OBJECTIVES: Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.METHODS: This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.RESULTS: Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.CONCLUSIONS: Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.
Child Health ; Child ; Conservation of Natural Resources ; Family Planning Services ; Growth Disorders ; Hepatitis B ; Human Development ; Humans ; Incidence ; Iran ; Maternal Health ; Maternal Mortality ; Mediterranean Region ; Parturition ; Vaccination

Several studies have reported adequate patient transfer to higher level hospitals according to the risk for improving perinatal outcomes. According to these reports, countries across the world divide the levels of maternal care on the basis of the assessment of hospital facilities and medical services as well as the assessment of high-risk pregnancies while evaluating the cases of and risks associated with maternal care that can be addressed by these hospitals at each level. Because the level of and policies on maternal care vary across countries, we aimed to evaluate risk assessments and introduction of treatment facility classifications in different countries. In Korea, birth rate is declining and the number of elderly pregnant women is increasing, whereas the number of hospitals that can deliver a baby and care for mothers at high risk is decreasing. We, therefore, need to establish an infrastructure for medically vulnerable areas, a localization center, and a medical personnel supplement. Moreover, establishing detailed guidelines and criteria for different levels of maternal care is necessary. The new guidelines will also need to supplement the policies on the requirement of well-trained obstetricians and of low medical insurance fee.
Aged ; Birth Rate ; Classification ; Fees and Charges ; Female ; Humans ; Insurance ; Korea ; Maternal-Child Health Services ; Mothers ; Patient Transfer ; Pregnancy, High-Risk ; Pregnant Women ; Prenatal Care ; Risk Assessment

OBJECTIVES: The aim of this study is to demonstrate how an integrated information system of mother and toddler cohorts can be developed as a basis of the continuum of care approach that subsequently can be used as the basis of early detection of risk factors of maternal mortality. METHODS: This research was carried out qualitatively. The data was collected through three techniques: in-depth interviews, focus group discussion, and document studies at six public health centers located in four sub-districts of Surabaya, Indonesia. This research was conducted from 2016 to 2018. RESULTS: The data collected from this research has become a basis input data requirement analysis for an integrated mother and toddler cohort information system. The system accommodates all the variables in each period of pre-marriage, pregnancy, labor, infancy and toddlerhood. The system facilitates healthcare workers to retrieve data and information related to mother and toddler health status. CONCLUSIONS: The availability of various pieces of information enables the health status of mothers and toddlers to be monitored thoroughly throughout their long-life cycle. This continuum of care approach is beneficial in the early detection and management of risk factors of maternal mortality, such as pregnancy complications as well as childbirth and postpartum complications.
Cohort Studies ; Continuity of Patient Care ; Delivery of Health Care ; Focus Groups ; Humans ; Indonesia ; Information Systems ; Maternal Mortality ; Maternal-Child Health Services ; Mothers ; Parturition ; Postpartum Period ; Pregnancy ; Pregnancy Complications ; Public Health ; Risk Factors

Cohort study is an irreplaceable method for studies related to maternal and child health. Compared with other countries, China's maternal and child cohort studies started relatively later but has its unique developing track. This paper summarizes the basic information and characteristics of the maternal and child cohorts with wide and great influence in China in the past 25 years.
Child ; Child Health ; Child Health Services/organization & administration* ; China ; Cohort Studies ; Humans ; Maternal Health ; Maternal Health Services/organization & administration*

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

PURPOSE: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. METHODS: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. RESULTS: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. CONCLUSION: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.
Child ; Communication Barriers ; Delivery of Health Care* ; Emigrants and Immigrants ; Female ; Health Services Accessibility ; Humans ; Immersion ; Infant ; Korea* ; Literacy ; Maternal-Child Health Services ; Mothers* ; Parturition ; Pregnancy ; Refugees* ; Social Identification ; Socioeconomic Factors ; Statistics as Topic

