bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal health care provision for refugee women
Authors: Kasper A 
Published: October 2020

Abstract

Background
In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications.
The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany.

Methods
Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews were analyzed following the standards of qualitative thematic analysis.

Results
Maternal health care professionals face challenges in implementing and providing maternal health care concerning their professional practices and interventions. Due to a lack of resources (e.g. translators, time) and other conditions, gynaecologists and midwives are forced to find new solutions that maintain (medical care), adapt (vaginal examination) or miss out on (informed consent) ordinary professional practices.

Key messages
Maternal health care professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers and problems in relationship building. The identification of challenges and opportunities for professionals in maternal health care provision may contribute to improve maternal health (care) for refugee women.
Public private strategy for elimination of congenital transmission of infectious diseases - Argentina
Authors: Castelli J M , Costa A , Wolovich T , Fontana S , Ávila M , Abril M , Gold S , Silvestrini Viola C , Monteverde M , Pereiro A C 
Published: October 2020

Abstract

Problem
Mother-to-child transmission of HIV, Syphilis, Chagas and Hepatitis B constitutes a significant public health issue in Latin America, mostly because of the great morbidity and mortality of these diseases, the social impact of their consequences and the opportunity to eliminate the transmission with timely diagnosis and treatment. Useful strategies to face this mayor problem may be beneficial for the region.

Description of the Problem
The number of newborns with congenital syphilis has been growing all over the region. Moreover, Argentina is the country with the largest affected population with Chagas Disease and, although treatment is very effective during infancy, less than 1% of the infected population accesses the drug. The recurring economic crisis raised the percentage of poverty from 4.6 % in 1974 up to 35.4 % in 2019, thus worsening health determinants and adding new challenges to the healthcare sector. The Framework for Elimination of Mother-to-Child Transmission of HIV, Syphilis, Hepatitis B and Chagas (EMTCT Plus) proposed by the Pan American Health Organization in 2017 was approved by Argentina and is of low complexity. Under this context, the non-governmental organization Mundo Sano Foundation together with the Municipality of Almirante Brown elaborated an intervention model to implement EMTCT Plus in a municipality of Buenos Aires Province.

Results
After two years, 3561 pregnant women were evaluated as well as their babies: 317 were positive for syphilis, 27 were positive for HIV, 25 for Chagas and 3 for Hepatitis B. At the moment, all the newborns were free of the four diseases. The social profitability evaluation was very high.

Lessons
Public-private associations could be an innovative way to deal with some major public health issues. EMTCT Plus is a useful framework for Latin American countries. The social profitability of investments in the elimination of mother to child transmission is very high.

Key messages
Elimination of Mother-to-Child Transmission of HIV, Syphilis, Chagas and Hepatitis B is a useful framework for Latin American countries. The social profitability evaluation was very high. Public-private associations could be an innovative way to deal with some major public health issues.
Determinants related to the risk of using ED among paediatric patients receiving home care services
Authors: Scattaglia M , Campagna S , Politano G , Dalmasso M , Dimonte V , Gianino M 
Published: October 2020

Abstract

Introduction
Pediatric home care services (PHC) are recommended to avoid hospital visits or readmission in children with chronic or complex conditions and to reduce the use of emergency departments. It would be useful to know the association of sociodemographic, clinical and health supply factors with Emergency Department (ED) access by patients receiving PHC.

Methods
A cross sectional retrospective cohort study was held from 2012 to 2017 in Pediatric home care services in Italy. Participants are children aged 0-18 years receiving pediatric home care services. Collected data are: sociodemographic variables (sex, age, presence or absence of an unfamiliar caregiver); distance from the ED in minutes; clinical variables (mortality rate at home, mortality rate in the ED, pathology responsible for the PHC activation and pathology determining the ED access); health supply variables (PHC proposed duration as stated by the proponent, subjects directing the patient to the ED, place of discharge after ED access, and arrival time to the ED).

Results
A total of 1236 PHC events contributed to 769 ED accesses. Receiving PHC services after hospital discharge (RR:1.26) and longer duration of charge-taking significantly increased the risk of experiencing ED access. The RR significantly decreased among children &gt;5 years-of-age (RR:0.84; RR:0.62; RR;0.57; in 5-9; 10-14; 15-18 years respectively) and among children with neoplastic (RR:0.7), respiratory (RR:0.69), trauma (RR:0.4) or musculoskeletal diseases (RR:0.31) at first evaluation.

Conclusions
Confirming that ED accesses are issue present among children receiving home care services, this study has the main strength of demonstrating which risk factors are associated with ED accesses by children using home care services. Knowledge of them is necessary in order to implement adequate prevention strategies on both management and quality of care.

