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ABSTRACT: Improvement of maternal morbidity and mortality indicators remains a major challenge for developing countries. Antenatal care is one of the key strategies in maintaining safe motherhood. The objective of this study was to develop and pretest a culturally relevant Antenatal Care Handbook (ANC handbook) utilizing the principles of information, education, and communication (IEC). We developed the ANC handbook after an extensive review of existing literature, available instruments (for keeping track of pregnancy and informing pregnant women), and seeking expert opinion. To pretest the ANC handbook, a cross-sectional approach was adopted, and information was collected from 300 expectant women, 150 women each from the community and from the health facility arm. Trained field workers conducted the pretesting from May 2004 to June 2004. Feedback on messages for pregnant mothers contained in the handbook was also assessed. At the same time, the ANC handbook was reviewed by 25 health care providers (including community health workers, physicians, nurses, and other health staff working at various kinds of health care facilities). Data were analyzed using both quantitative and qualitative methods.
Twenty-three percent of the interviewed women were primigravida, 50% were multigravida and 27% were grandmultipara. The mean age of the women in the community sample was 25.8 SD: 4.9 years and in the hospital sample it was 25.7 SD: 5.2 years. No significant differences were observed between women interviewed at community or health facilities related to their understanding of ANC messages, and the majority of messages were well understood. Similarly, health care providers found all of the instruments useful and workable in the health system. Finally, feedback from pregnant women and health care staff regarding different components of the handbook were incorporated and later verified by them.
Findings of pretesting reveal that a majority of pregnant women have an understanding of the culturally relevant ANC handbook. The handbook was found to be practical by healthcare paraprofessionals and community workers for use in different tiers of the health care system in Pakistan. The ANC handbook can be applied in the health service sector of Pakistan and can be adopted with relevant cultural modifications by countries with a similar context.
BMC Research Notes 03/2011; 4:91.
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ABSTRACT: It is estimated that at least 200 million children--mostly from developing countries--suffer from developmental delays. The study aims to contribute to an understanding of the contextual environment in which a child grows and develops in such setup; and in particular to evaluate the relative contributions of socio-economic status and rural-urban neighbourhoods on growth and psychomotor development. A cross-sectional study was conducted from May to November 2002 in 15 rural and 11 urban communities of Sindh, Pakistan. 1,244 children aged less than 3 years were assessed via home visits using Bayley's Infant Developmental Scale for psychomotor development, anthropometry and a socio-economic and demographic questionnaire. A socio-economic index was created using principal component analysis, and the study hypotheses explored through hierarchical linear modelling. We found that sub-optimal growth and development were prevalent among the study's children. Overall the mean psychomotor development (PD) index was 96.0 (SD 16.7), with 23% assessed as having delayed development, and undernourished with 39.8% stunted, 30.9% underweight and 18.1% wasted. Lower socio-economic status and living in a rural rather than urban neighbourhood were all found to have strong associations with lower psychomotor scores and with undernutrition. Rural-urban differences in undernutrition were explained by the lower socio-economic status of families in rural areas. By contrast, rural-urban differences in psychomotor scores remained strong even after controlling for differences in socio-economic status. It was estimated that rural residence accounted for 28% of cases of delayed psychomotor development among study children. Improvements in socio-economic status are vital to achieve optimal growth and development during early childhood. The study draws attention to the importance of taking heed of contextual needs, especially relating to differences between rural and urban neighbourhoods, in the formulation and implementation of early child care and development interventions.
Social Science [?] Medicine 07/2010; 71(1):102-9. · 2.70 Impact Factor
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ABSTRACT: Care for child development has gained international momentum in research and community-based programming. It encompasses various domains including cognitive, psychomotor, emotional, behavioural and social development, and a multitude of factors that have the potential to influence its trajectories. However, the multidisciplinary nature of child development initiatives is marred by a lack of unified perspectives across disciplines, especially basic conceptual understanding generated in the fields of education and psychology, which are not effectively exploited in public health programmes and epidemiological research.
The article suggests a four-point evaluation criteria to child development theories based on the ability to communicate in (1) Cross-disciplines, (2) an Overarching facility to address various developmental domains, (3) the capacity to link child development with Lifelong developmental potentials and, most importantly, (4) Epidemiological capability to provide supporting empirical evidence for community-based public health interventions (COLE criteria).
Key child development theories have been reviewed by broadly grouping them into three categories on the basis of content and approach, such as descriptive theories, psychological construct-based theories, and context-based theories. The strengths and challenges of these theories have been evaluated on the basis of COLE criteria.
Although most of these theories can contribute at different levels in child development initiatives, context-based theories have been particularly proposed to practitioners, researchers and policy makers for community-based programming, principally for its potential to address issues of social inequality, poverty and childcare practices, which are at the core of public health initiatives, and provide multiple level of opportunities to intervene.
Journal of epidemiology and community health 09/2009; 64(5):388-93. · 3.04 Impact Factor
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ABSTRACT: Despite the wide array of theoretical frameworks and research in the discipline of child development, there is a dearth of guidance to implement that knowledge in real world settings. This book nicely bridges the gap between theory and practice and successfully presents the integration of psychology, sociology, and public health of early childhood development in the much needed cross cultural context of the developing countries. The book takes this interdisciplinary approach a step further, and provides a detailed account to conceptualise and implement community based programmes to achieve optimal early childhood development. The text is developed on the belief that organised effort to ensure a better future for our children requires a basic understanding of principles of their growth and development, and skills to scientifically observe them.
First edited by Bilal Iqbal Avan, 08/2008; Oxford University Press., ISBN: ISBN13: 9780195473896 ISBN10: 0195473892
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ABSTRACT: This study focuses on determining the number of children considered ideal by Pakistani husbands and identifying the factors associated with this, with a special emphasis on family type. A cross-sectional survey was conducted among married males residing in four areas of Khairpur district. An equal number of study participants were selected systematically from each field site to achieve the required sample size of 500. Interviews were conducted by trained fieldworkers using a structured questionnaire to obtain information on background socioeconomic characteristics, family structure and reproductive health knowledge and practices, in particular family planning. Multivariate logistic regression analyses were used to assess the hypothesis that family type has an independent association with husbands' idealization of a larger number of children. The mean ideal number of children perceived by husbands was four. Living in an extended family (AOR = 1.81; 95%CI: 1.11, 3.35) and being illiterate (AOR = 2.13, 95%CI; 1.33, 3.42) are significantly associated with idealization of a larger number of children by the husband, while adjusting for socioeconomic status, family structure and family planning information. Understanding the dynamics of family type and its effects on husbands' opinions regarding ideal number of children can help strengthen population control efforts in Pakistan.
Journal of Biosocial Science 04/2006; 38(2):203-20. · 0.98 Impact Factor
