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1.
S Afr Med J ; 0(0): 13185, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33334393

RESUMEN

BACKGROUND: Current evidence indicates that children are relatively spared from direct COVID-19-related morbidity and mortality, but that the indirect effects of the pandemic pose significant risks to their health and wellbeing. OBJECTIVES: To assess the impact of the local COVID-19 outbreak on routine child health services. METHODS: The District Health Information System data set for KwaZulu-Natal (KZN) provincial health services was accessed, and monthly child health-related data were extracted for the period January 2018 - June 2020. Chronological and geographical variations in sentinel indicators for service access, service delivery and the wellbeing of children were assessed. RESULTS: During April - June 2020, following the start of the COVID-19 outbreak in KZN, significant declines were seen for clinic attendance (36%; p=0.001) and hospital admissions (50%; p=0.005) of children aged <5 years, with a modest recovery in clinic attendance only. Among service delivery indicators, immunisation coverage recovered most rapidly, with vitamin A supplementation, deworming and food supplementation remaining low. Changes were less pronounced for in- and out-of-hospital births and uptake rates of infant polymerase chain reaction testing for HIV at birth, albeit with wide interdistrict variations, indicating inequalities in access to and provision of maternal and neonatal care. A temporary 47% increase in neonatal facility deaths was reported in May 2020 that could potentially be attributed to COVID-19-related disruption and diversion of health resources. CONCLUSIONS: Multiple indicators demonstrated disruption in service access, service delivery and child wellbeing. Further studies are needed to establish the intermediate- and long-term impact of the COVID-19 outbreak on child health, as well as strategies to mitigate these.


Asunto(s)
Servicios de Salud del Niño , Accesibilidad a los Servicios de Salud , Control de Infecciones , Atención Perinatal , /epidemiología , Salud del Niño/normas , Servicios de Salud del Niño/organización & administración , Servicios de Salud del Niño/estadística & datos numéricos , Preescolar , Recursos en Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Atención Perinatal/normas , Atención Perinatal/estadística & datos numéricos , Sudáfrica/epidemiología
2.
Artículo en Inglés | MEDLINE | ID: mdl-33171882

RESUMEN

Presented in this paper is a study that examined the status of unmet healthcare needs of children in vulnerable families and identified factors affecting such unmet needs. The Community Child Center (CCC) Child Panel Survey data in Korea were used. A multiple stepwise logistic regression analysis was performed to examine factors influencing unmet healthcare needs of children. Influencing factors comprised predisposing, enabling, and need factors based on the Andersen Behavioral Model of Health Services Utilization. A total of 340 sixth-graders from vulnerable families participated, and 96 (28.2%) children had unmet healthcare needs. Factors included absence of an after-school caregiver (OR = 1.95, 95% CI [1.16, 3.27]), perceived physical symptoms (OR = 1.33, 95% CI [1.02, 1.73]), parental indifference (OR = 1.33, 95% CI [1.002, 1.77]), duration of daily stay at CCCs (OR = 1.32, 95% CI [1.01, 1.71]), and satisfaction with CCC teachers (OR = 0.65, 95% CI [0.49, 0.85]). The relationship with parents and CCC teachers had the strongest influence on unmet healthcare needs of children. In order to reduce the unmet healthcare needs of children in vulnerable families, existing support structures should be expanded to offer financial and administrative support for children's parents and CCC teachers.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Instituciones de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Disparidades en Atención de Salud , Poblaciones Vulnerables , Niño , Estudios Transversales , Humanos , República de Corea , Características de la Residencia , Factores Socioeconómicos , Encuestas y Cuestionarios
3.
Health Aff (Millwood) ; 39(10): 1752-1761, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33017237