Korea is one of the countries where the fertility rates are very low. Non-marriage and delayed marriage result in the high risk pregnancy. The high risk pregnancy increases the birth rate of the high risk newborn, causing the recent increase in the number of preterm infants. The high risk newborn should be treated in the neonatal intensive care unit. After discharge, the specific follow-up program should be continued until 2~3 years of age. The burden of the costs of high risk newborn plays a substantial role in the low fertility rate in Korea. The government should analyse the current maternal child health service system in the country. After a critical review, more specified support should be given to the family whose high risk newborn should be cared properly.
Birth Rate ; Child ; Child Health Services ; Follow-Up Studies ; Health Policy ; Humans ; Infant, Newborn* ; Infant, Premature ; Intensive Care, Neonatal ; Korea* ; Marriage ; Maternal-Child Health Services* ; Pregnancy, High-Risk

The Government of North Korea with WHO proposed the improvement of healthcare for mothers and children as the second-highest priority for North Korea in 2009. The maternal mortality ratio in North Korea was 76 per 100,000 live birth in 2012, almost seven times higher than that of South Korea. The leading cause of maternal death was postpartum hemorrhage, which accounted for 33 percent of all mothers' deaths. Postpartum hemorrhage is indeed a life-threatening crisis that requires a well-established emergency obstetric care (EmOC) system including safe blood. The rate of children under the age of five with chronic malnutrition stood at 27.9 percent in 2012. Infant malnutrition was more prevalent after the first six months of life, with the rate reaching a peak of 36.8 percent at 24 months of age. The proportion of chronic malnutrition was lowest in Pyongyang, at 19.6 percent, and second-lowest in South Phyongan, at 25.8 percent. On the other hand, the proportion was the highest in the three provinces of Ryanggang, Jagang and South Hamgyong at 39.6 percent, 33.4 percent, and 32.9 percent, respectively. Lack of food security has led to a high prevalence of malnutrition. The mortality rate of children under the age of five was 25 per 1,000 live birth in 2014. Of the North Korean children who die under the age of five, 51 percent died within first four weeks of their birth in 2010. Of these, 40 percent was born low birth weight (less than 2,500 grams at birth), indicating the severity of malnutrition in mothers. Therefore this paper suggests strategies approach to improve the quality of the population for the next generation unified the Korean peninsula for future initiatives. First, we need to develop of strategies and actions for reducing geographical disparity in access to maternal and child health services in North Korea. Second, we have to introduce a 'Mother and Child 1,000-Day Project' to reduce undernutrition among mothers and children in the first 1,000 days of a child's life, from conception to two years old. Third, it is desirable to adopt a policy on access to primary health care to build local governance.
Child Health Services ; Child Health* ; Child* ; Delivery of Health Care ; Democratic People's Republic of Korea* ; Emergencies ; Fertilization ; Food Supply ; Hand ; Humans ; Infant ; Infant Mortality ; Infant Nutrition Disorders ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Live Birth ; Malnutrition ; Maternal Death ; Maternal Mortality ; Mortality ; Mothers ; Parturition ; Postpartum Hemorrhage ; Prevalence ; Primary Health Care

OBJECTIVETo analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province.

METHODSIn 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze.

RESULTSIn the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001).

CONCLUSIONThere were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.

Child ; China ; Ethnic Groups ; Family ; Female ; Health Behavior ; ethnology ; Humans ; Infant ; Maternal Health ; ethnology ; Maternal Health Services ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Rural Population

PURPOSE: The purpose of this study was to identify effects of a maternal-child health education program for nurses in Tigray, Ethiopia. METHODS: One-group pre-posttest design was used. The maternal-child health (MCH) education program was given to nurses from 5 health centers in Tigray, Ethiopia. Knowledge and confidence levels were measured before and after each education session. Data were analyzed using paired t-test. RESULTS: The topics of the 5 educational sessions were family planning, antenatal care, care during labor, immunization, and integrated management of neonate, and child illness. Knowledge scores (1st: Z=3.931, p=.001; 2nd: Z=6.189, p<.001; 3rd: Z=5.658, .001, 4th: Z=8.734, .001, 5th: Z=14.167, .001) and confidence levels (1st: Z=8.467, .001; 2nd: Z=4.183, .001; 3rd: Z=4.992, .001) improved significantly. CONCLUSION: The findings of this study imply that the MCH education program for nurses was effective in developing the maternal-child health capacity of the nurses in Tigray, Ethiopia.
Child ; Education ; Education, Nursing ; Ethiopia* ; Family Planning Services ; Health Education* ; Humans ; Immunization ; Infant, Newborn ; Maternal Health Services