Maternal and child health

The United States has achieved dramatic improvements in overall maternal and child health status, yet faces disturbingly wide variations in the health status of many population subgroups. The Surgeon General in 1980 published specific quantitative objectives to stimulate further improvements in the health of the American people by 1990. A critical step in meeting relevant objectives is the more effective use at national, state, and local levels of available data, particularly infant, perinatal, neonatal, and maternal mortality rates and the incidence of low weight births. This paper reviews variations in infant mortality rates and five current federal categorical programs that aim to improve maternal and child health: Supplemental Feeding Program for Women, Infants and Children; Head Start; Maternal and Child Health; Family Planning; and Community Health Centers. Several examples are cited of effective use of data in the coordination and targeting of resources from these large public programs. Recommendations are made for enhancement of federal maternal and child health programs within current funding levels. These recommendations will be all the more relevant if the Congress enacts block grants to the states with lower total funding.Dr. Omenn is Professor of Medicine (Medical Genetics), and of Environmental Health, University of Washington, Seattle, Washington 98195. He was formerly Program Associate Director for Human Resources, Office of Management and Budget, Executive Office of the President, Washington, D.C. and Visiting Senior Fellow, Woodrow Wilson School for Public and International Affairs, Princeton University.The author is indebted to Barbara S. Selfridge and John O. Ostenso for expert technical assistance, program analyses, and many helpful comments. This paper was presented in part at the opening session of the Surgeon General's Workshop on Maternal and Infant Health, Reston, Virginia, December 1980, under the title, A Domestic View: Federal Maternal and Infant Health Services Programs.     

Maternal and child health and health care reform.

Women and children, because of particular characteristics and vulnerabilities, should be afforded special attention in health care reform. Health care reform provides an opportunity to positively affect the maternal and child health (MCH) status. Universal coverage of a comprehensive benefit package must be combined with a strong public health system of population-based services if benefits are to be realized. There must be an accountable public locus of responsibility for promoting MCH, including clear authority and resources for four primary activities: (1) core public health, (2) systems development, (3) coordinated services for children with special health care needs, and (4) access to care.     

Maternal social capital and child health in Vietnam

STUDY OBJECTIVE: To explore the association between maternal social capital and child physical and mental health in Vietnam. DESIGN: Cross sectional survey. Measures of maternal structural social capital comprised group membership, citizenship, and social support. Measures of cognitive social capital comprised trust, social harmony, sense of fairness, and belonging. Child health was measured by anthropometrics and mothers' reports of acute and chronic physical health problems and child mental health. PARTICIPANTS: 2907 mothers and their 1 year old or 8 year old children from five provinces in Vietnam. MAIN RESULTS: The study found low levels of group membership and citizenship and high levels of cognitive social capital and support, and generally higher levels of social capital among the mothers of 8 year old compared with 1 year old children. All but one association was in the hypothesised direction (that is, higher levels of social capital associated with reduced risk of child health problems). There were more statistically significant relations between maternal social capital and the health of 1 year olds compared with 8 year old children, and between measures of social support and cognitive social capital and child health, than with group membership and involvement in citizenship activities. CONCLUSION: This study is the first to explore the association between multiple dimensions of social capital and a range of different child health outcomes in the developing world. These results now need to be tested using longitudinal data.     

Maternal mode of living and child health

In this article, maternal mode of living is investigated, examining both socioeconomic conditions and lifestyle factors, in order to identify to what extent health policies are tangibly meeting the needs of low income Brazilian mothers and children. Data are derived from unstructured interviews with 17 mothers with children under age 6, residing in the Federal District, Brazil. Their stories reveal a life marked by economic difficulties and inadequate living conditions, aggravated by early reproductive behavior, confinement to the home and no leisure. Although they have access to primary health care, the quality is inadequate. Increased awareness to the mother's situation is necessary in order to improve the health of young children.     

青海省玉树地区鼠疫病原监测分析

1963年玉树地区首次从鼠疫患者尸体中检出鼠疫菌，同期开展的鼠疫自然疫源地调查结果支持该地区被判定为喜马拉雅旱獭鼠疫自然疫源地。喜马拉雅旱獭鼠疫每年4-lO月均有流行；藏系绵羊自然感染鼠疫导致的人间疫情从10月至翌年1月。     

Maternal and child health services in India -- past,present and future

This editorial commentary focuses on a review of past, present, and future maternal and child health (MCH) services in India. MCH was first initiated in the early 1900s, when maternity services were improved and rural midwives and birth attendants received training. MCH was voluntary work coordinated by the Maternal and Child Welfare Bureau under the Indian Red Cross Society. Madras state was the first to establish a separate Maternal Welfare section in the Office of Director of Health Services in 1931. In 1946, the Bhore Committee recommended the integration of MCH within General Health Services, but implementation occurred after 1955. Before 1953, MCH was unevenly distributed and delivered through maternity homes and midwives. WHO and UNICEF support contributed to the expansion of MCH services. The Mudaliar Committee in 1962 recommended, for instance, the expansion of MCH centers to include 1 ANM per 10,000 population. The Child Care Committee in 1960 prepared the first report on preschool child care and proposed several models of comprehensive child welfare services. In 1968, the Committee on Child Welfare Programs associated successful family planning (FP) with good MCH services. The 5-year plan for 1969-74 was the first to integrate FP with MCH. 1974 was a pivotal year. India established a National Policy for Children and a Children's Board. The 1983 National Health Policy identified 9 out of 17 goals as child-related. India today has an extensive set of MCH/FP services. Future child survival will depend upon increased immunization coverage. Future efforts should focus on establishing the community as the focus of updated and well-equipped services. Community volunteers will need to spread awareness and knowledge of FP and MCH. Programs must reduce poverty, expand schooling, empower women and girls, and treat domestic violence as a health issue. AIDS is another future challenge.     

