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

Pregnant women are prioritized to receive influenza vaccination. However, the maternal influenza vaccination rate has been low in Korea. To identify potential barriers for the vaccination of pregnant women against influenza, a survey using a questionnaire on the perceptions and attitudes about maternal influenza vaccination was applied to Korean obstetricians between May and August of 2014. A total of 473 respondents participated in the survey. Most respondents (94.8%, 442/466) recognized that influenza vaccination was required for pregnant women. In addition, 92.8% (410/442) respondents knew that the incidence of adverse events following influenza vaccination is not different between pregnant and non-pregnant women. However, 26.5% (124/468) obstetricians strongly recommended influenza vaccination to pregnant women. The concern about adverse events following influenza vaccination was considered as a major barrier for the promotion of maternal influenza vaccination by healthcare providers. Providing professional information and education about maternal influenza vaccination will enhance the perception of obstetricians about influenza vaccination to pregnant women and will be helpful to improve maternal influenza vaccination coverage in Korea.
Asian Continental Ancestry Group ; Cross-Sectional Studies ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Influenza Vaccines/*immunology ; Influenza, Human/*prevention & control ; Maternal Welfare ; *Perception ; Physicians/*psychology ; Pregnancy ; Pregnant Women ; Republic of Korea ; Surveys and Questionnaires ; Vaccination

Postpartum visits (PPVs) are still underutilized in rural China, and identification of factors that influence PPV use is important in ensuring the utilization of maternal health services and for wellbeing of women. A cross-section study was undertaken to collect related data from 347 rural women interviewed six weeks or more after delivery, and an ANOVA was performed to find whether there were significant differences in the number of PPVs among different rural areas in China. According to Andersen's socio-behavioral model of health service use, factors were divided into equitable and inequitable ones. Chi-squared test, univariate and multiple analyses were used to determine the equity of PPV use by identifying factors that were most strongly associated with the use of a PPV. The results showed that 20.2% of the respondents (n=70) did not receive any PPVs, and 62.5% (n=173) of those who had PPVs (n=277) did not receive standard PPVs (referring to at least 3 visits). There was no significant difference among different rural areas in terms of the number of PPVs (F=1.514, P=0.211). Multiple regression analyses revealed that enabling factors such as compensation for delivery expense [OR (95% CI)=2.825 (1.331, 5.995)], village type [OR (95% CI)=1.802 (1.021, 3.182)] and service quality [OR (95% CI)=1.847 (1.074, 3.176)] were strongly associated with PPV use. Both enabling factors such as home visits [OR (95% CI)=1.855 (1.085, 3.174)], service quality [OR (95% CI)=1.993 (1.155, 3.439)] and need factors such as low birth weight [OR (95% CI)=4.424 (1.482, 13.203)] were significantly associated with standard PPV use. Our results suggested that the equitable access to PPVs has been considerably improved in rural areas in China. The associations between inequitable factors and PPV use warrant further exploration, and policies aimed at improving quality and patterns of service supply are needed in order to ensure a full equitable access to maternal health services.
Adult ; Ambulatory Care ; China ; Female ; Health Services Accessibility ; Humans ; Maternal Welfare ; Postnatal Care ; Postpartum Period ; Quality of Health Care ; Rural Population ; Social Planning

Indian Muslims, compared to their counterparts from other religions, lag behind on several yardsticks related to socioeconomic progress and the same is true with maternal health care utilization. Due to low age at marriage among Muslims, a majority of births is ascribed to young (15-24 years) mothers, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literatures on Muslim women’s maternal health care reveals that the research on the determinants of maternal health care utilization among Muslim women is almost absent. Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators [Full Antenatal Care (ANC), safe delivery and Postnatal Care (PNC)] among YMMW (15-24 years) in India. Bi-variate analysis and chi-square test was applied and variables which were found to be significant were further included in binary logistic regression. The findings of the study reveal abysmally low levels of utilization for all three indicators of maternal health care i.e. full ANC, safe delivery and PNC. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. The study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW. Existing government policies and programs should integrate YMMW who are poor and belong to backward states with poor demographic indicators.​
Women ; Islam ; Adolescent ; Young Adult ; Maternal Welfare ; India