Key messages
Determinants associated with the risk of using emergency departments among paediatric patients receiving integrated paediatric home care services. ED visit is shown to be an issue among children receiving PHC and some determinants emerged as associated with ED visits by children in PHC.
Sexual dating violence victimization and adolescent psychological distress in Rio de Janeiro, Brazil
Authors: Faus D , de Moraes C L , Castro M C , Keefe-Oates B , Reichenheim M E , Taquette S 
Published: October 2020

Abstract

Background
Studies from high income countries showed physical and psychological dating violence associated with poor mental health (MH) outcomes, including depressive symptoms and suicide attempts. However, sexual dating violence (SDV) has received less attention, especially in low middle-income countries like Brazil. This study investigated the prevalence and the effect of SDV victimization on MH in adolescent students from Rio de Janeiro, Brazil.

Methods
This is a school-based study comprising 550 students enrolled in 13 high schools. Only adolescents reporting at least one romantic relationship in the prior twelve months were eligible. SDV and MH were measured using the Conflict in Adolescent Dating Relationships Inventory (CADRI) and General Health Questionnaire (GHQ-12), respectively. Frequency of SDV was assessed in the aggregate and by specific sociodemographic subgroups. Multivariate logistic models were employed to study the relationship between SDV victimization and MH status. Direct Acyclic Graphs steared the covariates selection process: skin color, maternal education, history of child sexual abuse, and sex.

Results
The prevalence of SDV victimization experienced over the last 12 months was 16.5%. SDV victimization was a significant risk factor for MH problems (OR = 2.04; 95%CI: 1.01 - 4.15).

Conclusions
The high prevalence of SDV among students in the sample was striking. Its relationship with psychological suffering highlights the importance of involving schools and health services in actions aimed at reducing all forms of SDV and at mitigating its consequences. The findings also indicate that mental health professionals should regurlarly investigate SDV victimization among adolescents reporting MH symptoms.

Key messages
Rio de Janeiro schools and health services need to join efforts to develop and implement actions aimed at the prevention of sexual dating violence. Health professionals might investigate if adolescents with psychological distress are also victims of sexual dating violence.
Intersectoral collaboration to promote child development: mapping the relationships
Authors: Chiari A P G , Soares A R S , Cury G C , Alves C R L , Senna M I B , Ferreira R C 
Published: October 2020

Abstract
Integrated and intersectoral interventions early in life have the greatest potential to address social inequities, ensuring better opportunities for access to child development support services. The “Projeto Nascente” (Universidade Federal de Minas Gerais and Ministry of Health, Brazil) sought to qualify health and other sectors professionals in actions to promote and monitor early child development, in primary health care. One of its focuses was to stimulate the intersectoral actions to promote child development. The research analyzed the intersectoral network in 31 municipalities in the State of Minas Gerais, Brazil, participating in the 'Projeto Nascente'.
A case study with a qualitative approach was developed using document research on the professionals' perception regarding intersectoral networking. The material was ecomaps elaborated by professionals during the training of the “Projeto Nascente”. The ecomaps represented the local intersectoral networks.
Initially, 29 ecomaps from eleven municipalities were analyzed. Social Protection, Education, Sports, Culture, churches and non-governmental organizations were cited. Other health services were also included. All ecomaps were represented with the family health team in a central position with the other services around them. In municipalities with more than one ecomap, there was no uniformity neither in the services nor in the quality of the relationships represented.
A closer relationship between Education and Social Protection was noticed. However, the quality of the relationships often seemed stressful. Health professionals reported that they invest more energy in relationships than other sectors. Sport and Culture, although less mentioned, seem to be potential partners for new collaborations. The emergence of other health services seems to reflect the fragmentation of the health sector, as well as evidence of the conceptual confusion surrounding intersectoral collaboration.

Key messages
The identification and mapping of the services networking aimed at promoting child development are essential steps in the process of stimulating and reflecting on intersectoral collaboration. The centrality and self-perceived protagonism of the health professionals may not be the best way to involve and count on the participation of other sectors in intersectoral collaboration.
An assessment of the Armenian national midwifery curriculum as per international standards
Authors: Aslanyan L , Sahakyan S , Petrosyan V 
Published: October 2020

Abstract

Background
Literature suggests increasing evidence that incompetent midwifery education results in poor quality of care. The study compared and evaluated the level of compliance of the Armenian national criterion on midwifery with the global competency standards and developed recommendations for improvement.