RESUMEN

Safety-net programs improve health for low-income children over the short and long term. In September 2018 the Trump administration announced its intention to change the guidance on how to identify a potential "public charge," defined as a noncitizen primarily dependent on the government for subsistence. After this change, immigrants' applications for permanent residence could be denied for using a broader range of safety-net programs. We investigated whether the announced public charge rule affected the share of children enrolled in Medicaid, the Supplemental Nutrition Assistance Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children, using county-level data. Results show that a 1-percentage-point increase in a county's noncitizen share was associated with a 0.1-percentage-point reduction in child Medicaid use. Applied nationwide, this implies a decline in coverage of 260,000 children. The public charge rule was adopted in February 2020, just before the coronavirus disease 2019 (COVID-19) pandemic began in the US. These results suggest that the Trump administration's public charge announcement could have led to many thousands of eligible, low-income children failing to receive safety-net support during a severe health and economic crisis.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Infecciones por Coronavirus/prevención & control , Asistencia Alimentaria/estadística & datos numéricos , Disparidades en Atención de Salud/economía , Medicaid/economía , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pobreza/estadística & datos numéricos , Adolescente , Niño , Salud del Niño , Preescolar , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Bases de Datos Factuales , Miedo , Femenino , Política de Salud/legislación & jurisprudencia , Humanos , Cobertura del Seguro/estadística & datos numéricos , Masculino , Innovación Organizacional , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Formulación de Políticas , Estudios Retrospectivos , Proveedores de Redes de Seguridad/organización & administración , Estados Unidos
4.
Child Adolesc Ment Health ; 25(4): 267-269, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33025729

RESUMEN

The pandemic is creating unprecedented demand for mental health support for young people. While schools often facilitate mental health support for their students, the demands for online teaching and the uncertainty created by the pandemic make traditional delivery of support through schools challenging. Technology provides a potential way forward. We have developed a digital ecosystem, HABITS, that can be integrated into school and healthcare systems. This has allowed us to deploy specific evidence-based interventions directly, and through schools, to students and to parents in New Zealand during the current pandemic. Chatbot architecture is particularly suited to rapid iteration to provide specific information while apps can provide more generalised support. While technology can provide some solutions, it is important to be aware of the potential to increase current inequities, with those facing the greatest challenges to health and well-being, also least able to afford the resources to access digital interventions. Development of an integrated and equitable digital system will take time and collaboration.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Infecciones por Coronavirus , Servicios de Salud Mental/organización & administración , Salud Mental , Pandemias , Neumonía Viral , Servicios de Salud Escolar/organización & administración , Estudiantes/psicología , Adolescente , Niño , Computadores , Ecosistema , Humanos , Nueva Zelanda , Telecomunicaciones
7.
Niger J Clin Pract ; 23(8): 1127-1134, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32788491

RESUMEN

Background: The Child Welfare Card (CWC) contains the records of a child's immunization and information on the other aspects of the child's health, including growth curves and home treatment of diarrheal disease to mention a few. How easily retrievable these records are and what influence the cards have on parents/caregivers regarding the child's nurture are uncertain in our environment. Aim: The present study was aimed at assessing the parents/caregivers' knowledge and utilization of CWCs as well as the health-providers' accessibility of the card in the hospital. Method: This study was a cross-sectional descriptive one that involved the parents/caregivers of children aged 60 months and below, attending the children's clinics and wards in a tertiary center. We collected the relevant information, including the sociodemographic data of the parents/caregivers, their knowledge, and assessed the utilization of CWC. The analysis of the categorical data was performed with the IBM Statistical Package for Social Sciences (S.P.S.S) version 23.0 for windows. P values < 0.05 were considered significant. Results: Of the 377 parents/caregivers enrolled in the study, good knowledge of the contents of the CWC was demonstrated by 82 (21.8%) while 78 (20.7%) made the cards available to the health care providers. Eighty (21.2%) made adequate use of the cards at home. A greater number of parents/caregivers from the higher social class had good knowledge of the intervention contents of the CWC (P = 0.005). The accessibility of the cards to the health care-providers was significantly higher among the older parents/caregivers (P = 0.010), those with a good knowledge of CWC (P = 0.020) and parents/caregivers from higher social class (P = 0.001). Subjects with good knowledge were 2.4 times (OR = 2.4, 95% CI = 1.4-4.2) more likely to utilize the intervention contents in the CWC. Conclusion: The overall knowledge, utilization, and accessibility of the CWC were poor. Parents/caregivers with good knowledge were more likely to utilize the information on the CWC compared with participants with poor knowledge.


