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Peer Reviewed

Title: Micronutrient supplementation affects maternal-infant feeding interactions and maternal distress in Bangladesh.
Author: Frith AL; Naved RT; Ekstrom EC; Rasmussen KM; Frongillo EA
Source: American Journal of Clinical Nutrition. 2009 Jul;90(1):141-8.
Abstract: BACKGROUND: Good maternal-infant interaction is essential for optimal infant growth, health, and development. Although micronutrient malnutrition has been associated with poorer interaction, the effects of maternal micronutrient supplementation on interaction are unknown. OBJECTIVES: We examined differences in maternal-infant feeding interaction between 3 maternal pre- and postpartum micronutrient supplementation groups that differed in iron dose and inclusion of multiple micronutrients and determined whether any differences observed were mediated by maternal distress. DESIGN: A cohort of 180 pregnant women was selected from 3300 women in the randomized controlled trial Maternal Infant Nutritional Interventions Matlab, which was conducted in Matlab, Bangladesh. At 8 wk of gestation, women were randomly assigned to 1 of 3 groups to receive a daily supplement of micronutrients (14 wk gestation to 12 wk postpartum): 60 or 30 mg Fe each with 400 microg folic acid or multiple micronutrients (MuMS; 30 mg Fe, 400 microg folic acid, and other micronutrients). A maternal-infant feeding interaction was observed in the home when infants were 3.4-4.0 mo of age, and maternal distress was assessed. RESULTS: Compared with 30 mg Fe, 60 mg Fe decreased the quality of maternal-infant feeding interaction by approximately 10%. Compared with 30 mg Fe, MuMS did not improve interaction but reduced maternal early postpartum distress. Distress did not mediate the effects of micronutrient supplementation on interaction. CONCLUSION: For pregnant and postpartum women, micronutrient supplementation should be based on both nutritional variables (eg, iron status) and functional outcomes (eg, maternal-infant interaction and maternal distress).
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | DOUBLE-BLIND STUDIES | PREGNANT WOMEN | VITAMINS AND MINERALS | FOOD SUPPLEMENTATION | BONDING | MATERNAL HEALTH | DEFICIENCY DISEASES | IRON | FOLIC ACID | ANXIETY DISORDERS | DEPRESSION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior | Nutrition Disorders | Diseases | Metals | Psychological Factors | Mental Disorders
Document Number: 341995

Peer Reviewed

Title: Change and stability in parent-child contact in five western countries.
Author: Kalmijn M; de Vries J
Source: European Journal of Population. 2009 Aug;25(3):257-276.
Abstract: Although much is known about changes in the conjugal family, little is known about trends in contact between parents and adult (independently living) children. Using unique survey data, we study changes in contact with the mother and the father in five western countries over a 15-year period (Austria, West Germany, Great Britain, the United States, and Italy). We describe changes and we examine the role of compositional changes in the trend. We find no evidence for a decline in intergenerational contact, in contrast to notions of individualism. In two countries, there has been an increase in contact with the mother and in three countries no net trend is observed. Contact with the father has not changed. Other forms of contact (e.g., telephone contact) have increased. Some compositional changes have had a downward pressure on the trend, leading to a decline in contact (i.e., rising education, declining church attendance), but these pressures have been compensated by counteracing compositional changes (declining sibsize) and by behavioral changes.
Language: English
Keywords:
UNITED KINGDOM | UNITED STATES OF AMERICA | GERMANY | AUSTRIA | ITALY | RESEARCH REPORT | PARENTS | CHILDREN | FAMILY LIFE | BONDING | CHANGES | BEHAVIOR CHANGE | Developed Countries | Europe, Western | Europe | North America | Americas | Europe, Central | Europe, Southern | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Interpersonal Relations | Behavior | Social Change
Document Number: 339897

Peer Reviewed

Title: Iron deficiency and child and maternal health.
Author: Murray-Kolb LE; Beard JL
Source: American Journal of Clinical Nutrition. 2009 Mar;89(3):946S-950S.
Abstract: BACKGROUND: Iron deficiency is most commonly found in women of reproductive age and infants worldwide, but the influence of maternal iron deficiency on infant development is underexplored. OBJECTIVE: The objective was to examine the relation between maternal iron status and mother-child interactions in a randomized, double-blind, intervention trial conducted in South Africa. DESIGN: Women were recruited into the study from a health clinic at 6-8 wk postpartum and were classified as either iron-deficient anemic (IDA) or iron-sufficient after blood analysis. IDA mothers received iron supplements of 125 mg FeSO(4) (IDA-Fe; n = 34) or placebo (IDA-PL; n = 30) daily from 10 wk to 9 mo postpartum. The control group (n = 31) consisted of iron-sufficient mothers. Free-play mother-child interaction sessions were videotaped in the clinic at 10 wk (n = 80) and 9 mo (n = 66) postpartum and coded per the Emotional Availability Scales (4 maternal scales: sensitivity, structuring, nonintrusiveness, and nonhostility; 2 infant scales: responsiveness and involvement). RESULTS: At 10 wk, scores for maternal sensitivity and child responsiveness were significantly greater in the control group than in the IDA groups (P = 0.028 and 0.009, respectively). At 9 mo, the control and IDA-Fe groups no longer differed. These 2 groups scored significantly better on the maternal sensitivity, structuring, and nonhostility scales and on the child responsiveness scale than did the IDA-PL group (P = 0.007-0.032), whose iron status remained low. CONCLUSION: These data indicate that maternal iron deficiency negatively affects mother-child interactions and that iron supplementation protects against these negative effects.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | WOMEN IN DEVELOPMENT | INFANT | MOTHERS | CHILD DEVELOPMENT | SERUM IRON LEVEL | DEFICIENCY DISEASES | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | ADMINISTRATION AND DOSAGE | BONDING | PARENTAL INVOLVEMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Studies | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Biology | Hemic System | Physiology | Nutrition Disorders | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Drugs | Treatment | Medical Procedures | Medicine | Interpersonal Relations | Behavior | Child Rearing
Document Number: 330708

