The Invisible Struggles: A Qualitative Study in Understanding Mothers’ Perceptions and Experiences in Nurturing Small for Gestational Age Infants

@#Introduction: Small for gestational age (SGA) infants have been linked to poor growth trends and nutritional status. SGA infants that do not reach their full growth potential must be supervised by a multidisciplinary medical team. Parents devote more time, energy, and money for raising of the SGA infants. The objective of this present study is to explore the perceptions and the experiences of the mother in nurturing the small for gestational age infants in their first year of life. Method: A qualitative exploratory descriptive study via in-depth interview was conducted in the primary health clinics in urban areas in Malaysia to explore the mothers’ perceptions and experiences in SGA infant’s care. 13 SGA infant’s mothers participated in the study after the children achieved the age of one year old. Thematic analysis was conducted using software ATLAS.ti version 8. Results: The average mothers’ age in this study were 33 years old, majority was Malay ethnicity. Only one mother was a housewife and others were working mother. Four out of 13 SGA infants were born prematurely. This study found that homogenous experiences throughout the pregnancy and baby nurturing phase, perceptions on husband involvement and external supports in infant care, infant health status and health services provided, were highlighted as important contributor to infant survival. Conclusion: The importance of monitoring SGA infant growth and nutritional status have been highlighted. Maternal psychological support needs to be enhanced to ease the burden in SGA infant care. Targeted program intervention for family and community social support during postnatal and empowering mothers in nurturing their infants are crucial.

Growth patterns and nutritional status of small for gestational age infants in Malaysia during the first year of life

Purpose@#This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors. @*Methods@#This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months. @*Results@#A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life. @*Conclusion@#SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.

What’s Mom Needs for Their Preemie After NICU Discharge? A Scoping Review

@#Support and education are vital for preemie moms to provide a comprehensive guide and ensure effective implementation of relevant information for premature baby care after NICU discharge. The present study aimed to determine the component of caregiving activities for premature babies. A six-stage methodological framework was used in guiding the review process recommended by Arksey and O’Malley (2005). The EBSCOhost Medical database, which included Medline, Psychology and Behavioural Sciences Collection, and Ovid, grey literature, reference list, and the Google Scholar search engine, was used for the search strategies. A total of 105 studies of English-language articles were tracked from the year 2000–2016. Selecting only full text and peer review resulting in ten studies and eight relevant documents. Nineteen themes were identified related to premature baby care activities. In conclusion, the themes revealed were best described as specific caregiving activities for premature babies valuable for mothers to organise post-discharge care. To engage, mothers should provide appropriate care to their premature babies as NICU babies are more fragile than normal newborn babies.

Will They Swim or Sink? Parental Perception of Water Safety Among Their Children

@#Introduction: The magnitude of drowning as one of the leading causes of death among children in Malaysia may have been underestimated. Little is known on the level of awareness on water safety among parents as it might be associated with appropriateness and adequacy of the supervision. This study aims to describe perceptions of water safety among parents of primary school children. Methods: A cross-sectional survey with 719 respondent conducted to obtain information on parents self-reported on their children’s water-involved activity and swimming ability, self-estimated ability to rescue their child and perceptions of the risk of drowning and water safety for their children. Results: The result revealed that about 21.6% of respondents did not perceive drowning as one of the unintentional injury leading causes of death among children. Parents reported that their children had experienced a near- drowning incident (16.1%), and only 12.2% of the child had attended a formal swimming lesson. Majority of the parents did not involve in any water safety program (98.7%), can’t swim (61.6%), not been certified in CPR (87.3%) and not confident (87.3%) to perform resuscitation (CPR). Respondents also perceived their children could swim (42.1%), and they felt confident when their child in the water (45.6%). There were statistical differences between parents who reported their child had a near-drowning experience with their perception of children’s swimming ability. Conclusion: An exploration of parent’s perception of water safety provided an overview of the need for promoting awareness on drowning risk and water safety education in this country.

Exploring the Determinant of Pre-Pregnancy Care Services Usage among Reproductive Ages Women in Kedah, Malaysia

​In Malaysia although mortality rate among women of reproductive ages has reduced over the years, the reduction has been stagnant for the past ten years. In order to achieve the 5th Millennium Development Goal, several measures need to be taken including a proper implementation of pre-pregnancy services in this country. This study explores the awareness, intention and usage of pre-pregnancy care (PPC) services and its determinant among women of reproductive ages in Kedah, Malaysia. This is a qualitative study, which consisted of a focus group discussion (FGD) among women in the ages of 18 to 45 years old from all ethnic groups who attended four government clinics in the state of Kedah. The mothers were chosen through purposive sampling from twelve districts that were selected through a multistage random sampling. A semi-structured questionnaire was utilized during the FGD. The results from the FGD were recorded verbatim and thematic analysis was finalized once saturation of information from respondents was achieved. These are two themes was identified, namely personal reasons and reasons of service and there are several subthemes under two main themes. Under the Personal reason themes, the subthemes including awareness and intention to used the services, knowledge, perception, social support and history of medical illness. While under pre-pregnancy care services themes, the subthemes including the promotion of the services, the communication relationship with the health staff, the waiting time and also the accessibility of the service. As a conclusion, there is still part of society who was unaware of pre-pregnancy services and its importance in reducing maternal mortality rate as well as producing good pregnancy outcome. Information and knowledge on pre-pregnancy care services should be disseminated among community members through various means including roadshows and pre wedding workshops.​

Managing Obesity In Malaysian Schools: Are We Doing The Right Strategies?

