2. Effectiveness of integrated early childhood development intervention on nurturing care for children aged 0-35 months in rural China
Huifeng SHI ; Jingxu ZHANG ; Xiaoli WANG ; Yuanyuan XU ; Shengli DONG ; Chunxia ZHAO ; Xiaona HUANG ; Qi ZHAO ; Xuefeng CHEN ; Ye ZHOU ; Margo O'SULLIVAN ; Ron POUWELS ; Robert W. SCHERPBIER
Chinese Journal of Pediatrics 2018;56(2):110-115
Objective:
To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China.
Methods:
IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors.
Results:
The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377)
3.Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool.
Zhen JIANG ; Su Fang GUO ; Robert W SCHERPBIER ; Chun Mei WEN ; Xiao Chao XU ; Yan GUO
Biomedical and Environmental Sciences 2015;28(8):606-610
China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.
Child Mortality
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Child, Preschool
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China
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epidemiology
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Female
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Health Priorities
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Humans
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Infant
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Infant, Newborn
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Maternal Mortality
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Pregnancy