Title: Community-Based Care for Low Birth Weight Newborns: The Role of Community Skin-to-Skin Care. Meeting Report, May 27, 2008, Washington, DC.
Author: Community-Based Care for Low Birth Weight Newborns:The Role of Community Skin-to-Skin Care (2008: Washington, D.C.)
Source: [Unpublished] 2008. 13 p.
Abstract: Saving Newborn Lives, ACCESS, and USAID sponsored a one-day consultation meeting to assess the state of the art of community-based skin-to-skin care (CSSC) for low birth weight (LBW) newborns. The specific objectives of the meeting were to: review the existing evidence on community-based skin-to-skin care, identify key knowledge and programming gaps, and recommend delivery approaches going forward. The meeting featured an overview of what is currently known about the results of facility-based skin-to-skin care (SSC), presentations and discussions of five community-based SSC initiatives, and three working group sessions to discuss key findings and make recommendations for going forward. The participants-key stakeholders from USAID, UNICEF, Saving Newborn Lives, USAID Cooperating Agencies, researchers, and field staff-agreed that the available evidence, drawn largely from facility-based experiences, conclusively demonstrates that skin-to-skin care is acceptable to mothers and communities (albeit not in all settings), and that SSC offers four major health benefits to newborns: (1) it is effective in preventing and treating hypothermia; (2) it increases the uptake and duration of breastfeeding; (3) it promotes weight gain; and (4) it reduces infection. Moreover, given that access to facility-based care is limited in developing countries and that nearly 60 percent of births occur at home, the participants concluded that the time has come to extend SSC beyond the facility and into the community. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | MOTHERS | INFANT | SAFE MOTHERHOOD | MATERNAL HEALTH | BONDING | BREASTFEEDING | LOW BIRTH WEIGHT | INFANT, PREMATURE | INFANT MORTALITY | INTERVENTIONS | PREVENTION AND CONTROL | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Interpersonal Relations | Behavior | Infant Nutrition | Nutrition | Birth Weight | Body Weight | Physiology | Biology | Mortality | Population Dynamics | Programs | Organization and Administration | Diseases
Document Number: 331788

Title: Perceptions among post-delivery mothers of skin-to-skin contact and newborn baby care in a periurban hospital in Uganda.
Author: Byaruhanga RN; Bergstrom A; Tibemanya J; Nakitto C; Okong P
Source: Midwifery. 2008 Jun;24(2):183-189.
Abstract: The objective was to explore the perceptions among post-delivery mothers of skin-to-skin contact and newborn baby care. The design used was a qualitative design using focus-group discussions. Five focus groups were conducted with post-delivery mothers who had had normal deliveries. A latent content analysis was used to derive the themes from the focus-group discussions. The settings and participants were 30 post-delivery mothers were purposively sampled from 249 mothers in the postnatal ward at St Francis Hospital, Nsambya, which is located in a periurban area in Kampala, Uganda. Two main themes emerged from the focus-group discussions: 'acceptability of health practices are influenced by knowledge and sensitisation' and 'pregnant women's choices are dependent on social, cultural and economic factors'. Mothers expressed varying opinions about the usefulness of skin-to-skin contact: some knew about its use to reduce the risk of hypothermia; others were ignorant, whereas some believed skin-to-skin contact was an intervention used to distract them from the pain in the post-delivery period. The vernix caseosa and the mixture of amniotic fluid with blood in the post-delivery period were perceived as dirty and infectious. The best informants for helping mothers understand the skin-to-skin intervention were the health-care providers. Social, cultural and economic factors, as well as the dominant role of the husband, were identified as important determinants for their choice and place of delivery. The gap between the knowledge and practice of skin-to-skin contact in hospital needs to be bridged. Health-care providers need to be encouraged to continuously advocate for, educate and implement regular skin-to-skin contact. (author's)
Language: English
Keywords:
UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERCEPTION | MOTHERS | INFANT | BONDING | BODY TEMPERATURE | KNOWLEDGE | SAFETY | BEHAVIOR | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Psychological Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Interpersonal Relations | Physiology | Biology | Public Health | Health
Document Number: 326924

Peer Reviewed

Title: Community involvement saves newborn infants in India.
Author: Kohn D
Source: Lancet. 2008 Apr;371(9620):1235-1236.
Abstract: In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. David Kohn reports. 4 million newborn babies die every year around the world-almost all in poor countries. Most infant mortality experts have argued that the answer is more specialised medical care. This solution, of course, is too costly for the developing world, and so in some countries little progress has been made in improving infant survival. But now some experts think that with a little training, local villagers can prevent many of these neonatal deaths themselves, with simple, inexpensive methods. This idea is controversial, though, because it shifts responsibility for infant health from doctors to poor, uneducated people with no training in neonatology. (excerpt)
Language: English
Keywords:
INDIA | CRITIQUE | BAREFOOT DOCTORS | CHILDBIRTH | POVERTY | LOW INCOME POPULATION | BONDING | HYGIENE | INFANT MORTALITY | COMMUNITY PARTICIPATION | PREVENTION AND CONTROL | Developing Countries | Asia, Southern | Asia | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Factors | Economic Factors | Social Class | Socioeconomic Status | Interpersonal Relations | Behavior | Public Health | Mortality | Population Dynamics | Demographic Factors | Population | Organization and Administration | Diseases
Document Number: 326152