Methods
The study team conducted a document review using a standardized checklist, which was adapted from the International Confederation of Midwives (ICM) core assessment tools. The document review explored if the main knowledge and skills/ability related elements of each ICM competency were separately covered by different modules of the national criterion using a scoring system with categories: not met, partially met, fully met and unspecified.

Results
Although the national criterion did not have specifically defined competencies, most of the elements required by the ICM were present as specific learning outcomes under different modules of the criterion. Midwifery program curriculum was described as intensive with unnecessarily heavy workload. Additionally, the document review reviled that most of the learning outcome defined in modules of the national criterion focused more on theoretical knowledge rather than practical skills and abilities. Overall, the ICM required competency in provision of care during pregnancy was the most comprehensively covered one in the national criterion, while the competency in facilitation of abortion related care was the lowest covered. National criterion did not highlight the importance of topics such as women's rights and health, principles of epidemiology, statistical methods of research, cultural, local and ethical beliefs.

Conclusions
The systematic comparison of the national criterion with internationally recognized essential competencies demonstrates significant gaps. The study team recommends revisions to the national criterion to make it competency based.

Key messages
Midwifery education criteria in Armenia did not reflect internationally accepted midwifery competency’s fundamental philosophy and values. Given the shortcomings of the current national midwifery education criterion, a comprehensive revision of the competencies of midwives in Armenia should be considered.
Predicting postpartum mothers' intention for vaccinating their infants
Authors: Bord S , Satran C , Schor A , Offer M , Ohana N , Sagi S 
Published: October 2020

Abstract

Background
Vaccines are administered for free in Israel. Yet, despite experts' agreement that vaccinations are important, some parents choose not to vaccinate their children - in part due to lack of trust in the health system. This study examines factors that predict mothers' intention to vaccinate their infants as per recommendations of the Israeli Ministry of Health.

Methods
The study included 344 women in a maternity ward of a hospital in northern Israel. After receiving approval from the Helsinki Commission, and with the mothers' consent, data were collected through a self-administrated questionnaire, from June to September 2019.

Results
Participants were aged 19-47 (M = 30.77), 96% were married, and 70% had 1-2 children. About 78% reported that their children had been vaccinated for hepatitis B upon birth and had received vitamin K by injection. About 20% did not know if their newborns had received the injection and vaccination, meaning that they probably did as part of the hospital routine. Only 1.5-3% of the mothers said they would vaccinate their child later or not at all. Overall, the mothers' intention to vaccinate their infants was high (4.33 on a 1-5 scale). A hierarchical linear regression model for predicting mothers' intentions to vaccinate their infants was significant, explaining 36% of the variance. Factors that predict mothers' intentions to vaccinate their infants as recommended include mothers' adherence to the pertussis vaccination administration during their pregnancy (P = 0.037), lower trust in non-medical factors (P &lt; 0.001), and positive attitudes (P &lt; 0.001), and subjective norms (P &lt; 0.001) regarding vaccinating their infants.

Conclusions
Mothers' adherence to vaccinations during pregnancy could help identify at-risk populations. Interventions for encouraging vaccinations should focus on information sources and levels of trust, as trust in authoritative sources could assist in shaping attitudes and create a supportive environment for vaccinations.

Key messages
Mothers' adherence to vaccinations during pregnancy could help identify at-risk populations. Lower trust in non-medical factors, positive attitudes, and subjective norms are important predictors of mothers' intention for vaccinating their newborns.
Triage in Preventive Child Healthcare: A novel triage protocol to identify health problems
Authors: Theunissen M 
Published: October 2020

Abstract

Background
A triage approach to routine health assessments was introduced to improve the efficiency of Preventive Child Healthcare (PCH): PCH assistants carry out pre-assessments of all children and send the children with suspected health problems to follow-up assessments conducted by a physician or nurse. Each PCH service use their own protocol (with health themes such as visuals disorders, sleeping- and psychosocial problems) to determine whether a follow-up assessment is needed. In this study a novel standardized triage protocol was developed. The aim was to improve the quality of detection of health problems in primary school children by PCH by investigating the quality of detection of health problems and satisfaction of this novel triage protocol.

Methods
We included 459 primary school children undergoing routine health assessments in 2 PCH services across the Netherlands. We used parent-reported child problems and PCH registry data. After each assessment PCH professionals reported whether they had identified any problems and carried out any additional actions (e.g., additional assessments, referral). The validity of the protocol is assessed, with problems identified by PCH professionals and performing additional actions as criteria.

