Mortalidade infantil por causas evitáveis: perfil epidemiológico e tendencial em um município de médio porte da região oeste do Paraná, 2011-2021 / Infant mortality from preventable causes: epidemiological and trend profile in a medium-sized municipality in the western Paraná region, 2011-2021 / Mortalidad infantil por causas prevenibles: perfil epidemiológico y tendencia en un municipio de tamaño medio de la región oeste del Paraná, 2011-2021

Objetivo: analisar o perfil epidemiológico e a tendência da mortalidade infantil por causas evitáveis em Fazenda Rio Grande/PR, de 2011 a 2021. Método: realizou-se um estudo de série temporal com dados obtidos dos Sistemas de Informações de Mortalidade e Nascidos Vivos. As taxas de mortalidade foram calculadas segundo categorias: neonatal precoce; tardia e pós-neonatal; evitáveis e não evitáveis; e reduzíveis por adequada atenção à mãe e neonato, com avaliação de tendência por regressão linear de Prais-Winsten. Resultados: As maiores proporções de óbitos evitáveis, foram por inadequada atenção à mulher no parto (36,5%), à mulher na gestação (26,8%), e ao recém- nascido (16%). Observou-se redução percentual nos coeficientes de óbitos gerais (ß = - 0,32; IC95% -0,91;0,68) e por causas evitáveis (ß = -0,74; IC95% -0,98;0,50), mesmo não havendo significância estatística nos resultados relativos às tendências (p ≥ 0,05). Conclusão: A partir dos resultados obtidos, Constatou-se a necessidade de intervenções voltadas ao cuidado materno-infantil, essencialmente na atenção à mulher no pré-natal e no parto e ao neonato, visto que constituem percentuais expressivos dentre as causas de morte evitáveis. A redução da mortalidade infantil é um desafio global para os serviços de saúde e sociedade como um todo. Sua análise permite incorporar o uso de informação qualificada no planejamento e avaliação de ações e políticas públicas voltadas à saúde materno-infantil, tal como, embasar novos estudos, fundamentais para alicerçar a avaliação crítica da prática em relação aos achados de pesquisa e promover mudanças baseadas em evidências.

Objective: to analyze the epidemiological profile and the trend of infant mortality from preventable causes in Fazenda Rio Grande/PR, from 2011 to 2021. Method: a time-series study was conducted with data obtained from the Mortality and Live Births Information Systems. Mortality rates were calculated according to categories: early neonatal; late and post-neonatal; preventable and non-preventable; and reduceable by adequate attention to the mother and neonate, with trend evaluation by Prais-Winsten linear regression. Results: The highest proportions of avoidable deaths, were due to inadequate care of the woman in childbirth (36.5%), the woman in pregnancy (26.8%), and the newborn (16%). There was a percentage reduction in the coefficients of general deaths (ß = -0.32; 95%CI -0.91;0.68) and by preventable causes (ß = -0.74; 95%CI - 0.98;0.50), even though there was no statistical significance in the results regarding trends (p ≥ 0.05). Conclusion: From the results obtained, there was a need for interventions aimed at maternal and child care, especially in the care of women in prenatal and childbirth and neonates, since they constitute significant percentages among the causes of preventable death. The reduction of infant mortality is a global challenge for health services and society as a whole. Its analysis allows us to incorporate the use of qualified information in the planning and evaluation of actions and public policies aimed at maternal and child health, as well as to support new studies, which are essential to support the critical evaluation of the practice in relation to research findings and to promote evidence-based changes.