8.
Title: Integral care for pregnant adolescents: impact on offspring.
Author: Oliva GS; de Mendonca RG; Sant'Anna MJ; Passarelli ML; Coates V; Omar HA
Source: International Journal of Adolescent Medicine and Health. 2008 Oct-Dec;20(4):537-46.
Abstract: PURPOSE: To assess the impact of integral support on the health of children of adolescent mothers and their children. METHODS: A prospective study involving 50 adolescent mothers, who had frequent meetings with a multi-professional group throughout pregnancy. After birth, medical followup was provided to mother and child. RESULTS: Mean schooling proved higher than the national average. After follow-up, the rate of return to education was 24%. These adolescents had good social network support from both family and father of the child. They considered themselves good mothers and felt happier after maternity experience. Adolescents demonstrated a responsible sex life involving family planning and correct use of contraception, yielding extremely low levels of repeat pregnancy. Of the mothers, 48% were employed, working, earning a mean monthly salary of 150% minimum wage. The children of mothers followed by were breastfed longer and had greater vaccination cover than the average for Sao Paulo State. CONCLUSIONS: The results suggest that our program promotes education of adolescents and their children; demonstrates the importance of a social support network through the family of the young mother and father of the child; fosters positive maternal social model addressing self-esteem and responsibility; informs mothers on contraception and encourages a responsible sex life, baby care, vaccination, and maternal breastfeeding.
Language: English
Keywords:
UNITED STATES OF AMERICA | KENTUCKY | RESEARCH REPORT | ADOLESCENTS, FEMALE | PREGNANCY | MOTHERS | INFANT | BONDING | ADOLESCENT PREGNANCY | IMPACT | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Interpersonal Relations | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Communication
Document Number: 331131

Title: Kangaroo Mother Care for low birth weight infants: A randomized controlled trial.
Author: Rao S; Udani R; Nanavati R
Source: Indian Pediatrics. 2008 Jan 17;45:17-23.
Abstract: The objective was to compare the effect of Kangaroo mother care (KMC) and conventional methods of care (CMC) on growth in LBW babies (less than 2000 g). The study design used was a randomized controlled trial. The setting for the study was a Level III NICU of a teaching institution in western India. The subjects used were 206 neonates with birth weight less than 2000 g. The subjects were randomized into two groups: the intervention group (KMC-103) received Kangaroo mother care. The control group (CMC: 103) received conventional care. Growth, as measured by average daily weight gain and by other anthropometrical parameters at 40 weeks postmenstrual age in preterm babies and at 2500 g in term SGA infants was assessed. The KMC babies had better average weight gain per day (KMC: 23.99 g vs CMC: 15.58 g, P less than 0.0001). The weekly increments in head circumference (KMC: 0.75 cm vs CMC: 0.49 cm, P = 0.02) and length (KMC: 0.99 cm vs CMC: 0.7 cm, P = 0.008) were higher in the KMC group. A significantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and sepsis. There was no effect on time to discharge. More KMC babies were exclusively breastfed at the end of the study (98% vs 76%). KMC was acceptable to most mothers and families at home. Kangaroo mother care improves growth and reduces morbidities in low birth weight infants. It is simple, acceptable to mothers and can be continued at home. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | MOTHERS | INFANT | LOW BIRTH WEIGHT | BREASTFEEDING | BONDING | MONITORING | PROGRAM ACCEPTABILITY | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Studies | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Infant Nutrition | Nutrition | Health | Interpersonal Relations | Behavior | Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 324485

10.

Title: Health consequences of the increasing caesarean section rates.
Author: Belizan JM; Althabe F; Cafferata ML
Source: Epidemiology. 2007 Jul;18(4):485-486.
Abstract: Caesarean section (C-section) rates are rising in many middle- and high-income countries, with the justification that higher rates of C-section are associated with better outcomes. A review of 79 studies comparing outcomes of elective caesarean sections with vaginal deliveries, including both observational studies and randomized trials, suggests that caesarean sections may have substantially greater risks than vaginal deliveries. In this issue of EPIDEMIOLOGY, Leung and colleagues present data from Hong Kong on morbidity in offspring related to C-section. Such studies are needed to widen the scope of possible health outcomes related to elective C-sections, including such endpoints as maternal satisfaction and women's relationship with their child. Testing of interventions to reduce unnecessary C-sections is also needed, with strategies to enhance the role of women in the process of their obstetric care. (author's)
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGY | LITERATURE REVIEW | INFANT HEALTH | CESAREAN SECTION | CHILDBIRTH | PREGNANCY OUTCOMES | BONDING | SATISFACTION | MORBIDITY | Public Health | Health | Child Health | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Interpersonal Relations | Behavior | Psychological Factors | Diseases
Document Number: 326509

11.

