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A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build. 关于 COVID-19 大流行期间围产期心理健康的共识声明以及关于大流行后恢复和重建的建议。
Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI: 10.3389/fgwh.2024.1347388
Leanne Jackson, Mari Greenfield, Elana Payne, Karen Burgess, Munira Oza, Claire Storey, Siân M Davies, Kaat De Backer, Flora E Kent-Nye, Sabrina Pilav, Semra Worrall, Laura Bridle, Nina Khazaezadeh, Daghni Rajasingam, Lauren E Carson, Leonardo De Pascalis, Victoria Fallon, Julie M Hartley, Elsa Montgomery, Mary Newburn, Claire A Wilson, Joanne A Harrold, Louise M Howard, Jane Sandall, Laura A Magee, Kayleigh S Sheen, Sergio A Silverio

Introduction: The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered.

Methods: A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy.

Results: The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice.

Discussion: The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision.

导言:COVID-19 大流行造成了生命周期的严重断裂,不仅对那些身体易受病毒感染的人造成了影响,而且对那些精神疾病患者也造成了影响。怀孕、经历围产期丧亲之痛或处于产后第一年(即围产期)的妇女和分娩者面临着许多精神疾病的风险因素,包括围产期护理方式的改变:通过跨学科的专家合作,综合了 COVID-19 大流行期间围产期精神健康合作工作的证据,并确定了研究、医疗实践和政策建议的优先事项,从而形成了一份共识声明:结果:对 COVID-19 大流行对围产期健康结果和护理实践的影响的研究综述提出了三项直接建议:围产期心理保健服务中应保留的内容、应恢复的内容和应取消的内容。此外,还提出了以下长期行动建议:公平和关系医疗;心理和生理医疗中的平等,重点是围产期专业服务;围产期心理健康研究、 政策和实践的地平线扫描:大流行病对围产期心理健康影响的证据基础正在不断扩大。本共识声明综合了上述证据,并就大流行后围产期心理健康服务和护理的恢复与重建提出了建议。
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引用次数: 0
Receipt of core antenatal care components and associated factors in Ethiopia: a multilevel analysis. 埃塞俄比亚产前护理核心内容的接受情况及相关因素:多层次分析。
Pub Date : 2024-02-21 eCollection Date: 2024-01-01 DOI: 10.3389/fgwh.2024.1169347
Anagaw Derseh Mebratie

Background: Despite recent promising progress, maternal morbidity and mortality are still unacceptably high in Ethiopia. This is partly attributed to the lack of quality health services. Pregnant women may not receive adequate services that are essential to protect the health of women and their unborn children. This study aimed to examine the extent of receiving prenatal care components and associated factors in Ethiopia. It also assessed prenatal service use inequality between urban and rural residents.

Methods: The analysis was carried out using the 2016 Ethiopian Demographic and Health Survey (EDHS), which is nationally representative survey data. A weighted sample of 4,772 women nested within 595 communities who had live births five years preceding the survey was included in the study. Necessary adjustments were made to account for the design of the survey, and sampling weights were used to adjust for nonproportional allocation of the sample to strata. Bivariate and multivariable multilevel ordered logit models were used to analyze factors associated with receiving comprehensive ANC contents. Statistically significant predictors were identified at p value ≤ 0.05.

Results: Among those women who had at least one ANC visit, only 15% (95% CI: 13, 16) received six core elements of antenatal care. The proportion of mothers who had essential prenatal components in rural areas was less than 13 percentage points. Approximately 43% of women did not receive at least two doses of tetanus toxoid vaccines to protect them and newborn infants against this life-threatening disease. Moreover, the majority of them, particularly those in rural Ethiopia, were not informed about pregnancy danger signs. Mothers who had at least four ANC visits received more types of prenatal components compared to those who had fewer ANC visits. The multilevel regression analysis revealed that receiving adequate ANC content is positively associated with having more frequent ANC visits, attaining a higher education level, being a member of a household in the highest wealth quintile and residing in urban areas.

Conclusion: The evidence implies that the quality of maternal health services needs to be improved. Health programs and interventions should also give priority to rural areas where the majority of Ethiopian women reside.

