With the motto ‘Equity from the Start for a Healthy Future’, the Seoul Healthy First Step Project (SHFSP) was launched in 2013 in an attempt to support women with young children, to improve the health and development of babies, and eventually to close the gap in child development. The SHFSP contains both universal components (universal risk assessment of mothers and universal home visitation after birth) and selective components (prenatal and postnatal sustained home visits, mothers' groups, and community service linkage), thereby taking a proportionate universality approach. For sustained home visits, the SHFSP introduced the Maternal and Early Childhood Sustained Home-visiting (MECSH) program from Australia, which has been proven to be effective in improving maternal and childhood outcomes. Between 2013~2017, the SHFSP has paid 58,327 visits to roughly 38 thousand families with babies. In 2017, the SHFSP covered 19.6% of families with newborn babies in Seoul. The SHFSP conducted internal satisfaction surveys of universal and sustained visitation service recipients, in which an overwhelming majority of mothers provided positive feedback. A performance assessment conducted in 2016 by an external organization showed that 93% of SHFSP service recipients were satisfied with the home visitations. Considering the popular support for the program from mothers and families in Seoul (the most affluent area in Korea) and the lack of a national home visiting program to promote early childhood health and development, this program should be expanded nationally in the near future.
Australia ; Child ; Child Development ; Female ; Home Health Nursing ; House Calls ; Humans ; Infant ; Infant, Newborn ; Korea ; Maternal-Child Health Services ; Mothers ; Risk Assessment ; Seoul ; Social Welfare

The relationship between the number of withdrawn/restricted drugs and socioeconomic, health, and welfare indicators were investigated in a comprehensive review of drug regulation information in the United Nations (UN) countries. A total of of 362 drugs were withdrawn and 248 were restricted during 1950-2010, corresponding to rates of 12.02+/-13.07 and 5.77+/-8.69 (mean+/-SD), respectively, among 94 UN countries. A socioeconomic, health, and welfare analysis was performed for 33 OECD countries for which data were available regarding withdrawn/restricted drugs. The gross domestic product (GDP) per capita, GDP per hour worked, health expenditure per GDP, and elderly population rate were positively correlated with the numbers of withdrawn and restricted drugs (P<0.05), while the out-of-pocket health expenditure payment rate was negatively correlated. The number of restricted drugs was also correlated with the rate of drug-related deaths (P<0.05). The World Bank data cross-validated the findings of 33 OECD countries. The lists of withdrawn/restricted drugs showed markedly poor international agreement between them (Fleiss's kappa=-0.114). Twenty-seven drugs that had been withdrawn internationally by manufacturers are still available in some countries. The wide variation in the numbers of drug withdrawals and restrictions among countries indicates the need to improve drug surveillance systems and regulatory communication networks.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Drug Utilization/*economics/statistics & numerical data ; Female ; Gross Domestic Product/*statistics & numerical data ; *Health Status Indicators ; Humans ; Infant ; Infant, Newborn ; Internationality ; *Life Expectancy ; Male ; Middle Aged ; Product Surveillance, Postmarketing/*economics/statistics & numerical data ; Safety-Based Drug Withdrawals/*economics/statistics & numerical data ; Social Welfare/economics/statistics & numerical data ; Socioeconomic Factors ; Statistics as Topic ; Young Adult

The Global Consensus for Feeding the Preterm Infant was published in the Journal of Pediatrics 3 supplement, 2013. The content of the consensus includes recommended nutrient intake for different gestational age preterm infants, identifying appropriate growth curves, the use of breast milk, nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge, nutritional requirements and feeding recommendations for small gestation age infants, reconsideration of the importance of vitamin A and vitamin D for immature infants, recommendations for immunonutrients, and the association of feeding of preterm infants with later metabolic and cardiovascular outcomes. The main characteristics of the consensus: (1) aimed to improve prognosis; (2) individualized nutritional strategy based on gestational ages; (3) coexistence of consensus and controversy in feeding of preterm infants.
Gestational Age ; Humans ; Infant Nutritional Physiological Phenomena ; Infant Welfare ; Infant, Newborn ; Infant, Premature ; Nutritional Requirements