Title: Short duration of skin-to-skin contact: Effects on growth and breastfeeding.
Author: Boo NY; Jamli FM
Source: Journal of Paediatrics and Child Health. 2007 Dec;43(12):831-836.
Abstract: The aim was to compare weight gain and head growth in very-low-birthweight (VLBW, less than 1501 g) infants with or without exposure to short duration of skin-to-skin contact (STSC) during their stay in a neonatal intensive care unit. Stable VLBW infants were randomised into either STSC or control group. Parents of the STSC group were encouraged to provide STSC for at least 1 h daily. One hundred and forty-six infants were randomised, but only 126 were enrolled (STSC group: n = 64; Controls: n = 62). Infants in the STSC group had better mean weekly increase in head circumference (1.0 cm (SD = 0.3) vs. 0.7 cm (SD = 0.3); P less than 0.0001) and higher breastfeeding rate at discharge (29.7% vs. 14.5%; P = 0.04). Although the mean duration of maternal education was longer in STSC (13.0 vs. 12.1 years; P = 0.04) than in controls, linear regression analysis showed that the significant predictors associated with weekly head growth were exposure to STSC (unstandardised coefficient: 0.2; 95% confidence intervals (CI): 0.1, 0.3; P less than 0.0001) and head circumference of infants at the time of enrolment (unstandardised coefficient: -0.05; 95% CI: -08, -0.03; P less than 0.0001); the number of years of maternal education was not a significant predictor. Logistic regression analysis showed that the only significant predictors of successful breastfeeding at discharge were receiving expressed breast milk at enrolment (adjusted OR: 4.1; 95% CI: 1.4, 11.7; P = 0.009) and receiving expressed breast milk during intervention period (adjusted OR: 8.3; 95% CI: 2.8, 24.4; P less than 0.0001); exposure to STSC and maternal education were not significant predictors. Exposure to short duration of STSC may promote head growth in VLBW infants. (author's)
Language: English
Keywords:
MALAYSIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | STATISTICAL REGRESSION | INFANT | MOTHERS | BREASTFEEDING | BONDING | GROWTH | BODY WEIGHT | LOW BIRTH WEIGHT | TIME FACTORS | ANTHROPOMETRY | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Studies | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Interpersonal Relations | Behavior | Child Development | Biology | Physiology | Birth Weight | Population Dynamics | Measurement
Document Number: 313973

12.

Peer Reviewed

Title: Breast milk composition in a cohort of pre-term infants� mothers followed in an ambulatory programme in Colombia.
Author: Charpak N; Ruiz JG
Source: Acta Paediatrica. 2007 Dec;96(12):1755-1759.
Abstract: The objectives were describing preterm breast milk evolution and composition according to gestational age (GA) and postnatal age (PNA) in a cohort of mothers cared for in an ambulatory Kangaroo Mother Care Program (KMCP) in a developing country. A cohort involving 113 mothers who delivered 'healthy' preterms adequate for GA was assembled. Mothers received intensive breastfeeding support before discharge. Samples of both fore- and hind milk were obtained at entry into KMCP and weekly thereafter, until term. Composition was described according to PNA and postconceptional age (PCA). Protein concentration varied inversely with both PCA and PNA. Fat concentration was consistently higher in hind milk than in fore milk samples of the same feed. Lactose increased steadily with PCA. Calcium/phosphorus ratios were stable, close to 2:1 and content of both was similar in samples of different PCA and PNA. Minerals concentration could be inadequate for preterms. Protein concentration decreases steadily to mature milk levels by the third week of PNA, regardless of birth GA. Therefore, from the third week of PNA onwards, protein content could be insufficient to satisfy needs of preterms born at 32 weeks or less. Feeding hind milk could increase caloric density and fat intake to better meet preterms' nutritional needs. (author's)
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | COHORT ANALYSIS | MOTHERS | INFANT | INFANT NUTRITION | WOMEN IN DEVELOPMENT | HUMAN MILK | BREASTFEEDING | GESTATIONAL AGE | BONDING | PREMATURE BIRTH | COUNSELING | AGE FACTORS | CALCIUM | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Economic Development | Economic Factors | Lactation | Maternal Physiology | Physiology | Biology | Fetus | Pregnancy | Reproduction | Interpersonal Relations | Behavior | Pregnancy Outcomes | Clinic Activities | Program Activities | Programs | Organization and Administration | Metals | Vitamins and Minerals
Document Number: 324850

13.

Peer Reviewed

Title: The mood variation in mothers of preterm infants in Kangaroo Mother Care and conventional incubator care.
Author: de Macedo EC; Cruvinel F; Lukasova K; D'Antino ME
Source: Journal of Tropical Pediatrics. 2007 Oct;53(5):344-346.
Abstract: Preterm babies are more prone to develop disorders and so require immediate intensive care. In the conventional neonatal intensive care, the baby is kept in the incubator, separated from the mother. Some actions have been taken in order to make this mother-child separation less traumatic. One of these actions is the Kangaroo mother care (KMC) characterized by skin-to-skin contact between a mother and her newborn. The objective of this study was to compare the mood variation of mothers enrolled in the KMC program to those in the conventional incubator care. In one general hospital in Sao Paulo, Brazil, 90 mothers were evaluated before and after contact with the baby in the Neonatal Intensive Care Unit. The participants were divided into three groups: 30 mothers of term newborns (TG), 30 mothers of preterm infants included in KMC program (PGK) and 30 preterms with incubator placement (PGI). The Brazilian version of the Visual Analogue Mood Scale (VAMS) was used for the assessment before and after the infant's visit. Results showed that TG mothers reported fewer occurrences of depressive states than PGK and PGI mothers. A significant mood variation was observed for PGK and PGI after the infant's visit. PGK mothers reported feeling calmer, stronger, well-coordinated, energetic, contented, tranquil, quick-witted, relaxed, proficient, happy, friendly and clearheaded. The only variation showed by PGI mothers was an increase in feeling clumsy. This study shows a positive effect of the KMC on the mood variation of preterm mothers and points to the need of a more humane experience during the incubator care. (author's)
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | EVALUATION INDEXES | POSTPARTUM WOMEN | INFANT, PREMATURE | WOMEN IN DEVELOPMENT | POSTPARTUM | DEPRESSION | BONDING | PSYCHOLOGICAL FACTORS | PREMATURE BIRTH | HEALTH STATUS INDEXES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Puerperium | Reproduction | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Mental Disorders | Diseases | Interpersonal Relations | Behavior | Pregnancy Outcomes | Pregnancy | Health
Document Number: 321844

14.