Objetivo: analizar el perfil epidemiológico y la tendencia de la mortalidad infantil por causas evitables en Fazenda Rio Grande/PR, de 2011 a 2021. Material y método: se realizó un estudio de series temporales con datos obtenidos de los Sistemas de Información de Mortalidad y Nacidos Vivos. Se calcularon las tasas de mortalidad según las categorías: neonatal precoz; neonatal tardía y posneonatal; prevenible y no prevenible; y reducible por atención adecuada a la madre y al neonato, con evaluación de la tendencia por regresión lineal de Prais-Winsten. Resultados: Las mayores proporciones de muertes evitables, se debieron a la inadecuada atención a la mujer en el parto (36,5%), a la mujer en el embarazo (26,8%) y al recién nacido (16%). Hubo una reducción porcentual en los coeficientes de muertes generales (ß = -0,32; IC 95% -0,91;0,68) y por causas evitables (ß = -0,74; IC 95% -0,98;0,50), aunque no hubo significación estadística en los resultados en cuanto a tendencias (p ≥ 0,05). Conclusiones: De los resultados obtenidos se desprende la necesidad de intervenciones dirigidas a la atención materno- infantil, especialmente en la atención de la mujer en el prenatal y parto y de los neonatos, ya que constituyen porcentajes significativos entre las causas de muerte prevenible. La reducción de la mortalidad infantil es un reto global para los servicios de salud y la sociedad en su conjunto. Su análisis permite incorporar el uso de información cualificada en la planificación y evaluación de acciones y políticas públicas dirigidas a la salud materno-infantil, así como apoyar nuevos estudios, que son esenciales para apoyar la evaluación crítica de la práctica en relación con los resultados de la investigación y promover cambios basados en la evidencia.

Investigation and analysis of on-the-job training of health technicians in maternal and child care institutions / 中华医学教育探索杂志

Objective:To analyze the current situation and requirements of education for health technicians in maternal and child health care institutions, and put forward feasible strategies and measures to improve the comprehensive quality and professional level of the talent team of maternal and child health care institutions.Methods:Questionnaire survey was carried out on education needs of health technical staff of 11 maternal and child health care hospitals in 4 provinces (regions), and provincial, municipal and district-level medical institutions. The survey results were recorded by Epidata 3.1. SPSS 22.0 software was used for statistical analysis.Results:A total of 1 678 questionnaires were included in the analysis. A total of 1 313 people received training, accounting for 78.2%. The main reason for not receiving training was that the unit didn't arrange (180 people), accounting for 49.3%(180/365). There were 779 people who had more than 3 days of training, accounting for 59.3%. There were 384 people who were trained in superior general hospitals, accounting for 29.2%, and 268 people were trained in superior maternal and child health institutions, accounting for 20.4%. There were 837 people who learned the content of new professional progress, accounting for 50.8%(837/1 648). According to the interview, there were still some requirements for thematic training, further education, online learning, continuing education and standardized training.Conclusion:Maternal and child health care institutions have accelerated the construction of professional personnel, intensified training, and thoroughly implemented health personnel training programs, established a long-term mechanism, increased funding, improved training content, ensured the quality of training, and made a good job in hierarchical training to meet the learning needs of personnel at all levels. This is of great significance for strengthening the technical personnel of maternal and child health care institutions and improving their service capacity.

Service quality dimensions regarding maternal and child health-care provided to the beneficiaries attending a Nagrik Hospital Rohtak Haryana

Background: Understanding service quality dimensions regarding maternal and child health (MCH) care are important for their utilization, and it could help in planning interventions for their betterment. It also encourages adherence to the services and contributes to enhancing the quality of MCH care services provided in health-care facility. Objective: The objective of the study was to determine the services quality dimensions related to MCH care provided to beneficiaries. Materials and Methods: A cross-sectional, descriptive study conducted in Nagrik Hospital among women of reproductive age group (15–49 years) who had come at least once previously to avail the MCH services. Systematic random sampling and exit interview technique were followed and data collected using pre-designed, pre-tested semi-structured schedule and permission from Institutional Ethics Committee Maulana Azad University Jodhpur taken. To determine services quality dimensions related to MCH care, factor analysis was used. This statistical approach was utilized to construct new factors affecting the quality of MCH care services availed by the beneficiaries. The analysis was done using software Statistical Package for the Social Sciences for Windows version 18.0. Results: Among 226 study participants, 125 beneficiaries utilized maternal health care services and 101 availed child health-care services. Health-care provider’s characteristics, expectations of beneficiaries toward healthcare services attributes were found statistically significant toward perceived satisfaction for utilization pattern of MCH care services. Conclusion: Services quality dimensions related to MCH care provided to beneficiaries concluded as health-care provider’s characteristics, expectations of beneficiaries toward health-care services and support and help by supporting staff such as Yashoda, Class IV employees, and sweepers from this study.