Asunto(s)
Cuidadores/estadística & datos numéricos , Servicios de Salud del Niño/estadística & datos numéricos , Bienestar del Niño/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Registros Médicos/estadística & datos numéricos , Adulto , Cuidadores/psicología , Niño , Salud del Niño , Servicios de Salud del Niño/organización & administración , Preescolar , Estudios Transversales , Familia , Femenino , Encuestas de Atención de la Salud , Humanos , Esquemas de Inmunización , Masculino , Persona de Mediana Edad , Nigeria , Clase Social , Factores Socioeconómicos
8.
Child Abuse Negl ; 110(Pt 2): 104642, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32753231

RESUMEN

BACKGROUND: The COVID-19 pandemic and associated response measures have led to unprecedented challenges for service providers working with vulnerable children and families around the world. OBJECTIVE: The goal of the present study was to better understand the impact of the pandemic and associated response measures on vulnerable children and families and provide data-informed recommendations for public and private service providers working with this population. PARTICIPANTS AND SETTING: Representatives from 87 non-government organizations (NGOs) providing a variety of direct services (i.e. residential care, family preservation, foster care, etc.) to 454,637 vulnerable children and families in 43 countries completed a brief online survey. METHODS: Using a mixed methods design, results examined 1) ways in which children and families have been directly impacted by COVID-19, 2) the impact of the pandemic on services provided by NGOs, 3) government responses and gaps in services for this population during the pandemic, and 4) strategies that have been effective in filling these gaps. RESULTS: Data revealed that the pandemic and restrictive measures were associated with increased risk factors for vulnerable children and families, including not having access to vital services. The NGOs experienced government restrictions, decreased financial support, and inability to adequately provide services. Increased communication and supportive activities had a positive impact on both NGO staff and the families they serve. CONCLUSIONS: Based on the findings, ten recommendations were made for service providers working with vulnerable children and families during the COVID-19 pandemic.


Asunto(s)
Servicios de Salud del Niño/estadística & datos numéricos , Servicios de Protección Infantil/estadística & datos numéricos , Prestación de Atención de Salud/estadística & datos numéricos , Organizaciones/estadística & datos numéricos , /prevención & control , Niño , Servicios de Salud del Niño/organización & administración , Servicios de Protección Infantil/organización & administración , Exposición a la Violencia/estadística & datos numéricos , Familia , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Pandemias , Factores Socioeconómicos
9.
Child Abuse Negl ; 110(Pt 2): 104668, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32828561

RESUMEN

BACKGROUND: Great Britain has the highest coronavirus death rate in Europe. While the pandemic clearly poses a risk to the lives and wellbeing of vulnerable groups, necessary public health measures taken to delay or limit the spread of the virus have led to distinctive challenges for prevention, family support, court processes, placement and alternative care. The pandemic has also come about at a time when statutory changes to partnerships have led to a reduction in the importance of educational professional representation in the new formulation in England and Wales. OBJECTIVES: In this discussion paper, we propose a novel and pragmatic conceptual framework during this challenging time. PARTICIPANTS: We consulted with 8 education professionals and 4 field-based student social workers. SETTING: Bodies responsible for safeguarding have been working quickly to develop new approaches to fulfilling their responsibilities, for example through online home visits and case conferences. However, some communities have been highlighted as experiencing particular challenges because of the pandemic and its impacts. Protection of vulnerable children is increasingly dependent on individualised - and often pathologising - practice with a lack of emphasis on the importance of the social. Holistic consideration of the child is side-lined. RESULTS: Our framework comprises two phases: pandemic and aspirational. CONCLUSION: The framework illuminates the importance of interconnected sectors and multi-agency working, the need for resilient and adaptable support systems, and the need to promote the importance of children's rights and voices to be heard above the noise of the pandemic.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Servicios de Protección Infantil/organización & administración , Práctica de Salud Pública , Adolescente , Servicios de Salud del Adolescente/organización & administración , Niño , Humanos , Pandemias , Maestros , Trabajadores Sociales , Factores Socioeconómicos , Reino Unido/epidemiología
12.
BMC Health Serv Res ; 20(1): 589, 2020 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-32600407