Peer Reviewed

Title: [Fatherhood: the male experience from a gender focus] Sentir-se pai: a vivencia masculina sob o olhar de genero.
Author: Faustino e Freitas WD; Coelho ED; da Silva AT
Source: Cadernos de Saude Publica. 2007 Jan;23(1):137-145.
Abstract: Pregnant and postpartum women frequently complain about the limited involvement of their partners with their children, beginning in pregnancy. The current study thus aimed to understand men's feelings towards fatherhood during this period of their lives. The research adopted a qualitative approach and a gender-theory focus. The universe included men whose children were being treated at a pediatric outpatient clinic, and data were collected through semistructured home interviews. Subjects' testimony was analyzed using discourse analysis, the basic principle of which is to recognize the most abstract levels of the text, identified by themes organized in blocks of meaning and allowing the construction of empirical categories. Study subjects' social position towards fatherhood shows that the model that men assume as father-providers coexists with that of the man who seeks to be a "new father", whose affective bond with the son or daughter begins during pregnancy, thus representing a break with traditional fatherhood. (author's)
Language: Portuguese
Keywords:
FATHERS | GENDER ISSUES | POSTPARTUM WOMEN | MEN'S INVOLVEMENT | PREGNANCY | BONDING | NEEDS | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Programs | Organization and Administration | Interpersonal Relations | Behavior | Economic Factors
Document Number: 312937

15.

Title: The participation of parents in the care of premature children in a neonatal unit: Meanings attributed by the health team.
Author: Martinez JG; Monti Fonseca LM; Silvan Scochi CG
Source: Revista Latino-Americana de Enfermagem. 2007 Mar-Apr;15(2):239-246.
Abstract: This qualitative study aims to identify and analyze the meanings the health team attributes to the parents' participation in the care of premature children hospitalized at a public hospital. Data were recorded and collected through semi-structured interviews performed with 23 professionals. The results show that parents' participation in the care of these children is still in an initial stage at the hospital's neonatal unit. However, there is interest from the health team to implement it because its importance is recognized in improving the clinical stability, the growth and development process of premature children. In addition to allowing for mother-child interaction and affective bonding, it prepares the mother for the child's discharge. The presence of the mother helps the nursing team by giving maternal care to the hospitalized child. On the other hand, the parents' presence interferes in the environment of the neonatal unit. It affects the work dynamics and creates insecurity among team workers, who feel supervised. Besides, there is concern regarding hospital infection. Thus, in accordance with other studies from different countries, these meanings entail reflections on the need to base the premature care in terms of collectively building a care philosophy that restores concepts of human rights, citizenship, bonding and mother-child attachment, pediatric psychology and also expands the concept of training for a participative health education. (author's)
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | INTERDISCIPLINARY STUDIES | KAP SURVEYS | INFANT, PREMATURE | PARENTS | NURSES AND NURSING | PARENTAL INVOLVEMENT | CHILD CARE | HOSPITALS | BONDING | PARTICIPATION | INFECTION PREVENTION | CLIENT-STAFF RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Child Rearing | Behavior | Health Facilities | Interpersonal Relations | Social Behavior | Infections | Diseases
Document Number: 319672

16.

Title: Associations between parents' marital functioning, maternal parenting quality, maternal emotion and child cortisol levels.
Author: Pendry P; Adam EK
Source: International Journal of Behavioral Development. 2007;31(3):218-231.
Abstract: Associations between family functioning and children's stress hormone levels are explored, by examining how aspects of the interparental relationship (parents' marital satisfaction and parent conflict styles), the mother-child relationship (maternal involvement and warmth) and maternal emotional functioning (depression, anxiety and self-esteem) relate to children's cortisol levels. Parents of 63 children (32 kindergarten-aged children, 31 adolescents) completed questionnaires regarding family and individual functioning, and children's salivary cortisol samples were collected on two consecutive weekdays at home immediately upon waking and at bedtime, such that wakeup, bedtime and average levels and the slope of their diurnal cortisol rhythms could be estimated. Higher marital functioning was significantly and independently associated with lower child cortisol levels (average levels and wakeup levels), while maternal parenting quality and emotional functioning were not significant when included in the same regression model. Associations between parents' marital functioning and children's bedtime cortisol levels and diurnal slopes were moderated by child age, with higher parent marital functioning being associated with a significantly greater lowering of bedtime levels and steeper diurnal slopes for kindergarten-aged children as compared to adolescents. Higher maternal parenting quality was found to be significantly related to steeper diurnal cortisol rhythms. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | PARENTS | CHILD | FAMILY RELATIONSHIPS | CHILD DEVELOPMENT | STRESS | CHILD REARING | BONDING | INTERPERSONAL RELATIONS | HUSBAND-WIFE COMMUNICATION | EMOTIONS | ADRENAL CORTEX HORMONES | Developed Countries | North America | Americas | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Psychological Factors | Behavior | Partner Communication | Hormones | Endocrine System | Physiology
Document Number: 322441

17.

18.

