Day-care supply by Dutch municipalities

"In this article we report and discuss our investigation into differences in day-care supply among Dutch municipalities....A description of day care in the Netherlands in relation to female labour supply is given.... Attention is given to the comparison of the Netherlands with other European countries.... Hypotheses are formulated concerning differences in day-care supply among Dutch municipalities." (SUMMARY IN FRE)

Paternal involvement in child care as a function of maternal employment in nuclear and extended families in India

Paternal involvement in childcare as a function of family structure and maternal employment status was assessed in 92 dual-wage and 103 single-wage Indian families with preschool-aged children residing in different areas of New Delhi, India. Mothers and fathers completed Radian's Paternal Involvement in Child Care Index (PICCI). Data showed that parents in single-wage families spent more time in primary care-giving compared with parents in dual-wage families. Fathers' involvement scores on the different components of the PICCI did not vary as a function of mother's employment status or family structure. Data are discussed with respect to the rigidity of men's role in a historically patriarchal society.

Family planning and parenthood needs of women with severe mental illness: clinicians' perspective

Family planning and parenthood are important issues for women with severe and persistent mental illness (SPMI). The role of adult mental health clinicians with regard to these issues has been under investigated. Clinicians treating patients with SPMI at a large community health center completed survey forms on 419 women. Clinicians reported that a large fraction of sexually active women were not thought to be using birth control. Despite this, many clinicians had not discussed birth control with these patients. Clinicians had concerns about childcare in 72% of cases where the patient with SPMI was the primary custodian of a younger child; however, the majority of these families were not receiving child or family services. Further consideration of the role of the adult mental health clinician in addressing issues of family planning and parenting is required.

Knowledge, attitudes and practices of mothers and knowledge of health workers regarding care of the newborn umbilical cord

OBJECTIVE

To determine the knowledge, attitudes and practices (KAP) of mothers and the knowledge of health workers regarding care of the newborn umbilical cord.

DESIGN

Cross-sectional survey.

SUBJECTS

Mothers with infants less than three months of age attending well child clinics and health workers (HW) in the clinics, maternity and newborn units of public health, facilities serving an urban slum area in Nairobi, Kenya.

RESULTS

Of the 307 mothers interviewed, 91% and 28% of mothers knew of the need for hygiene whilst cutting and tying the cord, respectively. Regarding postnatal cord care, 40% had good knowledge and 66% good practice. Fifty-one percent of mothers knew and 54% practised postnatal cord care for the appropriate duration of time. Seventy-nine percent of mothers were afraid of handling an unhealed cord. After multivariate analysis, the following variables showed significant independent association with good maternal KAP; increased level of education (OR 2.3, p < 0.001), living in middle class areas rather than slums (OR 1.5, p < 0.03), increased maternal age (OR 1.8, p < 0.001), acquisition of knowledge from a HW rather than from other sources (OR 1.5, p < 0.001), and living in stone/brick houses rather than mud houses (p = 0.01). Fifty per cent of HW had correct knowledge on type of postnatal cord care, and 79% had correct knowledge on duration required for the same. The knowledge of 50% on type of care was incorrect by international standards, but was in keeping with Nursing Council of Kenya teaching.

CONCLUSION

Mothers had good knowledge on the need for hygiene when cutting the cord, had poor knowledge and practice in other aspects of cord care, and were afraid of handling the cord. Poor KAP was associated with young, poor mothers of low education, who had acquired their knowledge from sources other than HW. The knowledge of a large proportion of HW was incorrect and outdated. We recommend that health education on cord care be given at all levels of contact with mothers and that knowledge of all primary HW on cord care be updated.

Growth and development of abandoned babies in institutional care in Nairobi

OBJECTIVE

To determine the pattern of growth and development of institutionalised infants and to compare the outcome with that of infants living with their biological mothers.

DESIGN

A cross-sectional survey.

SETTING

Seven children's homes; Kenyatta National Hospital's New Born Unit and Well Baby Clinics in Nairobi, Kenya.

PARTICIPANTS

Eighty-two abandoned babies who fulfilled the selection criteria were recruited and for each abandoned baby two mothered babies matched for age and sex were selected from the well baby clinics.

MAIN OUTCOME MEASURES

Anthropometric measures of weight, length, head circumference and left mid arm circumference (LUMAC) were taken and the mean values and Z scores determined to demonstrate growth pattern and nutritional status of the babies. The Revised Denver Development Screening Test (RDDST) was used to assess the development pattern of infants.

RESULTS

Seventy per cent of infants were below six months old and 73% were abandoned within the first week of life. Abandoned babies were significantly thinner with the mean LUMAC of 10.8 cm versus 12.3 cm (p = 0.02) Institutionalised babies were significantly wasted (p = 0.00001) and stunted (p = 0.00001). Abandoned babies were significantly delayed in development (p < 0.0001). In all the four sectors tested for, institutionalised babies showed significant delay, p < 0.0001 in each sector.

CONCLUSION

This study demonstrates that infants under institutional care have poorer growth and development compared to mothered infants.