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

In medicine, it is the physician's obligation to promote and protect the patient's interest. In obstetrics, the ethical principles of beneficence and autonomy provide the fundamental framework which guides the management of all pregnant patients. As there is the need for consideration of the fetus, autonomy can become a complex issue giving rise to what is sometimes called "maternal-fetal conflict." In this paper, we aim to discuss some scenarios we encounter in our day-to-day obstetric practice such as pre-eclampsia, fetal growth restriction and labour induction when the best interests of the mother and fetus may be conflicted. We hope to illustrate that logical consideration for maternal and fetal best interests is only possible when there is adequate knowledge to support clinical practice. Certainly, with the rapid availability of newer knowledge and technology, it is the duty of the physician to be educated continuously so as to protect the patient from harm.
Beneficence ; Clinical Competence ; Conflict (Psychology) ; Ethics, Medical ; Female ; Fetal Growth Retardation ; Fetus ; Health Knowledge, Attitudes, Practice ; Humans ; Maternal Welfare ; Maternal-Fetal Relations ; Obstetrics ; ethics ; methods ; Patient Care ; ethics ; Patient Rights ; Personal Autonomy ; Physician-Patient Relations ; ethics ; Pregnancy ; Pregnancy Complications ; Prenatal Diagnosis

INTRODUCTIONBreast milk fatty acids play a major role in infant development. However, no data have compared the breast milk composition of different ethnic groups living in the same environment. We aimed to (i) investigate breast milk fatty acid composition of three ethnic groups in Singapore and (ii) determine dietary fatty acid patterns in these groups and any association with breast milk fatty acid composition.

MATERIALS AND METHODSThis was a prospective study conducted at a tertiary hospital in Singapore. Healthy pregnant women with the intention to breastfeed were recruited. Diet profile was studied using a standard validated 3-day food diary. Breast milk was collected from mothers at 1 to 2 weeks and 6 to 8 weeks postnatally. Agilent gas chromatograph (6870N) equipped with a mass spectrometer (5975) and an automatic liquid sampler (ALS) system with a split mode was used for analysis.

RESULTSSeventy-two breast milk samples were obtained from 52 subjects. Analysis showed that breast milk ETA (Eicosatetraenoic acid) and ETA:EA (Eicosatrienoic acid) ratio were significantly different among the races (P = 0.031 and P = 0.020), with ETA being the highest among Indians and the lowest among Malays. Docosahexaenoic acid was significantly higher among Chinese compared to Indians and Malays. No difference was demonstrated in n3 and n6 levels in the food diet analysis among the 3 ethnic groups.

CONCLUSIONSDifferences exist in breast milk fatty acid composition in different ethnic groups in the same region, although no difference was demonstrated in the diet analysis. Factors other than maternal diet may play a role in breast milk fatty acid composition.

Arachidonic Acids ; metabolism ; Breast Feeding ; ethnology ; Diet ; Diet Records ; Docosahexaenoic Acids ; metabolism ; Eicosapentaenoic Acid ; metabolism ; Ethnic Groups ; Fatty Acids ; metabolism ; Female ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Maternal Welfare ; Milk, Human ; chemistry ; Nutritional Status ; Pregnancy ; Prenatal Nutritional Physiological Phenomena ; Prospective Studies ; Singapore ; Statistics, Nonparametric

Child ; Child Welfare ; trends ; Delivery of Health Care ; trends ; Humans ; Maternal Welfare ; trends ; Pediatrics ; methods ; trends ; Physician's Role ; Singapore

Background: Lang Son is a north mountianous province in Vietnam with population 727.081. It\u2019s residents belong to 8 ethnic minorities. Because their living conditions and education level is still low, they have limited access to new techniques to improve their living conditions, especially their health. In addtion, some districts in the province have to confront drug evil and HIV/AIDS epidemic. Objective: To define the current situation of maternal and child health care, reproductive health, HIV/AIDS and sexual transmissiondiseases prevention and offer interventional measures. Subjects and method: A cross-sectional, retrospective study was conducted in health workers and patients at the 4 commune health stations in Huu Lung and Chi Lang district on October/2004.Results and Conclusion: Termination of water and sanitation cause some diseases of mothers and children. Knowledge of people about pregnancy care as well as maternal and child health care are limited (32.2/12.6% pregnancy at labors in both districts has not been supported by trained attendance. In whole province, 32.6% children under 5 year older have malnutrition). Knowledge and practice of people on safe sex are limited so they might expose to HIV/AIDS, unwanted pregnancy and sexual transmission diseases.
Child Welfare/ psychology ; Maternal Welfare/ psychology ; Reproductive Medicine/ manpower ; methods ; HIV

Child health care and family planning service in Soc Son has been implementing very well. Even though there are different kind of contraceptives have been introduced, number of IUD users account for 69% of total couples using at least one contraceptive method account for 74.3%. Acces to the above mentiones health care services was convinient and meet the needs when require.
Delivery of Health Care ; Maternal Health Services ; Maternal Welfare ; Family Planning Services