PURPOSE: The purpose of this study is to test a model linking infant health problem, mother's depression and marital relationship to infant abuse. METHODS: This study employed a cross-sectional survey design. Data were collected from 2009 Data of Index Studies for Korean Children and Adolescents Development. Survey data from 1,060 infants and their mothers (including infant health status and infant physical illness scale, depression scale, marital relationship scale, and child abuse scale) were used to test the model. The model was tested using path analysis techniques within structural equation modeling. RESULTS: The model fit indices suggested that the original hypothesized model adequately fit the data (chi2 = .33, df = 5, p = .84, Tucker-Lewis Index = 1.04, Comparative Fit Index = 1.00, Root Mean Square Error of Approximation = .00). Infant health problem and mother's depression had a negative direct effect on marital relationship, which in turn had a direct negative effect on infant abuse. Infant health problems directly affected infant abuse and also influenced infant abuse indirectly through the marital relationship. Mother's depression had significant direct effects on infant abuse and also influenced infant abuse indirectly through the marital relationship. CONCLUSION: The findings from this study demonstrate the fundamental importance of infant health as linked to the mother's mental health, and marital relationship and increasing the quality of marital relationship may be the key to infant abuse prevention.
Adult ; Child Abuse/*psychology/statistics & numerical data ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*psychology ; Female ; *Health Status ; Humans ; Infant ; Infant Welfare/*psychology/statistics & numerical data ; Marriage/*psychology/statistics & numerical data ; Middle Aged ; Models, Psychological ; Mothers/*psychology ; Questionnaires ; Republic of Korea/epidemiology

PURPOSE: This study was conducted to evaluate the effectiveness of a mother/infant-toddler health program developed to enhance parenting knowledge, behavior and confidence in low income mothers and home environment. METHODS: A one-group pretest-posttest quasi-experimental design was used. Sixty-nine dyads of mothers and infant-toddlers (aged 0-36 months) were provided with weekly intervention for seven session. Each session consisted of three parts; first, educating to increase integrated knowledge related to the development of the infant/toddler including nutrition, first aid and home environment; second, counseling to share parenting experience among the mothers and to increase their nurturing confidence; third, playing with the infant/toddler to facilitate attachment-based parenting behavior for the mothers. RESULTS: Following the programs, there were significant increases in parenting knowledge on nutrition and first aid. A significant improvement was found in attachment-based parenting behavior, but not in home safety practice. Nurturing confidence was not significantly increased. The program led to more positive home environment for infant/toddler's health and development. CONCLUSION: The findings provide evidence for mother-infant/toddler health program to improve parenting knowledge, attachment-based parenting behavior and better home environment in low income mothers. Study of the long term effectiveness of this program is recommended for future research.
Adult ; Behavior ; Child, Preschool ; Female ; First Aid ; Health Promotion ; Humans ; Infant ; Infant Welfare ; Infant, Newborn ; Interviews as Topic ; Male ; Mothers/*psychology ; Nutrition Assessment ; Parenting/*psychology ; Poverty ; Program Development ; Program Evaluation ; Self Efficacy

PURPOSE: Mothers' postpartum depression is a worldwide health concern that produces compromising effects on their infants. This study was conducted to compare the infants' temperament and health problems according to the presence of maternal postpartum depression. METHODS: Data were collected from May to October in 2009. The sample was 137 mothers at one month postpartum. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess depressive symptoms. RESULTS: At one month postpartum, 22.6% of mothers were classified as having postpartum depression. Infants of depressed mothers were more frequently classified as difficult temperament infants. They showed lower scores on the amenability, rhythmicity and persistency and higher scores on activity in temperament. Also, infants of depressed mothers reported more infant health problems at one months. Maternal depression showed significant negative correlations with family functioning, social support and marital satisfaction. CONCLUSION: Study findings show that postpartum maternal depression is associated with infants' temperament and health, and thus screening and early interventions for postpartum depression would promote the health of both the mother and infant.
Adult ; Depression, Postpartum/diagnosis/*psychology ; Family Relations ; Female ; Humans ; Infant ; Infant Behavior/*psychology ; Infant Welfare ; Male ; Maternal Behavior/psychology ; Mother-Child Relations ; Mothers/*psychology ; Postpartum Period ; Psychiatric Status Rating Scales ; Questionnaires ; Social Support ; *Temperament ; Time Factors