背景:尽管最近取得了可喜的进展,但埃塞俄比亚的孕产妇发病率和死亡率仍然高得令人无法接受。部分原因在于缺乏优质的医疗服务。孕妇可能无法获得足够的服务,而这些服务对保护妇女及其胎儿的健康至关重要。本研究旨在探讨埃塞俄比亚孕妇接受产前护理的程度及相关因素。研究还评估了城市居民和农村居民在使用产前服务方面的不平等:分析采用了具有全国代表性的 2016 年埃塞俄比亚人口与健康调查(EDHS)数据。本研究的加权样本包括 595 个社区中的 4772 名妇女,这些妇女在调查前 5 年有过活产。根据调查的设计进行了必要的调整,并使用抽样权重对样本在分层中的非比例分配进行了调整。采用二元和多变量多层次有序对数模型来分析与接受全面产前保健内容相关的因素。在 p 值小于 0.05 时,可确定具有统计学意义的预测因素:在至少接受过一次产前检查的妇女中,只有 15%(95% CI:13,16)的妇女接受了产前检查的六项核心内容。在农村地区,接受过基本产前检查的产妇比例不到 13 个百分点。约 43% 的妇女没有接种至少两剂破伤风类毒素疫苗,以保护她们和新生儿免受这种威胁生命的疾病的侵袭。此外,大多数妇女,尤其是埃塞俄比亚农村妇女,并不了解怀孕危险征兆。与产前检查次数较少的母亲相比,接受过至少四次产前检查的母亲接受了更多类型的产前检查。多层次回归分析表明,接受足够的产前检查内容与产前检查次数较多、教育程度较高、属于最高财富五分位数的家庭成员以及居住在城市地区呈正相关:这些证据表明,孕产妇保健服务的质量有待提高。保健计划和干预措施也应优先考虑埃塞俄比亚大多数妇女居住的农村地区。
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引用次数: 0
Risk factors associated with anaemia among pregnant women in the Adaklu District, Ghana 加纳阿达克鲁地区孕妇贫血的相关风险因素
Pub Date : 2024-02-15 DOI: 10.3389/fgwh.2023.1140867
Eric Tettegah, Thomas Hormenu, Nancy Innocentia Ebu-Enyan
Anaemia during pregnancy is a major public health concern in both advanced and less-developed countries including Ghana. The prevalence of anaemia in Ghana has a serious repercussion on the country's social and economic development. This prevalence has been linked to various factors, including educational level and occupational status.A prospective study was conducted to investigate the factors influencing anaemia among 150 pregnant women, aged 15–49 years, who attended antenatal clinics in the Adaklu District of the Volta region of Ghana. Haemoglobin levels were assessed in the first, second, and third trimesters, and a questionnaire was also used to collect data on demographic information and barriers to maintaining haemoglobin levels. The data were analysed using frequencies, percentages, and binary logistic regression.The prevalence of pregnancy anaemia in the district was 78.5%. The study found that 92% and 8% of pregnant women had excellent and good knowledge on anaemia in pregnancy, respectively. The study also identified several barriers to maintaining an appropriate haemoglobin level during pregnancy, such as long distances to healthcare facilities, non-intake of antimalarial drugs, and lack of nutritious meals. Finally, the study found that low education level, number of pregnancies, and number of children a woman had were significant determinants of anaemia during pregnancy in the district.The findings of the study suggest that targeted interventions are needed to reduce the burden of anaemia during pregnancy in the district. These interventions should address the social and environmental determinants of anaemia during pregnancy, such as improving access to healthcare facilities and promoting healthy eating habits. In addition, interventions that address social determinants of health, such as education and occupation, may be effective in reducing the burden of anaemia during pregnancy in the district.