RESUMEN

BACKGROUND: Health services and systems research (HSSR) strategies dedicated to paediatric health care and service delivery are limited. Strategies are available but are outdated and yet to be optimised for use in a paediatric health system. We aim to describe the development and integration of a Children's Health Service and System Research Strategy (CHSSR-S) in Children's Health Queensland (CHQ), a large specialist quaternary hospital and health service caring for children and young people in Queensland and northern New South Wales, Australia. METHODS: The CHSSR-S was developed using an inductive, bottom-up, participatory systems approach across three phases: (1) Identifying local HSSR capacity; (2) Development; (3) Integration. A HSSR "Champion" was appointed to lead all phases. Clinical, research and system-based stakeholders (n = 14) were individually identified, contacted and participated in dedicated meetings and a workshop to iteratively design the CHSSR-S. A health system-wide CHSSR-S governance committee was established to drive phase three. Health system integration was achieved by multicomponent, action-based strategies. RESULTS: The final CHSSR-S comprised ten Research Priorities and three Research Enablers, and was successfully integrated within CHQ via a range of platforms. Research Priorities included: (1) Population Health; (2) Adolescent and Young Adult (AYA) Cancer; (3) Indigenous Health; (4); Mental Health; (5) Nutrition and Obesity; (6) Rare Neurodevelopmental Disorders; (7) Sepsis; (8) Screening, surveillance and monitoring; (9) Innovation; and (10) Electronic Medical Record (EMR). Research Priorities were supported by three Research Enablers: (1) Data; (2); Evaluation and Health Economics; and (3) Policy. CONCLUSIONS: The CHSSR-S is the first known paediatric HSSR strategy developed and integrated within a large dedicated paediatric health system. The CHSSR-S may be used to guide global paediatric healthcare systems to prioritise HSSR in their local setting to optimise health service delivery and patient outcomes.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Investigación sobre Servicios de Salud/métodos , Hospitales Pediátricos/organización & administración , Adolescente , Niño , Humanos , Queensland
13.
BMC Public Health ; 20(1): 1093, 2020 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-32652971

RESUMEN

BACKGROUND: The Chinese government has been strengthening the primary care system since the launch of the New Healthcare System Reform in 2009. Among all endeavors, the most obvious and significant improvement lays in maternal and child health. This study was designed to explore the association of primary care physician supply with maternal and child health outcomes in China, and provide policy suggestions to the law makers. METHODS: Six-year panel dataset of 31 provinces in China from 2012 to 2017 was used to conduct the longitudinal ecological study. Linear fixed effects regression model was applied to explore the association of primary care physician supply with the metrics of maternal and child health outcomes while controlling for specialty care physician supply and socio-economic covariates. Stratified analysis was used to test whether this association varies across different regions in China. RESULTS: The number of primary care physicians per 10,000 population increased from 15.56 (95% CI: 13.66 to 17.47) to 16.08 (95% CI: 13.86 to 18.29) from 2012 to 2017. The increase of one primary care physician per 10,000 population was associated with 5.26 reduction in maternal mortality per 100,000 live births (95% CI: - 6.745 to - 3.774), 0.106% (95% CI: - 0.189 to - 0.023) decrease in low birth weight, and 0.419 decline (95% CI: - 0.564 to - 0.273) in perinatal mortality per 1000 live births while other variables were held constant. The association was particularly prominent in the less-developed western China compared to the developed eastern and central China. CONCLUSION: The sufficient supply of primary care physician was associated with improved maternal and child health outcomes in China, especially in the less-developed western region. Policies on effective and proportional allocation of resources should be made and conducted to strengthen primary care system and eliminate geographical disparities.