Title: Good short-term outcomes of kangaroo mother care in infants with a low birth weight in a rural South African hospital.
Author: Rodriguez AN; Nel M; Dippenaar H; Prinsloo EA
Source: South African Family Practice. 2007 Jun;49(5):15.
Abstract: The aim of the study was to determine the outcome of kangaroo mother care (KMC) in low birth weight infants at a community hospital. This descriptive study included 87 mothers and their low birth weight infants who were in a stable condition and eligible for KMC at Dr JS Moroka Hospital, Thaba Nchu. The infants were assessed four times: at birth, twice during hospitalisation, and a week after discharge. Infants received breast milk exclusively. Regarding the mothers' obstetric history (n=87), gravidity ranged from 1 to 7 (median 3), with a 43% incidence of miscarriage. The median birth weight of the infants (n=87) was 1.5 kg (first assessment), the discharge weight (third assessment) was 1.8 kg, and a week after discharge (fourth assessment) it was 2.2 kg. Initially the infants lost weight significantly from birth to the second assessment (95% CI for median decrease [-0.02; -0.01]), but significantly gained weight from the second to the third (95% CI for median increase [0.27; 0.33]) and from the third to the fourth assessment (95% CI for median increase [0.32; 0.45]). Approximately half (49%) of the infants had developed jaundice by the time of second assessment. These babies had a significantly lower birth weight [0.12;0.30]. Our findings confirm that infants with a low birth weight treated with KMC can have a good growth pattern, and exclusive breast milk is sufficient to guarantee such growth. Kangaroo mother care is a safe method for stable infants with a low birth weight in a community hospital. (author's)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | INFANT | MOTHERS | BONDING | LOW BIRTH WEIGHT | ABORTION, SPONTANEOUS | RISK FACTORS | PARITY | JAUNDICE | COMPLICATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Interpersonal Relations | Behavior | Birth Weight | Body Weight | Physiology | Biology | Pregnancy Complications | Diseases | Fertility Measurements | Fertility | Population Dynamics | Signs and Symptoms
Document Number: 319507

19.

Title: Innovative approaches to cohort retention in a community-based HIV / STI prevention trial for socially marginalized Peruvian young adults.
Author: Villacorta V; Kegeles S; Galea J; Konda KA; Cuba JP
Source: Clinical Trials. 2007;4:32-41.
Abstract: The conduct of longitudinal clinical trials must involve effective strategies to retain study participants in order to ensure internal validity, adequate statistical power and generalizability of results. In a large trial in Peru, we implemented various retention strategies to maintain high participation rates over time. Novel participant retention strategies were used to follow highly marginalized populations for two years because traditional locator information, such as telephone numbers and official identification (eg, passport, driver's license, the local equivalent of a social security number) were often unreliable or unavailable. These strategies included detailed preliminary ethnographic research to identify the behaviours of key target groups, approaches to develop strong informal bonds between project staff and participants outside of study settings, and methods to enhance positive participant attitudes towards the study. The overall study retention rate after two years was 84%, even though only 26% of the study populations supplied complete locator information (telephone, address and the names of two friends). The retention strategies used were labour intensive and iterative, which could prove difficult to replicate. The two-year retention rate in this study was sufficient to maintain required sample sizes. The methods used to maintain contact with the populations were labour intensive, low tech and adequate for these populations and could be used to retain study participants in other marginalized, urban, low-income areas. (author's)
Language: English
Keywords:
PERU | METHODOLOGICAL STUDIES | COHORT ANALYSIS | CLINICAL TRIALS | RESEARCH METHODOLOGY | SAMPLING STUDIES | LONGITUDINAL STUDIES | YOUTH | MEN HAVING SEX WITH MEN | LOW INCOME POPULATION | HIV PREVENTION | ANTHROPOLOGY, CULTURAL | PERSONAL IDENTIFICATION SYSTEMS | BONDING | ATTITUDES | South America, Western | South America | Latin America | Americas | Developing Countries | Clinical Research | Studies | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | Anthropology | Social Sciences | Science | Sociocultural Factors | Records | Information Processing | Information | Interpersonal Relations | Psychological Factors
Document Number: 322253

20.

Title: Feeding low birthweight babies.
Author: Academy for Educational Development [AED]. Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program [LINKAGES]
Source: Washington, D.C., AED, LINKAGES, 2006 Mar. [8] p. (Facts for FeedingUSAID Cooperative Agreement No. HRN-A-00-97-00007-00USAID Development Experience Clearinghouse Doc ID / Order No. PN-ADH-499)
Abstract: Low birthweight (LBW)--defined as weight at birth of less than 2500 grams--is one of the most important contributing factors to neonatal and infant death, illness, and malnutrition. Studies show that LBW is also associated with the development of diabetes and heart disease in adulthood. Good feeding practices can reduce the increased risks of morbidity and mortality associated with LBW. Every year around 21 million low birthweight babies are born. They represent 16 percent of all newborns, but large regional variations exist. The percentage of babies born with LBW is 28 percent in South Asia, 14-15 percent in sub-Saharan Africa and North Africa/the Middle East, and 7-9 percent in Latin America and the Caribbean, East Asia, and industrialized countries. (excerpt)
Language: English
Keywords:
GLOBAL | MOTHERS | PERSONS LIVING WITH HIV/AIDS | LOW BIRTH WEIGHT | PREMATURE BIRTH | BONDING | BREASTFEEDING | INFANT NUTRITION | RISK FACTORS | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Birth Weight | Body Weight | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Interpersonal Relations | Behavior | Nutrition | Health
Document Number: 311531

21.

