A new framework for childhood health promotion: the role of policies and programs in building capacity and foundations of early childhood health

Social protection systems in vulnerable families: their importance for the public health

OBJECTIVE

To analyze the effectiveness of the Chilean System of Childhood Welfare in transferring benefits to socially vulnerable families.

METHODS

A cross-sectional study with a sample of 132 families from the Metropolitan Region, Chile, stratified according to degree of social vulnerability, between September 2011 and January 2012. Semi-structured interviews were conducted with mothers of the studied families in public health facilities or their households. The variables studied were family structure, psychosocial risk in the family context and integrated benefits from the welfare system in families that fulfill the necessary requirements for transfer of benefits. Descriptive statistics to measure location and dispersion were calculated. A binary logistic regression, which accounts for the sample size of the study, was carried out.

RESULTS

The groups were homogenous regarding family size, the presence of biological father in the household, the number of relatives living in the same dwelling, income generation capacity and the rate of dependency and psychosocial risk (p ≥ 0.05). The transfer of benefits was low in all three groups of the sample (≤ 23.0%). The benefit with the best coverage in the system was the Single Family Subsidy, whose transfer was associated with the size of the family, the presence of relatives in the dwelling, the absence of the father in the household, a high rate of dependency and a high income generation capacity (p ≤ 0.10).

CONCLUSIONS

The effectiveness of benefit transfer was poor, especially in families that were extremely socially vulnerable. Further explanatory studies of benefit transfers to the vulnerable population, of differing intensity and duration, are required in order to reduce health disparities and inequalities.

Effectiveness of the Comprehensive Childhood Protection System for vulnerable mothers and children

OBJECTIVES

To establish the effectiveness of the public benefits and services of the "Chile Grows with You" and "Protect Network" programs for socially vulnerable women and children in an urban community in the Metropolitan Region of Chile.

METHOD

Descriptive study employing a questionnaire. The sample consisted of 132 mothers and their 133 infants, all grouped according to social vulnerability. Primary data were collected via a structured interview of the mothers and were complemented with institutional (secondary) data. Descriptive and associative analyses were performed.

RESULTS

The perception of social vulnerability by the professionals was low at the time of admission into the program. The effectiveness of the universal and specific benefits was low, with better results for the children than for the mothers. However, no significant differences were observed according to vulnerability. Another finding was the low access to specific benefits for children with psychosocial risk and psychomotor delay, especially in the most vulnerable group.

CONCLUSION

The results revealed a gap in the access to the benefits guaranteed by law. To overcome this situation, nurses must strengthen their skills in contextualized health practices and the comprehensive administration of interdisciplinary and intersectoral networks.

A parent-focused pilot intervention to increase parent health literacy and healthy lifestyle choices for young children and families

Health literacy affects caregivers' ability to engage in preventive health care behaviors for themselves and their children. Studies suggest that health literacy among low-income families needs improvement, and this possibly contributes to disparities in preventive health care rates. Additionally, parents and caregivers may not be able to provide or seek preventive health care for their children because of lack of knowledge and skills to do so effectively. This study designed and piloted an intervention that delivered to parents of young children (1) health literacy information in an experiential manner and (2) practical skills to engage their families in healthy lifestyle choices. Specifically, the intervention focused on diet/nutrition, physical activity, sleep hygiene, parenting, and mental wellness. Postintervention improvements were noted for factual knowledge for diet/nutrition, physical activity, and sleep, beliefs about diet/nutrition, and the relationship between mental health and stress. Additionally, postintervention improvements were noted for general knowledge and beliefs about sleep, knowledge about the relationship between sleep and health, knowledge about common childhood sleep problems, and parents' bedtime interactions with children. The efficacy of the intervention should be evaluated on a larger, more diverse sample in the future with considerations for multiple health behavior change in the evaluation.