在包括加纳在内的发达国家和欠发达国家,孕期贫血都是一个重大的公共卫生问题。加纳贫血症的流行严重影响了该国的社会和经济发展。这项前瞻性研究调查了加纳沃尔特地区 Adaklu 区 150 名 15-49 岁孕妇产前检查中贫血的影响因素。在第一、第二和第三孕期对孕妇的血红蛋白水平进行了评估,并通过问卷调查收集了有关人口信息和维持血红蛋白水平的障碍的数据。采用频率、百分比和二元逻辑回归法对数据进行了分析。研究发现,分别有 92% 和 8% 的孕妇对妊娠贫血有非常好和良好的认识。研究还发现了孕期保持适当血红蛋白水平的几个障碍,如距离医疗机构较远、不服用抗疟疾药物和缺乏营养膳食。研究结果表明,需要采取有针对性的干预措施来减轻该地区孕期贫血的负担。这些干预措施应解决孕期贫血的社会和环境决定因素,如改善医疗保健设施的可及性和促进健康的饮食习惯。此外,针对健康的社会决定因素(如教育和职业)的干预措施可能会有效减轻该地区孕期贫血的负担。
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引用次数: 0
Risk factors associated with anaemia among pregnant women in the Adaklu District, Ghana 加纳阿达克鲁地区孕妇贫血的相关风险因素
Pub Date : 2024-02-15 DOI: 10.3389/fgwh.2023.1140867
Eric Tettegah, Thomas Hormenu, Nancy Innocentia Ebu-Enyan
Anaemia during pregnancy is a major public health concern in both advanced and less-developed countries including Ghana. The prevalence of anaemia in Ghana has a serious repercussion on the country's social and economic development. This prevalence has been linked to various factors, including educational level and occupational status.A prospective study was conducted to investigate the factors influencing anaemia among 150 pregnant women, aged 15–49 years, who attended antenatal clinics in the Adaklu District of the Volta region of Ghana. Haemoglobin levels were assessed in the first, second, and third trimesters, and a questionnaire was also used to collect data on demographic information and barriers to maintaining haemoglobin levels. The data were analysed using frequencies, percentages, and binary logistic regression.The prevalence of pregnancy anaemia in the district was 78.5%. The study found that 92% and 8% of pregnant women had excellent and good knowledge on anaemia in pregnancy, respectively. The study also identified several barriers to maintaining an appropriate haemoglobin level during pregnancy, such as long distances to healthcare facilities, non-intake of antimalarial drugs, and lack of nutritious meals. Finally, the study found that low education level, number of pregnancies, and number of children a woman had were significant determinants of anaemia during pregnancy in the district.The findings of the study suggest that targeted interventions are needed to reduce the burden of anaemia during pregnancy in the district. These interventions should address the social and environmental determinants of anaemia during pregnancy, such as improving access to healthcare facilities and promoting healthy eating habits. In addition, interventions that address social determinants of health, such as education and occupation, may be effective in reducing the burden of anaemia during pregnancy in the district.
在包括加纳在内的发达国家和欠发达国家,孕期贫血都是一个重大的公共卫生问题。加纳贫血症的流行严重影响了该国的社会和经济发展。这项前瞻性研究调查了加纳沃尔特地区 Adaklu 区 150 名 15-49 岁孕妇产前检查中贫血的影响因素。在第一、第二和第三孕期对孕妇的血红蛋白水平进行了评估,并通过问卷调查收集了有关人口信息和维持血红蛋白水平的障碍的数据。使用频率、百分比和二元逻辑回归对数据进行了分析。研究发现,分别有 92% 和 8% 的孕妇对妊娠期贫血有很好和良好的认识。研究还发现了孕期保持适当血红蛋白水平的几个障碍,如距离医疗机构较远、不服用抗疟疾药物和缺乏营养膳食。研究结果表明,需要采取有针对性的干预措施来减轻该地区孕期贫血的负担。这些干预措施应解决孕期贫血的社会和环境决定因素,如改善医疗保健设施的可及性和促进健康的饮食习惯。此外,针对健康的社会决定因素(如教育和职业)的干预措施可能会有效减轻该地区孕期贫血的负担。
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引用次数: 0
