers several strategies for facilitating the process. Developing a child health research agenda is essential to advancing dental care and professional education and, thus, is relevant to educators as well as researchers and policy makers. Oral health considerations are not likely to have high visibility or priority within that agenda unless dental health services researchers and dental schools become involved. An obvious question that is bound to be raised is "does it make sense to attempt to direct some portion of the already scarce resources available for dental health services research to children's issues?" Many individuals in leadership positions will probably think not; however, with an appropriate strategy, a small number of organized individuals and institutions can make a significant difference. Given the nature of dental diseases and the historical values of the profession, what better place to start?

Child↗
PubMed1977

The pediatric practice of the child health associate.

Child health associates are individuals who have completed the three-year Child Health Associate Program at the University of Colorado School of Medicine and are certified by the Colorado State Board of Medical Examiners to practice pediatrics under physician supervision. To our knowledge, this study is the first to describe the practice profile of child health associates. We found them able to provide health care services without direct physician assistance to 91.4% (2,160 of 2,363) of pediatric patients in ambulatory settings. They saw the same variety of patients as primary physicians and identified a broad range of common pediatric problems. Each supervising physician spent an average time of 5.9 minutes with the child health associate in evaluating the 8.6% of patients who required consultation. The child health associate is fully able to serve as a primary health care practitioner for children.

Adolescent↗
PubMed1993

The characteristics of clients and public health nurses in child health services interactions.

The purpose of this paper is to describe the characteristics of clients (i.e. mothers) and public health nurses in child health services based on interviews of the mothers and the public health nurses. In addition, the meaning of the visit to the participants is described. The data were collected by interviewing 20 mothers in their homes and 20 public health nurses. Grounded theory was used in the data analysis. Four categories describing the clients were found: disengaged clients, interested but shy clients, interested but disappointed clients and eager and responsible clients. Three types of public health nurses were identified according to their own descriptions: families' needs are the more important, balancing and orders are the most identified. Client's satisfaction depended on the mother's mood, the child's behavior during the visit, having the same nurse and especially the public health nurse's character or personality. The paper emphasizes the importance of nursing research on interactions in health care, especially client-public health nurse relationships and their consequences for both parties.

Adult↗
PubMed2001

Parents: the best experts in child health care? Viewpoints from parents and staff concerning child health services.

The aim was to describe what parents and staff think about child health care, to identify agreements and disagreements. A qualitative study was made with semi-structured interviews based on a phenomenographic approach. Sixty parents, 14 nurses and six doctors from southern Sweden were interviewed. Parents and staff emphasized two tasks as being of particular importance: support and check-ups. There was a conflict between parents' need for security versus integrity. Individual nurses experienced a conflict between what they wanted to do and what they felt that they had to do. The parents viewed parental education as a chance to exchange experiences with other parents and receive support from other adults, while the staff mainly saw it as an opportunity to inform parents and strengthen them in their parental role. The study gives grounds for reflection about how the work of child health care can be changed in the future.

Attitude of Health Personnel↗
PubMed2002

Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population.

UNLABELLED: Feasibility, reliability, and discriminative validity of the cross-culturally adapted Dutch version of the originally US child health questionnaire-child form (CHQ-CF87), an 87-item generic pediatric health-related quality of life instrument, were assessed. The success criterion in this first evaluation was the equivalence of psychometric properties of the adapted and the original CHQ. A total of 466 schoolchildren (9-17 years) were invited to complete the questionnaire in the classroom. Test-retest reliability was measured after 14 days in a subgroup (n = 71). Response was 96%. Four scales had ceiling effects (>50%), as was reported in an Australian study. Cronbach alpha-values were adequate (>0.70), except for 'physical functioning' (0.56). Test-retest correlations, not previously reported, were not statistically significant for two CHQ-scales, whereas average retest scores indicated better health for five scales (p < 0.01). The CHQ scales discriminated significantly (p < 0.01) between children without (n = 281) and children with two or more self-reported chronic diseases (n = 59). This is in correspondence with US and Australian reports. CONCLUSIONS: The current data support application of the Dutch CHQ-CF in predominantly healthy populations, e.g. in school settings. Given the limitations of this study and some less favorable results (score distributions, internal consistency, test-retest reliability), further evaluation of the CHQ-CF is recommended, preferably by analyses of item performance and scale validity in international data sets that include varied clinical subgroups.

Adolescent↗
PubMed1997

Impact of maternal and child health strategy on child survival in a rural community of Pondicherry.