Prediction of maternal and child health care indicators in China based on GM(1,1) model / 中华疾病控制杂志

Objective To study the predictive effect of model ［GM(1,1)］ in China’s maternal and child health indicators, and to predict the future maternal and child health indicators in a short-term, and provide a scientific basis for the gradual improvement of maternal and child health care services in China. Methods The maternal mortality rate (MMR), neonatal mortality rate (NMR), infant mortality rate (IMR) and under-five mortality rate (U5MR) were collected from 2008 to 2017 in China. Models were established and MATLAB 2018b software was used for predictive analysis. Results The prediction models of maternal mortality rate, neonatal mortality rate, infant mortality rate and under-five mortality rate were as follows: x

Analysis on Health Resource Allocation and Service Utilization of Maternal and Child Health Care Institutions in Guizhou / 中国卫生经济

Objective:To discuss on the allocation and service utilization of health resources in maternal and child health care institutions and the existing problems in Guizhou Province,to provide a scientific basis for the further development of maternal and child health care.Methods:It analyzed the situation of health resource allocation,service utilization efficiency and maternal and child mortality in Guizhou province by means of statistical description,comparative analysis and correlation analysis.Results:The average number of health workers per hospital increased rapidly,the average number of beds per hospital grew slowly.The number of outpatient visits,the number of admissions and the number of people discharged were positive growth.The number of bed turnover,the working day of the bed,the bed use rate and the average hospitalization date appeared a certain degree of negative growth.Infant mortality rates,child mortality rates and maternal mortality rates under the age of five were all higher than the national average.Conclusion:Health resources of maternal and child health institutions in Guizhou should be tilted to the grassroots health institutions.It needed to further improve the efficiency of maternal and child health care use,strengthen the training of personnel and enhance the comprehensive service capacity of grassroots organizations.

Saúde nas fronteiras: análise quantitativa e qualitativa da clientela do Centro Materno Infantil de Foz do Iguaçu, Brasil / Health at the border: quantitative and qualitative analysis of patients treated at the Maternal and Child Care Center in Foz do Iguaçu, Brazil

Resumo Foz do Iguaçu participa do SIS-Fronteiras e instalou o Centro Materno Infantil (CMI), ofertando atendimento ao pré-natal das gestantes brasileiras moradoras no Paraguai (brasiguaias). Para analisar as características do CMI e comparar o perfil de brasiguaias com gestantes brasileiras residentes no Brasil, conciliou-se abordagem quanti-qualitativa na metodologia. Verificou-se que gestantes brasiguaias atendidas no CMI procuram o local devido à precariedade do sistema de saúde paraguaio. Elas são mais jovens, apresentam maior paridade, menor escolaridade e não têm companheiro, quando comparadas às moradoras no Brasil. Elas omitem onde moram, tentando minimizar a possiblidade de terem atendimento inferior ao das brasileiras do local, ou terem negado seu direito à consulta; e buscam o serviço de obstetrícia tardiamente para evitar a negativa do atendimento. Elas geram custo alto para o município, sobretudo pela desinformação sobre a sua história reprodutiva e gestacional, o que aumenta as chances de serem submetidas a parto cesáreo e de internação da mãe e/ou do bebê, por complicações. Ações efetivas em relação à saúde materno-infantil nas zonas de fronteira precisam ser priorizadas.