Food security status and cardiometabolic health among pregnant women in the United States 美国孕妇的食品安全状况与心脏代谢健康
Pub Date : 2024-02-13 DOI: 10.3389/fgwh.2023.1286142
Jamie A. Murkey, Symielle A. Gaston, Christopher W. Payne, W. B. Jackson, Chandra L. Jackson
Pregnant women and their offspring are particularly vulnerable to food insecurity and its adverse effects during critical periods of fetal development. Racially/ethnically minoritized women in the United States (US) who are pregnant are additionally burdened by food insecurity, which may exacerbate cardiovascular health (CVH) disparities. Despite heightened social vulnerability, few studies have employed an intersectional framework, including race and gender, to assess the food insecurity and CVH relationship.We used 2012–2018 and 2020 National Health Interview Survey data among US pregnant women aged 18–49 years old (N = 1,999) to assess the prevalence of food insecurity status by race/ethnicity and to investigate household food security status in relation to ideal CVH, using a modified ideal CVH (mICVH) metric. We categorized food security status as “very low/low”, “marginal”, or “high”. To assess mICVH, a summary score of 7 clinical characteristics and health behaviors was dichotomized as yes [(7)] vs. no [<7]. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of associations between food security status and mICVH were estimated using Poisson regression with robust variance. Models were adjusted for age, household income, educational attainment, geographic region, marital status, alcohol consumption, survey year, and race/ethnicity (in overall model).The mean age ± standard error was 29.0 ± 0.2 years. Among pregnant women, 12.7% reported “very low/low”, 10.6% reported “marginal”, and 76.7% reported “high” food security. “Very low/low” food security prevalence was higher among NH-Black (16.2%) and Hispanic/Latina (15.2%) pregnant women compared to NH-White (10.3%) and NH-Asian (3.2%) pregnant women. The mICVH prevalence was 11.6% overall and 14.5% for NH-White, 4.1% for NH-Black, 5.0% for Hispanic/Latina, and 26.7% for NH-Asian pregnant women. Among all pregnant women, “very low/low” and “marginal” vs. “high” food security status was associated with a lower prevalence of mICVH {[PRvery low/low = 0.26 (95% CI: 0.08–0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 −0.96)]}.Household food insecurity was higher among pregnant women in minoritized racial/ethnic groups and was associated with lower mICVH prevalence. Given the higher burden of food insecurity among minoritized racial/ethnic groups, food security may be an important intervention target to help address disparities in poor CVH among pregnant women.
在胎儿发育的关键时期,孕妇及其后代特别容易受到粮食不安全及其不利影响的影响。在美国,种族/人种上属于少数群体的怀孕妇女还要承受粮食不安全带来的额外负担,这可能会加剧心血管健康(CVH)方面的差异。我们利用 2012-2018 年和 2020 年美国全国健康访谈调查的数据,对年龄在 18-49 岁之间的美国孕妇(N = 1,999 人)进行了调查,评估了不同种族/族裔的食品不安全状况,并使用修正的理想心血管健康状况(mICVH)指标,调查了家庭食品安全状况与理想心血管健康状况的关系。我们将粮食安全状况分为 "极低/低"、"边缘 "或 "高"。为评估 mICVH,我们对 7 项临床特征和健康行为进行了综合评分,并将其分为 "是"[(7)] 与 "否"[<7]。采用带稳健方差的泊松回归估算了食品安全状况与 mICVH 之间的患病率比 (PR) 和 95% 置信区间 (CI)。根据年龄、家庭收入、教育程度、地理区域、婚姻状况、饮酒量、调查年份和种族/人种(在总体模型中)对模型进行了调整。在孕妇中,12.7%的人报告粮食安全 "非常低/低",10.6%的人报告粮食安全 "边缘",76.7%的人报告粮食安全 "高"。与新罕布什尔州白人孕妇(10.3%)和新罕布什尔州亚裔孕妇(3.2%)相比,新罕布什尔州黑人孕妇(16.2%)和西班牙裔/拉丁裔孕妇(15.2%)的 "极低/低 "食品安全发生率更高。总的 mICVH 患病率为 11.6%,北 荷 兰 白 人 为 14.5%,北 荷 兰 黑 人 为 4.1%,西班牙裔/拉丁裔为 5.0%,北 荷兰亚裔孕妇为 26.7%。在所有孕妇中,"极低/低 "和 "边缘 "与 "高 "粮食安全状况与较低的 mICVH 患病率相关 {[PRvery low/low = 0.26 (95% CI: 0.08-0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 -0.96)]}.鉴于少数种族/族裔群体的食物不安全负担较重,食物安全可能是一个重要的干预目标,有助于解决孕妇CVH不佳的差异问题。
