Maternal and child health journal
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With its independence secured on 9th July 2011, the Republic of South Sudan faces a daunting task to improve public health and primary care in one of the poorest countries in the world. Very high maternal and child mortality rates must be a major concern for the new national government and for the many international agencies working in the country. Poor maternal health outcomes are primarily due to poor prenatal, delivery and post natal care services in health facilities, coupled with low literacy, widespread poverty, and poor nutrition among the general population. ⋯ This paper explores barriers and identifies opportunities available to work toward achieving the targets for Millennium Development Goals (MDGs) 5 and 4 to reduce maternal mortality from its current rate of 2,054 deaths per 100,000 live births, and child mortality (currently 135 deaths per 1,000 live births) respectively in the new nation. National and international organizations have a social responsibility to mobilize efforts to focus on maternal, child health and nutrition issues targeting the worst affected regions for improving access to primary care and obstetrical services. Initiatives are needed to build up community access to primary care with a well supervised community health workers program, as well as training mid level management capacity with higher levels of funding from national and international sources to promote public health than current in the new republic.
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Matern Child Health J · Jul 2012
A qualitative analysis of vaccine safety perceptions and concerns among caretakers in Uganda.
Parents and caretakers of young children often have concerns about vaccine safety and adverse events following immunization (AEFI). Little is known about vaccine safety perceptions in Uganda and their influence on parental decision-making about infant immunization. The study objectives were: to identify community sources of information on immunization, vaccine safety and AEFI; determine caretakers' knowledge of immunization; identify community concerns/fears about immunization and AEFI and their influence on caretakers' decisions to vaccinate; and obtain an understanding of knowledge, perceptions, and experience of health care workers (HCWs) and policy administrators on vaccine safety and AEFI. ⋯ Inadequate communication between HCWs and caretakers was noted. Concerns and misconceptions about vaccination still exist among caretakers in Uganda and influence decisions to vaccinate. Effective inter personal communication initiated by HCWs towards caretakers is needed.
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Matern Child Health J · Jul 2012
Unmet need and problems accessing core health care services for children with autism spectrum disorder.
To investigate the health care experiences of children with autism spectrum disorder, whether they have unmet needs, and if so, what types, and problems they encounter accessing needed care. We address these issues by identifying four core health care services and access problems related to provider and system characteristics. Using data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) we compared children with autism spectrum disorder with children with special health care needs with other emotional, developmental or behavioral problems (excluding autism spectrum disorder) and with other children with special health care needs. ⋯ Families of children with autism spectrum disorder were in fact significantly more at risk for having unmet specialty and therapy care needs. Additionally, families of children with autism spectrum disorder were more likely to report provider lack of skills to treat the child as a barrier in obtaining therapy and mental health services. Disparities in unmet needs for children with autism suggest that organizational features of managed care programs and provider characteristics pose barriers to accessing care.
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Matern Child Health J · May 2012
Can the Medical Home eliminate racial and ethnic disparities for transition services among Youth with Special Health Care Needs?
The Medical Home (MH) is shown to improve health outcomes for Youth with Special Health Care Needs (YSHCN). Some MH services involve Transition from pediatric to adult providers to ensure YSHCN have continuous care. Studies indicate racial/ethnic disparities for Transition, whereas the MH is shown to reduce health disparities. ⋯ Disparities remained. Rates and associated characteristics differed by race/ethnic group. Culturally tailored interventions incorporating universal factors to improve MH Transition outcomes are warranted.
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Matern Child Health J · May 2012
Have the health gaps between Indigenous and non-Indigenous Australian children changed over time? Results from an Australian National Representative Longitudinal Study.
The purpose of this study was to evaluate the changes of health gaps between Indigenous and non-Indigenous children over time and to explore critical factors that contribute to the changes. We employed data consisting of two cohorts of Australian children: infant (0/1 year) and children (4/5 years) that are part of the Longitudinal Study of Australian Children. Health outcomes were measured by physical outcome index (POI) and parent-rated health during 2004, 2006 and 2008. ⋯ Carer's depression status, socio-economic position and neighbourhood liveability had significant and consistent impacts on parent-rated health, but had only varying impacts on POIs between Indigenous and non-Indigenous children as well as between the birth cohorts at different time periods. Similarly, low birth weight, carer's binge drinking behaviour and other risk factors showed such varying impacts at a particular time period. The study implied that appropriate interventions accompanied by monitoring of health outcomes are necessary in order to decrease the health gaps between Indigenous and non-Indigenous children.