Day care centres as an institution for health promotion among needy children: an analytical study in São Paulo, Brazil.
ABSTRACT To evaluate the role of day care centres in the nutritional state of children belonging to a low-income population, comparing the nutritional state of the children in the day care centres with children in the same population who were given other types of day care.
Analytical cross-sectional study.
Public day care centres/primary health care.
Children aged 0-6 yr attending in 4 public day care centres (n=446) and sample of population obtained during vaccination campaign (n=1626).
Nutritional evaluation was conducted through weight and height measurements, using as a standard the NCHS (USA) table and Gomez and Waterlow methodology. The type of daily care received by the children was assessed through a questionnaire answered by the responsible persons during the vaccination campaign.
The nutritional status of children attended in the day care centers was better than children of the same community receiving other types of daily care (OR=0.48; CI 95%=0.36-0.65;P>0.0001). The improvement was related to more than 1 year of enrollment in the day care (OR=0.74; CI 95%=0.57-0.96;P=0.02).
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ABSTRACT: Attendance to a child-care facility is known to be associated with increased rate of episodes of infectious diseases in children. This retrospective cohort study investigates the infection episode rate and the effect of total attending period on infection episode rates in a child-care center (Gulveren Child-Care Center, Ankara, Turkey), at a stable environmental condition, over a 7-year follow-up period. During the study period, 288 children attended the center and enrolled. Sex, total duration of breastfeeding, starting age at the center, total duration of attendance, and the type and frequency of infections diseases were recorded. Episode rates were calculated for each child. Results: The mean starting age at the child care center was 4.1 +/- 0.7 years (range: 2.5-5.8 years); the mean total duration of attendance at the center was 20.4 +/- 9.9 months. Over the study period, 1000 infection episodes were detected. The general infection episode rate was calculated as 2.04/child per year. In bivariate analysis, children with longer attendance period (> or =12 months), and a younger starting age at the center (<4 years of age) had lower 'moderate general infection' (> or =3 episode/child per year) episode rates than those of other groups. In multiple logistic regression analysis, only total attending period in the center was significantly associated with 'moderate' level general infection episode rate. The presence of asthma slightly increased the lower respiratory tract infections episode rate in bivariate analysis, and was the only significant predictor of LRTI episode rate in multivariate analysis. The results of the present study show that among children attending a single facility, longer periods of attendance at the facility was associated with a decreased risk of general infection episode, regardless of starting age at the center. Additional cohort studies are needed to determine whether this reduction in general infection episode rate extends into school-age years and whether children moving between different centers affects the incidence of infectious episodes.Pediatrics International 11/2004; 46(5):555-60. · 0.88 Impact Factor
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ABSTRACT: We examined (1) whether attending out-of-home day care centres (DCCs) has differential effects on improvement of child nutrition and facilitation of maternal employment depending on availability of non-institutionalised childcare support and (2) whether attendance increases infectious diseases. In a prospective before-after comparison study at public DCCs in Pokhara, Nepal, we compared weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) among children attending DCCs between at admission, after 6 months, and after 1 year and determined differential changes in these measures between those with and without appropriate childcare support. We used repeated measures analysis of variance with interaction terms between support availability and DCC attendance. We compared maternal income and incidence of diarrhoea and fever in children between the periods of waiting and attending. After 6 months, neither WAZ nor HAZ significantly changed. After 1 year, WAZ significantly improved, but HAZ did not change among all participants. Those without appropriate childcare support showed greater improvement in both WAZ and HAZ than those with support. While children were attending, income increased only among those mothers who were already working without any childcare support at baseline. Neither diarrhoea nor fever increased. DCCs can be more beneficial for child nutrition and working mothers in households lacking childcare support than in those with support.Health Policy 03/2010; 97(1):16-25. · 1.51 Impact Factor
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ABSTRACT: BACKGROUND: The early childhood development is most crucial and the mother's care and attention is essential. The inevitable changes like women entering the work field have an effect on the child care and development. AIM: To study the selected anthropometric indices of the children of employed and unemployed women. SETTINGS AND DESIGN: This study was done in the urban slums of Guntur city by using a cross sectional, descriptive design. METHODS AND MATERIAL: This study was conducted during January - April 2011 with a sample of 312 children of non working women and 311 children of working women, who were selected through the systemic random quota sampling method in 6 randomly selected slums. The data was collected through questionnaires who were named as the Mother's schedule and the Child schedule, which consisted of close-ended questions which were coded for an easy data entry. The Mother's schedule looked at the information regarding the mother, like the caretaker during the mother's absence, the time which was spent with her child each day, etc. The Child schedule looked for information like whether the child was exclusively breast fed, its age in months when the weaning started, whether the government sponsored crèche services (Anganwadi center) were utilized, etc. It also included the anthropometrical measurements of the child like its current weight, current height and mid arm circumference, which were obtained by using standardized tools. STATISTICAL ANALYSIS: For each schedule, a separate table was created in a relational basis in MS Access, with suitable key fields to connect the information for the analysis. RESULTS: The children of the unemployed mothers weighed significantly higher than the children of the employed mothers. The children of the unemployed mothers also stood significantly taller than the children of the employed mothers. CONCLUSION: In the absence of the mothers who are at work, a childcare service is essential and this should be facilitated through legislation, NGO efforts, etc. Breast feeding and the bonding time with children are to be encouraged for the employed mothers.Journal of clinical and diagnostic research : JCDR. 12/2012; 6(10):1718-1721.