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引用次数: 0
Food security status and cardiometabolic health among pregnant women in the United States 美国孕妇的食品安全状况与心脏代谢健康
Pub Date : 2024-02-13 DOI: 10.3389/fgwh.2023.1286142
Jamie A. Murkey, Symielle A. Gaston, Christopher W. Payne, W. B. Jackson, Chandra L. Jackson
Pregnant women and their offspring are particularly vulnerable to food insecurity and its adverse effects during critical periods of fetal development. Racially/ethnically minoritized women in the United States (US) who are pregnant are additionally burdened by food insecurity, which may exacerbate cardiovascular health (CVH) disparities. Despite heightened social vulnerability, few studies have employed an intersectional framework, including race and gender, to assess the food insecurity and CVH relationship.We used 2012–2018 and 2020 National Health Interview Survey data among US pregnant women aged 18–49 years old (N = 1,999) to assess the prevalence of food insecurity status by race/ethnicity and to investigate household food security status in relation to ideal CVH, using a modified ideal CVH (mICVH) metric. We categorized food security status as “very low/low”, “marginal”, or “high”. To assess mICVH, a summary score of 7 clinical characteristics and health behaviors was dichotomized as yes [(7)] vs. no [<7]. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of associations between food security status and mICVH were estimated using Poisson regression with robust variance. Models were adjusted for age, household income, educational attainment, geographic region, marital status, alcohol consumption, survey year, and race/ethnicity (in overall model).The mean age ± standard error was 29.0 ± 0.2 years. Among pregnant women, 12.7% reported “very low/low”, 10.6% reported “marginal”, and 76.7% reported “high” food security. “Very low/low” food security prevalence was higher among NH-Black (16.2%) and Hispanic/Latina (15.2%) pregnant women compared to NH-White (10.3%) and NH-Asian (3.2%) pregnant women. The mICVH prevalence was 11.6% overall and 14.5% for NH-White, 4.1% for NH-Black, 5.0% for Hispanic/Latina, and 26.7% for NH-Asian pregnant women. Among all pregnant women, “very low/low” and “marginal” vs. “high” food security status was associated with a lower prevalence of mICVH {[PRvery low/low = 0.26 (95% CI: 0.08–0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 −0.96)]}.Household food insecurity was higher among pregnant women in minoritized racial/ethnic groups and was associated with lower mICVH prevalence. Given the higher burden of food insecurity among minoritized racial/ethnic groups, food security may be an important intervention target to help address disparities in poor CVH among pregnant women.