OBJECTIVE: To determine the impact of Maternal and Child Health (MCH) services on child survival in a socio-economically backward rural community. SETTING: Twelve villages in Pondicherry with a population of 16,803. DESIGN: Prospective study. SUBJECTS: A birth cohort of 356 live births (LB) born between January 1st and December 31st 1988. METHODS: The live births were followed-up from birth to five years age (1988-1993). The health care received by this cohort and the antenatal services received by the cohort mothers was reviewed. Outcome measures related to child survival were determined and their changing trend since 1967 was examined. RESULTS: Fifty-four per cent of the cohort children were from families below the poverty line. Antenatal registration and tetanus immunization coverage of the mothers of the cohort was 100%. Immunization coverage of the cohort children was more than 98% for BCG, DPT (three doses) and OPV (three doses) and 82% for measles. The infant mortality rate had reduced from 201/1000 LB in 1967 to 64/1000 LB (95% CI 58.9-68.1) in 1989. The child death rate decreased from 29.4/1000 children 1-4 years of age (1970) to 18/1000 (95% CI 13.9-22.1) in 1992. There were no deaths due to neonatal tetanus or measles. Neonatal mortality (35/1000 LB; 95% CI 29.9-40.1) was higher than the post-neonatal mortality (29/1000 LB; 95% CI 24.1-33.9). Fifty eight per cent of the neonatal deaths were due to non-infective causes like prematurity, birth asphyxia, birth injuries and congenital anomalies. Eighty per cent of post neonatal deaths were due to infections. Overall, the child survival index was high (91.27%; 95% CI 88.14-94.26). This was inspite of the low socio-economic background of the children's families. CONCLUSIONS: Good MCH services can substantially improve child survival inspite of prevailing low socio-economic situations. Inputs for neonatal care need to be strengthened to further enhance child survival.

Cause of Death↗
PubMed1991

[Interaction between clients and public health nurses in child health care].

The purpose of this study was to describe the contents and patterns of interaction between clients (mother and child under one year of age) and public health nurses in child health care at Finnish health centers. The data were collected by observing client--public health nurse interactions during the visits. The data reported in this article were collected during 1987-1989. Totally 1554 interactions were observed out of 20 visits to child health centers. The data were analyzed according to grounded theory method. The contents of the interaction between clients and public health nurses concentrated on child's growth and development. Additionally, family issues like relationships in the family and relatives were discussed. Situational matters during the visit were also included in the contents. Various relationships were identified between child and mother, child and public health nurse and mother and public health nurse. The relationship between child and mother during the visit was called a tenderness, protective and persuasive relationship. The relationship between child and public health nurse was called a persuasive and entertainment relationship. The main relationship between mother and public health nurse was called relationship supporting selfconfidence. This study has produced descriptive knowledge about interactions in health care.

Adult↗
PubMed1998

Role of schools of public health on maternal and child health programmes in the Asia-Pacific region.

This paper assessed the role of public health schools on maternal and child health programmes in the Asia Pacific region. Economic development and its associated effects, particularly in the ASEAN countries, for example, migrant labour, ageing, environmental health, turbulence and social climate, has a tremendous impact on maternal and child health. Based on these current issues, it is evident that public health schools can play a major role in maternal and child health in terms of policy formulation and programme development. Several areas were proposed as to what schools of public health can do, namely, through networking, communication, research and training.

Adult↗
PubMed1999

A controlled trial of parent initiated and conventional preschool health surveillance using personal child health records.

OBJECTIVES: A comparison of parent initiated preschool surveillance, using personal child health records, with the then current system of child health surveillance using child health records. DESIGN: Prospective, controlled trial with randomisation of five general practices into two groups. SETTING: Five general practices, a well baby clinic, and an orthoptic clinic at Yeovil District Hospital. SUBJECTS: 538 babies born between 1 April 1992 and 1 November 1994, from within the five general practices. MAIN OUTCOME MEASURES: The number of screenable abnormalities in the two groups that were missed in the first 3 years of a baby's life. RESULTS: 163 babies from the parent initiated preschool surveillance group and 107 from the conventional group completed the study. Although all the mothers from the parent initiated preschool surveillance group understood the concept of parent initiated surveillance, 117 stated their health visitor had made their appointments. Only 45 mothers made their own appointments. The abnormality rates were: 12 of 163 and eight of 107 at 1 year and nine of 163 and six of 107 at 3 years. No medically important conditions were missed. Most mothers did not want to make their own appointments because it was inconvenient. The system was unpopular with health visitors. CONCLUSION: Parent initiated preschool surveillance is as safe as the current system. Implementing the idea involved a small change in work practice and a large change conceptually for some of the primary health care team. It was not adopted in east Somerset.

Appointments and Schedules↗