Results
Results showed that the psychometric properties of the novel triage protocol were moderate to good. Sensitivity (true positives) and specificity (true negatives) for the novel triage protocol were 0.73 and 0.62, respectively for the identification of any problems, and were 0.91 and 0.41, respectively, for additional PCH actions.

Conclusions
The novel triage protocol is a valid tool for the detection of health problem in primary school children by PCH. Few children with health problems were missed. Professionals and parents were very satisfied with the novel protocol. Professionals made specific recommendations about adaptations of the protocol to improve efficiency and facilitate implementation in daily PCH practice.

Key messages
The novel triage protocol is a valid tool for the detection of health problem in primary school children. For optimal implementation in preventive child healthcare the novel triage protocol needs some minor adaptations.
Planned teenage pregnancy: a sociocultural health problem that lead to a local intervention
Authors: Carmona A , Paixão M , Silva A 
Published: October 2020

Abstract
According to data from the National Statistics Institute (2018), Portugal was the country with the second highest birth rate in the European Union in mothers between 15 and 19 years old. This number of births may be influenced by ethnic-cultural issues, such as acceptance and encouragement of marriage and early motherhood, especially in some African ethnic-cultural groups. Our public health unit is located in Amadora, a suburban area of the Portuguese capital with a high percentage of migrants, a high rate of teenage pregnancies and economically deprived areas.
The aim of our research was to understand beliefs and values in both native and migrant girls regarding motherhood in order to better tailor interventions aiming to prevent teenage pregnancy.
We interviewed fifteen participants, seven migrants and eight natives, who were or had been teenage mothers. The participants were selected through non-probabilistic snowball sampling. Afterwards, we performed a qualitative content analysis.
Overall, we found no difference between the 2 groups of participants with most, 12, having wished for their pregnancies. The social and religious framing of fertility as a gift was often stated. The housing context was also mentioned given several participants lived in overcrowded houses with poor conditions and believed pregnancy could have provided a way out of their living situation. Low education and poor job prospects were also mentioned as pregnancy was framed as a “life project” in the absence of a career prospect.
We found evidence of a “social and cultural pregnancy” not related to certain migrant cultures but associated with a “neighbourhood” culture associated with economic deprivation. As such, we are now implementing a pilot study within the community, by creating regular group sessions to discuss the meaning and impact of motherhood to try to capacitate girls to find a different life project other than choosing pregnancy during teenage years.

Key messages
Teenage pregnancy can be planned who use it to try to find a life project, be accepted within their community and escape their daily conditions. Public health interventions aiming to prevent teenage pregnancies should acknowledge social and cultural factors that encourage these pregnancies.
Do primary healthcare providers have the competency of providing adolescent-friendly health services?
Authors: Grigoryan Z , Hayrumyan V , Sargsyan Z , Petrosyan V 
Published: October 2020

Abstract

Background
Investment in adolescents' health is one of the most rewarding efforts for meeting the Sustainable Development Goals. The national standard on state assured free-of-charge services defines the minimum requirements of adolescent-friendly healthcare services (AFHS) in primary healthcare facilities (PHCFs); however, services for adolescents are highly inconsistent in terms of quality and coordination. We aimed to assess the PHC providers' (PHPs) capacity to provide AFHS in PHC facilities in Armenia.

Methods
A qualitative cross-sectional study through in-depth interviews and focus-group discussions was conducted in two biggest cities of Armenia. Overall, six focus group discussions and 16 in-depth interviews were conducted with adolescents (18 and 19 years old), PHPs, managers of PHCFs, and experts in adolescent health. Eight PHC facilities were chosen for conducting observations. The WHO Global standards for quality health-care services for adolescents guided the deductive content analysis.

Results
PHPs' capacity to provide AFHS in assessed PHCFs was not satisfactory. PHPs did not know the specific age range of adolescence and the content of AFHS in the national standard. PHPs perceived friendliness of services as welcoming and good attitude. Facility managers and most PHPs did not participate in professional education activities to advance their expertise in adolescent health. Experts concluded that services provided to adolescents were not “friendly” and PHPs did not have appropriate competencies. However, PHPs' had the opposite opinion - they were confident in their knowledge and skills to work with adolescents. Adolescents complained that PHPs did not provide explanations for provided services and lacked appropriate communication skills.

Conclusions
The PHCFs have formal grounds to provide AFHS, however lack of appropriate competencies among PHPs and managers of PHCs hinder advancement of AFHS.

Key messages
Qualitative findings suggest that visited PHCFs fail to appropriately implement AFHS as guided by the national standard. Provision of AFHS can be promoted in PHCFs through strengthening PHPs' competencies via continuous professional development activities.