在胎儿发育的关键时期,孕妇及其后代特别容易受到粮食不安全及其不利影响的影响。在美国,种族/人种上属于少数群体的怀孕妇女还要承受粮食不安全带来的额外负担,这可能会加剧心血管健康(CVH)方面的差异。我们利用 2012-2018 年和 2020 年美国全国健康访谈调查的数据,对年龄在 18-49 岁之间的美国孕妇(N = 1,999 人)进行了调查,评估了不同种族/族裔的食品不安全状况,并使用修正的理想心血管健康状况(mICVH)指标,调查了家庭食品安全状况与理想心血管健康状况的关系。我们将粮食安全状况分为 "极低/低"、"边缘 "或 "高"。为评估 mICVH,我们对 7 项临床特征和健康行为进行了综合评分,并将其分为 "是"[(7)] 与 "否"[<7]。采用带稳健方差的泊松回归估算了食品安全状况与 mICVH 之间的患病率比 (PR) 和 95% 置信区间 (CI)。根据年龄、家庭收入、教育程度、地理区域、婚姻状况、饮酒量、调查年份和种族/人种(在总体模型中)对模型进行了调整。在孕妇中,12.7%的人报告粮食安全 "非常低/低",10.6%的人报告粮食安全 "边缘",76.7%的人报告粮食安全 "高"。与新罕布什尔州白人孕妇(10.3%)和新罕布什尔州亚裔孕妇(3.2%)相比,新罕布什尔州黑人孕妇(16.2%)和西班牙裔/拉丁裔孕妇(15.2%)的 "极低/低 "食品安全发生率更高。总的 mICVH 患病率为 11.6%,北 荷 兰 白 人 为 14.5%,北 荷 兰 黑 人 为 4.1%,西班牙裔/拉丁裔为 5.0%,北 荷兰亚裔孕妇为 26.7%。在所有孕妇中,"极低/低 "和 "边缘 "与 "高 "粮食安全状况与较低的 mICVH 患病率相关 {[PRvery low/low = 0.26 (95% CI: 0.08-0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 -0.96)]}.鉴于少数种族/族裔群体的食物不安全负担较重,食物安全可能是一个重要的干预目标,有助于解决孕妇CVH不佳的差异问题。
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引用次数: 0
Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa 南非波洛克瓦内母亲纯母乳喂养的障碍和促进因素
Pub Date : 2024-02-13 DOI: 10.3389/fgwh.2024.1209784
M. Makwela, R. G. Mashaba, C. Ntimana, K. P. Seakamela, Eric Maimela
Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa.A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively.Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%).Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
强烈建议纯母乳喂养(EBF)6 个月,之后添加适当的辅食,母乳喂养持续到 2 岁及以后。这每年可挽救全球多达 140 万儿童的生命。尽管如此,南非的母乳喂养率仍未达到最佳水平,未能实现世界卫生大会(WHA)建议的 50%的目标。本研究旨在调查影响南非林波波省波洛克瓦内市母亲实行纯母乳喂养的原因。研究采用经过验证的结构化问卷对 146 名母亲进行了横断面定量和描述性调查。使用 STATA 对数据进行了分析。虽然 94% 的母亲开始了母乳喂养,但在收集数据时,8% 的母亲停止了母乳喂养。在停止母乳喂养的母亲中,有 5%是在开始母乳喂养后一个月内停止的。39%的母亲采用纯母乳喂养,61%的母亲采用混合喂养。纯母乳喂养的做法与母亲的年龄呈正相关,年龄较大的母亲更倾向于母乳喂养。母亲停止母乳喂养的原因是:母亲生病(45%)或重返学校或工作岗位(27%)。不进行母乳喂养的原因有:身体状况、奶水不足、婴儿拒绝母乳喂养(33%)。母亲们认为,艾滋病毒呈阳性的妇女应该用母乳喂养婴儿(57%),卫生工作者是母亲们获得艾滋病毒信息的主要来源(77%)。婴儿配方奶粉和固体食物的引入较早,通常是在母乳喂养的第一个月内。这项研究揭示了影响早期开始母乳喂养的因素以及波洛克瓦内的纯母乳喂养实践。
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引用次数: 0
Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa 南非波洛克瓦内母亲纯母乳喂养的障碍和促进因素
Pub Date : 2024-02-13 DOI: 10.3389/fgwh.2024.1209784
M. Makwela, R. G. Mashaba, C. Ntimana, K. P. Seakamela, Eric Maimela
Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa.A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively.Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%).Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
强烈建议纯母乳喂养(EBF)6 个月,之后添加适当的辅食,母乳喂养持续到 2 岁及以后。这每年可挽救全球多达 140 万儿童的生命。尽管如此,南非的母乳喂养率仍未达到最佳水平,未能实现世界卫生大会(WHA)建议的 50%的目标。本研究旨在调查影响南非林波波省波洛克瓦内市母亲实行纯母乳喂养的原因。研究采用经过验证的结构化问卷对 146 名母亲进行了横断面定量和描述性调查。使用 STATA 对数据进行了分析。虽然 94% 的母亲开始了母乳喂养,但在收集数据时,8% 的母亲停止了母乳喂养。在停止母乳喂养的母亲中,有 5%是在开始母乳喂养后一个月内停止的。39%的母亲采用纯母乳喂养,61%的母亲采用混合喂养。纯母乳喂养的做法与母亲的年龄呈正相关,年龄较大的母亲更倾向于母乳喂养。母亲停止母乳喂养的原因是:母亲生病(45%)或重返学校或工作岗位(27%)。不进行母乳喂养的原因有:身体状况、奶水不足、婴儿拒绝母乳喂养(33%)。母亲们认为,艾滋病毒呈阳性的妇女应该用母乳喂养婴儿(57%),卫生工作者是母亲们获得艾滋病毒信息的主要来源(77%)。婴儿配方奶粉和固体食物的引入较早,通常是在母乳喂养的第一个月内。这项研究揭示了影响早期开始母乳喂养的因素以及波洛克瓦内的纯母乳喂养实践。
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引用次数: 0