Title: Parent-child connectedness: new interventions for teen pregnancy prevention.
Author: Bean S; Rolleri LA; Wilson P
Source: Santa Cruz, California, ETR Associates, 2006. 74 p.
Abstract: These intervention activities represent the culmination of three and a half years of work by the Parent-Child Connectedness: Bridging Research and Intervention Design (PCC BRIDGE) project team. The activities were conceptualized by PCC BRIDGE project codirectors Lori Rolleri and Steve Bean at Education, Training, Research Associates (ETR) in collaboration with our curriculum consultant Pamela Wilson, MSW, who wrote the initial drafts of all the activities except the active listening activity. The purpose behind designing these activities is to provide community-based organizations (CBOs) with intervention resources they can use to start impacting parent-child connectedness (PCC) with the parents and teens with whom they work. These activities were designed primarily for use by practitioners in the area of adolescent reproductive health (ARH), but they are general enough to be used for a variety of prevention topics and by a variety of prevention practitioners across many different intervention settings. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | MANUAL | ADOLESCENTS | PARENTS | CHILDREN | ADOLESCENT PREGNANCY | PARENTAL INVOLVEMENT | CHILD REARING | BONDING | INTERPERSONAL COMMUNICATION | WORKSHOPS | PARENTING EDUCATION | North America | Americas | Developed Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Interpersonal Relations | Communication | Education
Document Number: 309447

22.

23.
Peer Reviewed

Title: Addressing Japan's fertility decline: influences of unintended pregnancy on child rearing.
Author: Goto A; Yasumura S; Yabe J; Reich MR
Source: Reproductive Health Matters. 2006 May;14(27):191-200.
Abstract: Japan has been experiencing a continuing decline in fertility and an increase in premarital conceptions and abortions among young people. Child rearing is often viewed as a burden. In response, Japan is now seeking ways to improve the child-rearing environment for parents. In this context, we conducted a prospective study among 206 pregnant women in Sukagawa City, Fukushima, to explore the influences of pregnancy intention on child rearing. We found that unintended pregnancy was associated with a higher risk of negative child-rearing outcomes, including lower mother-to-child attachment, increased negative feelings of mothers and a lower level of participation of fathers in child rearing. Unintended pregnancy exacerbates the real and perceived burdens of child rearing. Japan is currently facing a conflict between wanting to reduce unintended pregnancies and increase the national fertility rate. We believe the government needs to address the social challenges affecting people's family lives, which underpin low fertility, rather than focus on fertility decline per se. We suggest Japan seeks to reduce unintended pregnancies and provide support to parents at high risk of child-rearing difficulties. We also suggest adopting a comprehensive approach to improving the lives of young couples, with a focus on adolescents, including life-skills education to prepare for adulthood, marriage and parenthood. (author's)
Language: English
Keywords:
JAPAN | RESEARCH REPORT | PROSPECTIVE STUDIES | KAP SURVEYS | PREGNANT WOMEN | YOUTH | COUPLES | ADOLESCENTS | PREGNANCY, UNPLANNED | FERTILITY DECLINE | CHILD REARING | PREMARITAL PREGNANCY | ABORTION RATE | BONDING | FAMILY PLANNING POLICY | Developed Countries | Asia, Eastern | Asia | Studies | Research Methodology | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Age Factors | Family Characteristics | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Fertility Changes | Behavior | Fertility Control, Postconception | Family Planning | Interpersonal Relations | Population Policy | Social Policy | Policy | Political Factors
Document Number: 304731 Notification

24.

Title: Forced feeding practice in Yoruba community of southwestern Nigeria: Evidence from ethnographic research.
Author: Jegede AS; Ajala AS; Adejumo OP; Osunwole SO
Source: Anthropologist. 2006 Jul;8(3):171-179.
Abstract: Despite health policies on child care, forced feeding is still a widespread practice in Yoruba culture. It is not clear the factors sustaining the practice. This study describes the practice and highlights the factors responsible for its continuity despite advances in medicine and health transition. Ethnographic data were collected in Aiyedire community, examining the biographies of mothers, through focus group discussion with women and men categories, key informant interviews, and case studies. Data revealed that the practice is sustained through gender stereotypes, traditions, and peer influence of mother-in-law. Reasons advanced for the practices include the perception that child will have intimacy with mother, and child's poor attitude to better food and medication. Gender dynamics exists between male and female as the practice is female role. Respondents do not have the knowledge of the health implication of the practice. It was concluded that public enlightenment programme targeting mother and the significant others identified in the study should be put in place. (author's)
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | INTERVIEWS | FOCUS GROUPS | CASE STUDIES | DATA COLLECTION | MOTHERS | CHILD | BONDING | CHILD CARE | CHILD HEALTH | CHILD NUTRITION | CULTURE | HARMFUL TRADITIONAL PRACTICES | KNOWLEDGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Interpersonal Relations | Behavior | Child Rearing | Health | Nutrition | Traditional Health Practices
Document Number: 321359

