ABSTRACT
【Objective】 To understand factors associated with children′s attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. 【Methods】 During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children′s hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children′s sociodemographic characteristics, parents′ knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. 【Results】 Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ2=835.27), more likely to be from the local area (87.2% vs. 81.4%,χ2=12.25), more likely to have parents with a college degree (mother: 83.6% vs. 74.2%, χ2=35.29; father: 79.9% vs. 70.0%, χ2=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ2=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ2=31.4) The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children′s attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children′s physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. 【Conclusions】 Children′s age, grandparent involvement in routine care, and family annual income are the main factors associated with children′s attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.
ABSTRACT
A doença falciforme é uma das enfermidades mais antigas da humanidade, decorrente de uma mutação genética ocorrida, majoritariamente, no continente africano. A imigração forçada dos africanos em decorrência do escravismo trouxe o gene a todo território brasileiro. Desse modo, percebe-se que a doença é hereditária, incurável e de alta morbidade e mortalidade, sendo seu tratamento tradicionalmente compreendido, como de competência dos centros hematológicos. Na década de 1990, graças aos movimentos sociais formados por amigos, familiares e pessoas com a doença, o processo de organização social e de reivindicação por políticas públicas foi iniciado. Em 2001, o exame que detecta anemia falciforme foi incluído no Programa Nacional de Triagem Neonatal de 12 estados da Federação. Em 2005, a Portaria ministerial nº1.391 incluiu a atenção aos doentes falciformes no Sistema Único de Saúde (SUS). Com isso, surgem novos desafios no campo de enfermagem: a atenção qualificada aos doentes falciformes na atenção básica. Deste modo, neste artigo procurou-se enfocar a enfermidade em seus aspectos, culturais, sociais e da atenção à saúde. Espera-se, dessa forma, poder contribuir para a atenção qualificada dessas pessoas na atenção básica e estimular a produção de conhecimentos.
Sickle cell disease is one of the oldest diseases known to mankind. It arises from a genetic mutation that mainly occurs on the Africa Continent. With the forced immigration during slavery, the gene arrived in Brazilian. Thus, it was perceived that the disease is hereditary, incurable and has high morbidity and mortality, with its treatment traditionally understood as the competence of hematology centers. In the 1990s thanks to the social movements formed by friends, relatives and patients with the disease the social organization and demands for public healthcare policies was initiated. In 2001, the examination that detects sickle cell disease was included in the National Newborn Screening Program in 12 states of Brazil. In 2005, a national law included the treatment of sickle cell disease in the Government Healthcare System. Thus, new challenges appeared for nursing professionals: qualified care of sickle cell patients in basic healthcare. This article focuses on cultural, social and healthcare aspects of nursery. Thus, it is hoped that this work contribute to the qualified basic healthcare of these patients.