Hope amidst crisis: exploring perinatal mental health and family dynamics in out-of-home care through virtual assessments during the UK COVID-19 response 危机中的希望:在英国 COVID-19 应对行动中通过虚拟评估探索家庭外护理中的围产期心理健康和家庭动态
Pub Date : 2024-02-12 DOI: 10.3389/fgwh.2024.1343944
Udita Iyengar, Jessica Heller-Bhatt
Caring for a young child exposed to early trauma, along with caregiving stress and heightened by the impact of lockdowns as a result of the COVID-19 response, may compromise the development of the parent-child relationship. Understanding a foster carer's attachment history and considering relational dynamics through an attachment lens may shed light on areas they need support in, to enhance their parenting capacity for vulnerable children. The feasibility of collecting and coding observational data and attachment interviews of foster carers and their children, when conducted remotely during COVID-19, needs to be explored. This perspective piece considers the impact on infant and perinatal health in the context of COVID-19 with particular emphasis on relational dynamics and attachment assessments, using a case study of a foster carer and her child in an out-of-home-care placement. Understanding these dynamics is crucial for safeguarding the well-being of both caregivers and vulnerable children during this challenging time.
由于 COVID-19 应对措施造成的封锁影响,照顾受到早期创伤的幼儿,再加上照顾压力,可能会损害亲子关系的发展。了解寄养照护者的依恋史并从依恋的角度考虑亲子关系的动态发展,可以帮助他们了解自己在哪些方面需要支持,从而提高他们养育弱势儿童的能力。在 COVID-19 期间对寄养者及其子女进行远程观察数据和依恋访谈时,收集和编码的可行性有待探讨。本视角文章以一名寄养照料者和她在家庭外照料安置的孩子为案例,探讨了 COVID-19 对婴儿和围产期健康的影响,并特别强调了关系动态和依恋评估。在这一充满挑战的时期,了解这些动态变化对于保护照顾者和弱势儿童的福祉至关重要。
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引用次数: 0
Understanding gender inequity in brain health outcomes: missed stroke as a case study for intersectionality 了解大脑健康结果中的性别不平等:将漏诊中风作为交叉性案例研究
Pub Date : 2024-02-12 DOI: 10.3389/fgwh.2024.1350294
S. Berkhout, Syeda Hashmi, Aleksandra Pikula
Recent attention into sex and gender-based inequities surrounding outcomes for brain health disorders has generated momentum toward addressing what has been called the “brain health gap.” Importantly though, “women” are not uniform demographic group. In this perspective piece, we discuss misdiagnosis in stroke as an aspect of access and quality of care within brain health. Drawing on narrative data from a mixed methods study of young stroke survivors we suggest that while missed stroke isn't only an issue of gender, if we are going to understand gender-based gaps in access and navigation through stroke care, we have to understand how intersections of gender with age, ethnoracial identity, nationality, language, (dis)ability, and other aspects of social identity come together to create affordances as well as biases that contribute to stroke outcomes.
最近,人们开始关注在脑健康疾病的治疗结果方面存在的基于性别的不平等现象,这为解决所谓的 "脑健康差距 "问题提供了动力。但重要的是,"女性 "并不是一个统一的人口群体。在这篇视角文章中,我们将讨论脑卒中误诊作为脑健康医疗服务获取和质量的一个方面。通过对年轻中风幸存者的混合方法研究中的叙事数据,我们认为,虽然中风漏诊不仅仅是性别问题,但如果我们要了解在中风治疗的获取和导航方面基于性别的差距,我们就必须了解性别与年龄、种族身份、国籍、语言、(不)能力以及社会身份的其他方面是如何交织在一起,从而产生了导致中风结果的能力和偏见。
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引用次数: 0
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Frontiers in global women's health
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