Abstract Foz do Iguaçu participates in the SIS-Fronteiras program and installed the Maternal and Child Care Center (CMI) to offer prenatal care service to pregnant Brazilian women resident in Paraguay (Brasiguaias). To analyze the characteristics of the CMI and compare the profile of Brasiguaias with pregnant Brazilian women resident in Brazil, a quantitative and qualitative approach in methodology was applied. It was found that Brasiguaias go to the CMI because of the precariousness of services of the Paraguayan Health System. They tend to be younger, bear more children, have lower education and are unmarried compared with pregnant Brazilian woman resident in Brazil. They omit where they live to avoid being denied the right or receiving inferior treatment than local pregnant Brazilian women and seek obstetric treatment later to avoid being denied attendance. Pregnant Brazilian women resident in Paraguay are onerous to the municipality, especially due to misinformation about their reproductive and pregnancy history, which increases the chances of undergoing cesarean delivery and hospitalization of the mother and/or infant due to complications. Effective actions in relation to maternal and child health in the border areas need to be prioritized.

Motor development of Japanese twins in childhood as reported by mothers

<p><b>OBJECTIVE</b>Twins tend to lag behind singletons in their motor development, though the causes of this appear to be complicated and are not yet fully understood. The present study was performed to clarify the factors associated with the motor development of twins.</p><p><b>METHODS</b>The twins in the first group consisted of school applicants, including 1131 twin pairs, and the second group consisted of children of members of several maternal associations, and included 951 pairs. All data were gathered by questionnaire survey, and six gross-motor development milestones were analyzed in individuals or pairs.</p><p><b>RESULTS</b>Relative to general population norms in Japan, twins tended to be delayed in reaching several motor development milestones. Stepwise regression analysis showed that of all the variables measured, gestational age was the most influential on all six milestones. Birthweight was also influential on most milestones. Other factors affecting motor development milestones were parity for 'sitting without support,' 'pulling up to a standing position,' and 'walking without support,' and zygosity for 'walking without support.' In these cases, longer gestational age, heavier birthweighf, primiparity, and dizygosity showed a tendency toward earlier attainment of development. Motor development within pairs was more similar in monozygotic pairs compared with dizygotic pairs regarding each item, suggesting genetic contributions.</p><p><b>CONCLUSION</b>The results of the present study showed specific and nonspecific factors that affect motor development of twins. These findings should prove useful in understanding the motor development of twin children and help clinicians to refine maternal and child health care for multiple-birth children.</p>

Motor Development of Japanese Twins in Childhood as Reported by Mothers

Objective: Twins tend to lag behind singletons in their motor development, though the causes of this appear to be complicated and are not yet fully understood. The present study was performed to clarify the factors associated with the motor development of twins. Methods: The twins in the first group consisted of school applicants, including 1131 twin pairs, and the second group consisted of children of members of several maternal associations, and included 951 pairs. All data were gathered by questionnaire survey, and six gross-motor development milestones were analyzed in individuals or pairs. Results: Relative to general population norms in Japan, twins tended to be delayed in reaching several motor development milestones. Stepwise regression analysis showed that of all the variables measured, gestational age was the most influential on all six milestones. Birthweight was also influential on most milestones. Other factors affecting motor development milestones were parity for ‘sitting without support,’ ‘pulling up to a standing position,’ and ‘walking without support,’ and zygosity for ‘walking without support.’ In these cases, longer gestational age, heavier birthweight, primiparity, and dizygosity showed a tendency toward earlier attainment of development. Motor development within pairs was more similar in monozygotic pairs compared with dizygotic pairs regarding each item, suggesting genetic contributions. Conclusion: The results of the present study showed specific and nonspecific factors that affect motor development of twins. These findings should prove useful in understanding the motor development of twin children and help clinicians to refine maternal and child health care for multiple-birth children.

Teaching Innovation and Practice of Maternal and Child Health Care / 中华医学教育探索杂志

Based on our long-time teaching practice,we tried to explore some measures of the teaching innovation about maternal and child health care,in terms of the innovation of course system,the compiling of teaching materials and the updating of teaching methods and skills.Through the discussion,we aimed to enhance our students' integrated qualities,cultivate and bring up more and more capable medical students of new-pattern fit for the social demands.