This study is designed to serve as a reference for the establishment of health security systems for children’s critical diseases. Through analysis of the operation of Shanghai Children Hospital Care Aid (SCHCA), this study explored the financing model and management of a children’s critical disease healthcare system and analyzed the possibility of expanding this system to other areas. It is found that a premium as low as RMB 7 per capita per year under SCHCA can provide high-level security for children’s critical diseases. With the good experience in Shanghai and based on the current basic medical insurance system for urban residents and the new rural cooperative medical scheme (NRCMS), it is necessary and feasible to build a health security system for children’s critical diseases at the national level.
Adolescent ; Child ; Child Welfare ; Child, Preschool ; China ; Delivery of Health Care ; Health Policy ; economics ; legislation & jurisprudence ; Humans ; Infant ; Infant, Newborn

To examine the current state and social ramifications of disability evaluation in Japan, public data from Annual Reports on Health and Welfare 1998-1999 were investigated. All data were analyzed based on the classification of disabilities and the effects of age-appropriate welfare services, which have been developed through a half-century of legislative efforts to support disability evaluation. These data suggest that disability evaluation, while essentially affected by age and impairment factors at a minimum, was impacted more by the assistive environment for disabilities. The assistive environment was found to be closely linked with the welfare support system related to a global assessment in the field of community-based rehabilitation.
Adolescent ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Community Health Services/economics ; *Disability Evaluation ; Disabled Persons/classification/rehabilitation ; Female ; Humans ; Infant ; Infant, Newborn ; Japan ; Male ; Middle Aged ; Social Support ; Social Welfare

INTRODUCTIONIn recent years, acellular pertussis combination vaccines have facilitated compliance with and coverage of the national immunisation programme in Singapore. This phase-II study (Rota-007) evaluated the immunogenicity, reactogenicity and safety of a DTPa-IPV/Hib combined vaccine when co-administered with a rotavirus vaccine.

MATERIALS AND METHODSA total of 2464 children aged 3 months were vaccinated with DTPa-IPV/Hib together with a randomised 1:3 ratio of either placebo (n=653) or 1 of 3 different formulations of a rotavirus vaccine. Blood samples were collected for immunogenicity analysis 1 month after the third DTPa-IPV/Hib vaccine dose in a subset of subjects (n = 640). Local and general reactogenicity and unsolicited adverse events were recorded during the follow-up after each vaccination.

RESULTSSerological analysis showed >95% response for all antigens in the co-administered DTPa-IPV/Hib vaccine, with no difference between the rotavirus vaccine and placebo groups. No differences in adverse events and reactogenicity were reported in the rotavirus vaccine and placebo groups. Only 0.2% of the subjects reported Grade 3 adverse events. Three subjects (from the vaccine groups) died during the study, which were assessed by the investigators as unrelated to vaccination. No deaths were reported in the placebo group.

CONCLUSIONThe combined DTPa- IPV/Hib vaccine is safe, well tolerated and highly immunogenic when given alone or coadministered with the rotavirus vaccine for infants in Singapore.

Child ; Child Welfare ; Child, Preschool ; Double-Blind Method ; Female ; Haemophilus Infections ; immunology ; prevention & control ; Haemophilus influenzae type b ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Compliance ; Poliomyelitis ; prevention & control ; Rotavirus Vaccines ; Singapore ; Vaccines, Combined ; Vaccines, Conjugate ; adverse effects ; immunology

Over the last 40 years newborn screening has been an undoubted success and many thousands of children have been saved from mental retardation and other problems because of early diagnosis of their disorders. Now many diseases can be diagnosed early by newborn screening and many more are on the horizon. It must be a long-term goal to extend newborn screening tests to all children but, in areas of the world where healthcare delivery is insufficient, solving other health problems has to take precedence over introducing newborn screening. If it is decided to introduce newborn screening in a region where currently there is none screening for congenital hypothyroidism alone should be started before anything else at all is attempted so that proper systems can be put in place. There is an exciting future for newborn screening ahead. If new programmes are approached with proper caution maximal benefit will be achieved from newborn screening, which is one of the few clearly effective preventive strategies in healthcare.
Child ; Child Welfare ; Humans ; Infant, Newborn ; Neonatal Screening ; standards