Asunto(s)
Salud del Niño/estadística & datos numéricos , Servicios de Salud Materna/organización & administración , Médicos de Atención Primaria/organización & administración , Atención Primaria de Salud/organización & administración , Adulto , Niño , Servicios de Salud del Niño/organización & administración , China/epidemiología , Femenino , Reforma de la Atención de Salud , Humanos , Recién Nacido , Mortalidad Materna/tendencias , Embarazo
14.
BMC Health Serv Res ; 20(1): 623, 2020 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-32641117

RESUMEN

BACKGROUND: In many high-income countries, primary care practitioners are the main point of referral for specialist mental health services. In England, Child and Adolescent Mental Health Services (CAMHS) are increasingly adopting a Single Point of Access (SPA) to streamline referrals and introduce self and parent/carer-referrals. This involves a significant shift of responsibility from primary care towards CAMHS who adopt a more active role as gatekeeper for their service. This study evaluates the adoption of a SPA in CAMHS across a large region in England. METHODS: We conducted an observational mixed methods study in two CAMHS from January 2018 to March 2019 to evaluate the adoption of a SPA. We collected quantitative data from electronic patient records and qualitative data through ethnographic observation and in-depth interviews of staff and stakeholders with experience of using CAMHS. Additional data on volumes was shared directly from the SPAs and a further snapshot of 1 week's users was collected. RESULTS: A similar SPA model emerged across the two services. Staff were positive about what the model could achieve and access rates grew quickly following awareness-raising activities. Despite the initial focus being on a telephone line, online referrals became the more regularly used referral method. Increased access brought challenges in terms of resourcing, including identifying the right staff for the role of call handlers. A further challenge was to impose consistency on triage decisions, which required structured information collection during the assessment process. Similar to GP referrals, those self-referring via the SPA were mainly from the least deprived areas. CONCLUSIONS: The introduction of a SPA has the potential to improve young people's access to mental health services. By addressing some of the barriers to access, simplifying where to go to get help and making it easier to contact the service directly, a SPA can help more individuals and families access timely support. However, the introduction of a SPA does not in itself expand the capacity of CAMHS, and therefore expectations within services and across sectors need to be tempered accordingly. SPA services providing different referral approaches can further improve access for the harder to reach populations.


Asunto(s)
Servicios de Salud del Adolescente/organización & administración , Servicios de Salud del Niño/organización & administración , Accesibilidad a los Servicios de Salud , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Adolescente , Niño , Registros Electrónicos de Salud , Inglaterra , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Atención Primaria de Salud , Investigación Cualitativa , Derivación y Consulta/estadística & datos numéricos
15.
BMC Public Health ; 20(1): 1122, 2020 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-32677944

RESUMEN

BACKGROUND: Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF in 1992. It was deployed as an integrated approach to improve children's health in the world. This strategy is divided into three components: organizational, clinical, and communitarian. If the Integrated Management of Childhood Illnesses implementation-related factors in low- and middle-income countries are known, the likelihood of decreasing infant morbidity and mortality rates could be increased. This work aimed to identify, from the clinical component of the strategy, the implementation-related factors to Integrated Management of Childhood Illnesses at 18 Colombian cities. METHODS: A quantitative cross-sectional study was performed with a secondary analysis of databases of a study conducted in Colombia by the Public Health group of Universidad de Los Andes in 2016. An Integrated Care Index was calculated as a dependent variable and descriptive bivariate and multivariate analyses to find the relationship between this index and the relevant variables from literature. RESULTS: Information was obtained from 165 medical appointments made by nurses, general practitioners, and pediatricians. Health access is given mainly in the urban area, in the first level care and outpatient context. Essential medicines availability, necessary supplies, second-level care, medical appointment periods longer than 30 min, and care to the child under 30 months are often related to higher rates of Integrated Care Index. CONCLUSION: Health care provided to children under five remains incomplete because it does not present the basic minimums for the adequate IMCI's implementation in the country. It is necessary to provide integrated care that provides medicine availability and essential supplies that reduce access barriers and improve the system's fragmentation.