25.
Title: Descriptive study of the clinical and nutritional profile and follow-up of premature babies in a Kangaroo Mother Care Program.
Author: Penalva O; Schwartzman JS
Source: Jornal de Pediatria. 2006;82(1):33-39.
Abstract: The objective was to describe the profile of premature newborns participating in the Kangaroo Mother Care Program and the data from, and to verify possible correlations between these descriptive data. A descriptive study of 70 children, 5-34 months old, born between April 1999 and 2002, with gestation age of 32.5 weeks, birth weight 1,560 g, participating in the Kangaroo Mother Care Program (modified for Brazil) for at least 3 days. They were discharged from Kangaroo Mother Care weighing around 3,000 g and followed-up to 1 year. Birth weight, gestational age and Apgar scores were determinants of better clinical, nutritional and motor outcomes as well as for enrollment on the Kangaroo Mother Care Program. During the second phase of the program 8.6% of the children were readmitted due to apnea. Exclusive breastfeeding started at a mean postconceptual age of 35.3 weeks and mean age postpartum of 18.6 days. By hospital discharge, children were at a mean age of 29 days, mean weight of 1,734 g and 85.7% were on exclusive breastfeeding. Predominant breastfeeding up to 6 months of age was observed in 60.3%. We initially identified motor disorders in 42.8% decreasing to 14.3% in the final review of records, including cerebral palsy (6.9%) and retarded motor development (6.9%). Enrollment on the Kangaroo Mother Care Program, in common with data on breastfeeding and clinical outcomes were determined by gestational age and birth weight and were influenced by clinical conditions of each preterm infant. Kangaroo Mother Care proved itself a good breastfeeding instrument, but its role as an intervention for motor development must be better investigated. (author's)
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | FOLLOW-UP STUDIES | MOTHERS | INFANT, PREMATURE | BONDING | CHILD CARE | RESPIRATORY INSUFFICIENCY | BIRTH WEIGHT | GESTATIONAL AGE | INFANT NUTRITION | BREASTFEEDING, EXCLUSIVE | NEUROLOGIC EFFECTS | CHILD DEVELOPMENT | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Interpersonal Relations | Behavior | Child Rearing | Pulmonary Effects | Physiology | Biology | Body Weight | Fetus | Pregnancy | Reproduction | Nutrition | Health | Breastfeeding
Document Number: 304324

26.
Peer Reviewed

Title: Adolescent adjustment over six years in HIV-affected families.
Author: Rotheram-Borus MJ; Stein JA; Lester P
Source: Journal of Adolescent Health. 2006 Aug;39(2):174-182.
Abstract: The purpose was to assess predictors of adjustment of adolescents of parents with HIV (PWH) at three and six years after the delivery of either a coping skills intervention or a standard care condition. A randomized controlled intervention trial was conducted with 288 parents with human immunodeficiency virus (HIV) and their adolescent children. Indicators of adolescent adjustment at both three and six years were examined as a function of intervention condition, demographics, prior behaviors, and parental bonds using structural equation modeling (SEM). Adolescent adjustment at six years was also examined as a function of death of the PWH. Protective factors: Youth in the intervention condition reported significantly less substance use three and six years later. In addition, positive parental bonds reported at baseline reduced emotional distress at three years and increased positive future expectations at six years. Risk factors: Substance use at three years predicted heightened sexual risk behaviors, continued substance use, and lower future expectations at six years. Early emotional distress and being Latino predicted increased emotional distress at three years. Parental death by three years predicted more sexual risk behavior and lowered future expectations at six years. A time-limited, family based intervention with adolescents of PWH demonstrated both direct and indirect benefits lasting into early adulthood, especially in decreasing substance use, and identifies key risk factors for problematic adjustment, including the death of a PWH. (author's)
Language: English
Keywords:
NEW YORK | RESEARCH REPORT | LONGITUDINAL STUDIES | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | PARENTS | HISPANICS | HIV INFECTIONS | FAMILY RELATIONSHIPS | STRESS | PSYCHOSOCIAL FACTORS | SOCIAL ADJUSTMENT | BONDING | RISK BEHAVIOR | DRUG USE AND ABUSE | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Psychological Factors | Behavior | Social Behavior | Interpersonal Relations
Document Number: 304829

27.
Peer Reviewed

Title: Factors determining client satisfaction with hospital-based perinatal care in Sri Lanka.
Author: Senarath U; Fernando DN; Rodrigo I
Source: Tropical Medicine and International Health. 2006 Sep;11(9):1442-1451.
Abstract: The objectives were to describe mothers' satisfaction with perinatal care received during hospitalization for delivery, and to identify sociodemographic and health-care-related factors associated with satisfaction. A cross-sectional study of 446 mother--newborn pairs from five hospitals in Puttalam district, Sri Lanka, was carried out by stratified randomization. Client satisfaction was measured using a 16-item survey instrument with high internal consistency (Cronbach's a = 0.81), through exit interview. The proportion of mothers who were fully satisfied varied from 10.8% to 31.4% for interpersonal aspects, and from 10.1% to 28.9% for technical aspects of care. The satisfaction rates were lower with physical environment (6.1--10.1%) and higher with outcome of care (41.0--48.0%). Multivariate analyses indicated that mothers were more satisfied with the services available from lower level hospitals. Multiparae were more satisfied than primiparae. Determinants of satisfaction included providing immediate mother--newborn contact, information after examination and counselling on family planning. Higher satisfaction with the physical environment was associated with being Moor or Tamil as opposed to Sinhalese and with lower family income. The factors associated with client satisfaction identified in this study may be helpful in improving quality of care. Hospital staff should ensure that these are addressed and develop interpersonal relationships, especially with the first-time mothers and in higher level hospitals. Maternity units of lower level institutions should be upgraded with essential facilities. (author's)
Language: English
Keywords:
SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | ETHNIC GROUPS | SATISFACTION | HOSPITALS | CHILDBIRTH | DEMOGRAPHIC FACTORS | PARITY | BONDING | COUNSELING | FAMILY PLANNING EDUCATION | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Puerperium |