The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.

Engaging Men In Health Services: Are We Ignorant?

Men’s health remain unclear term for majority of general population as well as physician worlwide. Nowadays there is an increase interest in addressing men’s requirement in health care as a separate branch. When discussing about men’s health, it is fair to say that even a man himself does not know much about men’s health. Most of them think that men’s health is just a discussion on sex. This thought is not entirely right. The scope of men’s health is actually larger than the male sex organ itself. To define men’s health, we have to look at man holistically.

Poor Adherence To Antiretroviral Therapy And Associated Factors Among People Living With Hiv In Omdurman City, Sudan

Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46–8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02–1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51–23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74–73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44–18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27–12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.

Factors Associated With Fall Injury At Home Among Children Under 5 Years Old In Yemen

Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.

Knowledge on Sexual and Reproductive Health among Adolescents in a College at Seremban, Negeri Sembilan

Prevalence of adolescents involved in sexual and reproductive problems is on rise and it was associated with its knowledge. Several factors found to be associated with the knowledge and various sources of knowledge are chosen by adolescents for this information. Thus, this study was to determine the knowledge score, its influencing factors and the preference of the sources of knowledge. A cross-sectional study was done using adopted questionnaire involving 330 respondents aged 18 and 19 years old in Kolej MARA Seremban selected by simple random sampling. They were gathered in the halls and 338 adolescents from 454 students consented to involve in this study. Self-administered questionnaire was used whereby a correct response was given a score of 2, 0 for an incorrect response and 1 for an answer of don’t know. Total score for all correct answers was 42. Descriptive analysis, bivariate and multivariate analysis was done in the analysis. The mean knowledge score was 37.32 (±2.967) with a significant difference for gender. Internets were the most common and preferred sources of the knowledge among them. There was 5.2% of them had heard on SMS intervention and 37.0% of them disagreed on SMS intervention. The result showed that the knowledge score was lower in males than females and internets were the most preferred source of the knowledge. Thus, interventions for knowledge improvement should be more on male adolescents.​

The Impact of Maternal Factors on Neonatal Mortality among Low Birth Weight in Aceh Province, Indonesia

The health of newborns is inextricably linked to that of their mothers. Some maternal factors can influence neonatal survival, particularly for low birth weight babies who are more vulnerable to diseases than normal weight babies. The aim of this study is to assess the impact of maternal factors on neonatal mortality among low birth weight babies in Aceh Province, Indonesia. Study design was unmatched case control. Data collected from 2010 to 2012 in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into 250 LBW who died in neonatal period (case group) and 250 who did not die in neonatal period (control group). There were 6 maternal variables analysed. Three of six variables analysed were not associated with neonatal mortality among LBW (P > 0.05); these were: maternal death, parity and education level. The age of the mother had a significant association with neonatal mortality among LBW (P < 0.05), but was not a determinant factor. The maternal illness and birth interval were determinant factors of neonatal mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI: 1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91). Maternal illness and birth interval were determinant factors of neonatal mortality among LBW. Appropriate care throughout stages of pregnancy and increasing women’s knowledge on high risk pregnancy are the key factors to the decrease of the neonatal mortality related to the maternal factors.​

Trend of Stillbirths and Neonatal Deaths in University Kebangsaan Malaysia Medical Centre (UKMMC) From 2004-2010

The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children’s health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.

Prevalence of Helicobacter pylori infection in epilepsy patients in a teaching hospital in Malaysia

Background & Objective: Helicobacter pylori infection has been associated with extradigestive diseases including epilepsy. The main aim of the study was to determine the prevalence of Helicobacter pylori using 13C urea breath test (UBT) in epilepsy patients in a teaching hospital in Malaysia and compared to control. Methods: The study subjects were epilepsy patients from the neurology clinic in a teaching hospital. The study was conducted from August 2010 to February 2011. The control consisted of healthy individuals matched for age and gender, not on any acid suppression medications and antibiotics. All subjects underwent UBT as per protocol. Variables such as age, race, household income, types of epilepsy, duration of epilepsy, number of antiepileptic drugs, prognosis were analysed. Good prognosis was defi ned as seizure free for 3 years. Results: Forty eight epilepsy patients and 47 control subjects were studied. Prevalence of H. pylori infection in the epilepsy patients was 37.5% (n=18) and was 36.2% (n=17) in control. There were signifi cantly more subjects in the epilepsy group with lower income. There were also more smokers in the epilepsy group but there was no association between smoking and positive UBT. Epilepsy patients with poor prognosis have a higher UBT positive rate compared to the good prognosis group (64.3% vs 35.7 %). However the difference was not statistically signifi cant. Conclusion: The prevalence of H. pylori infection in epilepsy patients is similar to that of the control in this study involving Malaysian subjects.