Maternal depression, changing public assistance, food security, and child health status

Maternal depression, changing public assistance, food security, and child health status . Casey , P. , Goolsby , S. , Berkowitz , S. , Frank , D. , Cook , J. , Cutts , D. , Black , M.M. , Zaldivar , N. , Levenson , S. , Heeren , T. & Meyers , A. ( 2004 ) Pediatrics 113 , 298 – 304 .     

Maternal and child health nutrition training builds leadership skills

For more than 30 years, the Maternal and Child Health Bureau (MCHB) has funded specialized professional training in nutrition with an emphasis on the development of leadership skills. A survey was conducted of individuals who received Maternal and Child Health nutrition training at the Center for Human Development and Disability (CHDD) at the University of Washington. Those surveyed were asked to reflect on the impact of the training on their career pathway and to report on their leadership activities. Of the 91 respondents, 83 (92%) indicated that the training supported a career pathway that emphasized maternal and child health or children with special healthcare needs. Eighty-five former trainees (93% of respondents) reported leadership activities at the local level, 61 (67%) reported leadership activities at the state level, and 46 (51%) reported leadership activities at the national level. The results of the survey indicate that specialized, intensive training in the field of nutrition develops and supports leadership skills.     

湖南省妇幼保健机构产后抑郁症防治现状及需求研究

目的通过对全省妇幼保健机构的抽样调查,了解产后抑郁症的防治能力和需求状况,为下一步有针对性地指产后抑郁症防治的开展,制定适合三级妇幼保健网络的孕产期心理保健方案奠定基础。方法采取多阶层随机整体取样的方法抽取湖南省16家妇幼保健机构和179位医务人员。结果在16所调查的妇幼保健机构中,开展了产后抑郁症筛查的机构7所,占43.8%,开展了心理咨询门诊的4所,占25.0%,配备了心理疏导、心理治疗设施设备的2所,占12.5%。179名被调查的医务人员中,有68.7%的认为所在机构对产后抑郁症的防治不能满足孕产妇的需求。结论全省妇幼保健机构对产后抑郁症的识别和干预机制不健全,网络覆盖不全面,医务人员的服务能力不强,下一步应逐步完善防治网络和强化能力建设。     

Maternal and child health care in Ecuador: Obstacles and solutions

This report analyzes the obstacles to improving maternal and child health care in Ecuador and examines the steps that have been followed to alleviate these problems. The principal factors hindering maternal‐child health program effectiveness are the lack of a grassroots program and insufficient organization development. Several recommendations are made for alleviating these problems in Ecuador's health system, most notably reorganization strategies that support local initiative. This analysis has value for developed and developing countries interested in improving the delivery of maternal‐child health services.     

Maternal and child health in the 1950s and 1960s

The author reflects upon her work in Bangladesh, Vietnam, and Cambodia in the early years of the World Health Organization's (WHO) existence, inventing and building the modes in which the organization was to put its mandate into practice. The author was in Bangladesh in 1953-58, in Vietnam in 1958-61, and in Cambodia in 1961-66. In Bangladesh, then East Pakistan, the men cut sugar cane or planted rice seedlings, while the women stayed closer to home, fetching water, tending vegetable gardens, and caring for their many children. The women were often worn out from frequent pregnancies and childbirth. WHO's Maternal and Child Health Project met a need and eventually became an ongoing, integrated national program in the country. The project in Vietnam was similar to the one in Bangladesh, but broader in scope. With maternal and child health were included pediatrics, hospital obstetric care, regional programs to develop community maternal and child health services, and the education and training of midwives, assistant midwives, and pediatric nurses to staff a large, new hospital. In Cambodia, WHO-assisted projects sometimes worked closely together, although the sad subsequent history of Cambodia likely eroded most of the activities in which the author was involved.     

2003-2013年河南省孕产妇保健情况综合分析

摘要:目的　对河南省近10年孕产妇保健数据纵向分析,找出优劣年份,评价孕产妇保健工作。方法　采用TOPSIS法对高危产妇比重、建卡率、系统管理率、产前检查率、产后访视率、住院分娩率、新法接生率、孕产妇死亡率（1/10万）等八项指标进行综合分析。结果　2013年孕产妇保健工作质量最优,2004年孕产妇保健情况最差。2003-2013年河南省孕产妇保健工作总体上逐步改善,尤其是近3年的保健状况更是直线上升。结论　孕产妇保健工作受多种因素影响,加强政府的领导,制定相关政策能够有效规范孕产妇保健工作。