Asunto(s)
Servicios de Salud del Niño/estadística & datos numéricos , Salud del Niño/estadística & datos numéricos , Prestación Integrada de Atención de Salud/estadística & datos numéricos , Implementación de Plan de Salud/estadística & datos numéricos , Salud Pública/estadística & datos numéricos , Niño , Servicios de Salud del Niño/organización & administración , Preescolar , Ciudades , Colombia , Estudios Transversales , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Investigación sobre Servicios de Salud , Humanos , Lactante , Masculino , Naciones Unidas , Organización Mundial de la Salud
17.
BMC Public Health ; 20(1): 993, 2020 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-32580720

RESUMEN

BACKGROUND: Universal child health services (UCHS) provide an important pragmatic platform for the delivery of universal and targeted interventions to support families and optimize child health outcomes. We aimed to identify brief, evidence-based interventions for common health and developmental problems that could be potentially implemented in UCHS. METHODS: A restricted evidence assessment (REA) of electronic databases and grey literature was undertaken covering January 2006 to August 2019. Studies were eligible if (i) outcomes related to one or more of four areas: child social and emotional wellbeing (SEWB), infant sleep, home learning environment or parent mental health, (ii) a comparison group was used, (iii) universal or targeted intervention were delivered in non-tertiary settings, (iv) interventions did not last more than 4 sessions, and (v) children were aged between 2 weeks postpartum and 5 years at baseline. RESULTS: Seventeen studies met the eligibility criteria. Of these, three interventions could possibly be implemented at scale within UCHS platforms: (1) a universal child behavioural intervention which did not affect its primary outcome of infant sleep but improved parental mental health, (2) a universal screening programme which improved maternal mental health, and (3) a targeted child behavioural intervention which improved parent-reported infant sleep problems and parental mental health. Key lessons learnt include: (1) Interventions should impart the maximal amount of information within an initial session with future sessions reinforcing key messages, (2) Interventions should see the family as a holistic unit by considering the needs of parents with an emphasis on identification, triage and referral, and (3) Brief interventions may be more acceptable for stigmatized topics, but still entail considerable barriers that deter the most vulnerable. CONCLUSIONS: Delivery and evaluation of brief evidence-based interventions from a UCHS could lead to improved maternal and child health outcomes through a more responsive and equitable service. We recommend three interventions that meet our criteria of "best bet" interventions.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Servicios de Salud del Niño/estadística & datos numéricos , Medicina Basada en la Evidencia/organización & administración , Medicina Basada en la Evidencia/estadística & datos numéricos , Cobertura Universal del Seguro de Salud/organización & administración , Cobertura Universal del Seguro de Salud/estadística & datos numéricos , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino
18.
BMC Health Serv Res ; 20(1): 561, 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32560690

RESUMEN

BACKGROUND: Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been many studies on child health in Nepal however, rarely explored the status and factors associated with the child health service provided by these volunteers. This study aimed to identify the factors associated with the child health service delivery by FCHVs. METHODS: A national survey was conducted in 2014 in Nepal that included 4302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. Factors associated with the use of child health services was examined using Chi-square test (χ2) followed by logistic regression. RESULTS: Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers' group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technology-wise, FCHVs who were using mobile were more likely to provide child health services. CONCLUSIONS: FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs; availability of key commodities, involvement of FCHVs in regular health mothers' group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Agentes Comunitarios de Salud/estadística & datos numéricos , Voluntarios/estadística & datos numéricos , Adulto , Niño , Femenino , Encuestas de Atención de la Salud , Humanos , Persona de Mediana Edad , Nepal
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