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Xie Y, Gao S, Wang Q, Cai M, Feng S, Huang Z, Huang Y, Hong Y, Tan X, Li J, Yuan L, Liu F, Jiang H. Multilevel factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China: a social-ecological model-informed study. Arch Public Health 2024; 82:160. [PMID: 39294812 PMCID: PMC11409580 DOI: 10.1186/s13690-024-01382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND HIV-related stigma continues to hinder optimal HIV care, and its determinants should be understood at multiple levels. Based on the social-ecological model, this study aimed to explore factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China. METHODS A cross-sectional study was conducted from July to August 2022 to recruit newly reported women living with HIV with a history of pregnancy or current pregnancy in 2021 in 21 cities in Guangdong Province. HIV-related stigma was assessed using an abbreviated Chinese version of Berger's HIV Stigma Scale. Univariate and multivariable hierarchical regression analyses based on the social-ecological model were conducted to explore factors associated with HIV-related stigma and its four dimensions (personalized stigma, disclosure concerns, negative self-image and concerns about public attitudes) at the community/hospital, interpersonal, and individual levels. RESULTS A moderate level of HIV-related stigma was found among the 360 participants included, with a mean score of 45.26. Multivariable hierarchical regression analysis showed that at the community/hospital-level, individuals were more likely to experience high levels of HIV-related stigma if they had experienced the discriminatory behaviors from health care workers (aOR = 2.34, 95%CI: 1.48-3.70) and if they rated serostatus disclosure services as less helpful (aOR = 0.69, 95%CI: 0.48-0.98). At the interpersonal-level, individuals with an HIV-positive partner (aOR = 1.71, 95%CI: 1.01-2.90) were more likely to experience high levels of HIV-related stigma than those with an HIV-negative or unknown partner. Individuals with high resilience (aOR = 0.22, 95%CI: 0.13-0.35) had lower levels of HIV-related stigma at the individual-level. In addition, ever experiencing discriminatory behaviors from health care workers, thinking serostatus disclosure services helpful, having ever seen publicity about personal interest protection services and complaint channels for people living with HIV(PLHIV), knowing about care and support services for PLHIV from social organizations at the community/hospital-level, partner notification and support at the interpersonal-level, and violations of personal interests, resilience at the individual-level were also associated with different dimensions of HIV-related stigma. CONCLUSIONS HIV-related stigma was moderate among women living with HIV. The social-ecological model can facilitate a better understanding of factors associated with HIV-related stigma. Multilevel intervention strategies need to be tailored to reduce HIV-related stigma.
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Affiliation(s)
- Yufan Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Shuang Gao
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Qian Wang
- Department of Women Healthcare, Center for Women and Children Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Min Cai
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Shuaixin Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Zhaoqian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Ying Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Yeting Hong
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Xiaoxia Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Jinbin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Li Yuan
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Fenghua Liu
- Guangdong Women and Children Hospital, Guangzhou, 511400, China.
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China.
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Hossain SJ, Hamadani JD, Tofail F, Fisher J, Rahman MA, Rahman SM. Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh. Child Care Health Dev 2024; 50:e13225. [PMID: 38265136 DOI: 10.1111/cch.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 10/30/2023] [Accepted: 12/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development. METHODS This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors. RESULTS Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development. CONCLUSION Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.
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Affiliation(s)
- Sheikh Jamal Hossain
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | | | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Md Anisur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
| | - Syed Moshfiqur Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh
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Mohammed S, Afaya A, Abukari AS. Reading, singing, and storytelling: the impact of caregiver-child interaction and child access to books and preschool on early childhood development in Ghana. Sci Rep 2023; 13:13751. [PMID: 37612323 PMCID: PMC10447571 DOI: 10.1038/s41598-023-38439-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023] Open
Abstract
Optimal early childhood development (ECD) is crucial in shaping future academic and economic accomplishments. Recognising its profound influence, the United Nations has included a specific target and indicator related to ECD in the Sustainable Development Goals to ensure universal access to high-quality ECD for all preschoolers by 2030. This study investigated whether caregiver-child engagements, early stimulation, and learning opportunities are associated with ECD among children aged 36-59 months. Data on 6752 children were pooled from the 2011 and 2017 Ghana Multiple Indicator Cluster Surveys. The ECD outcomes of interest were literacy-numeracy, social-emotional, learning-cognitive, and physical development, measured with UNICEF's Early Childhood Development Index (ECDI). Binary logistic regression assessed the effects of various caregiver-child engagements and early learning opportunities on the ECD outcomes. We found that most children were developmentally on track in the physical (95.0%) and learning-cognitive (86.4%) domains, but fewer were on track in the literacy-numeracy (36.7%) and social-emotional (68.6%) domains. Reading to or with a child (aOR 1.72; 95% CI 1.35-2.19), telling them stories (aOR 1.61; 95% CI 1.26-2.04), counting or drawing with them (aOR 1.63; 95% CI 1.30-2.04) and a child's attendance at preschool (aOR 4.62; 95% CI 3.34-6.38) were associated with a higher odds for on track literacy-numeracy development. Playing with a child was associated with higher odds of on-track social-emotional development (aOR 1.29; 95% CI 1.04-1.59), physical development (aOR 1.61; 95% CI 1.01-2.55), and learning-cognitive development (aOR 1.51; 95% CI 1.14-2.00). However, singing songs to or with a child (aOR 0.78; 95% CI 0.62-0.89) and taking a child outside the home (aOR 0.78; 95% CI 0.64-0.95) were associated with lower odds for on track social-emotional development. Access to children's books at home was associated with higher odds for on track literacy-numeracy and social-emotional development. In subgroup analysis, some observed associations varied depending on a child's residence (urban or rural). Our findings confirmed that caregiver-child interaction and early learning opportunities could increase a child's likelihood of achieving early developmental milestones.
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Affiliation(s)
- Shamsudeen Mohammed
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Agani Afaya
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Alhassan Sibdow Abukari
- Department of General Nursing, School of Nursing and Midwifery, Wisconsin International University College, North Legon, Postal Address: Box LG 751, Accra, Ghana.
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Teixeira JA, Oliveira CDF, Bortoli MCD, Venâncio SI. Studies on the Child Handbook in Brazil: a scoping review. Rev Saude Publica 2023; 57:48. [PMID: 37585947 PMCID: PMC10392774 DOI: 10.11606/s1518-8787.2023057004733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE To systematically identify and map studies involving the Caderneta da Criança (Child Handbook - CH) in Brazil. METHODS A scoping review using the methodology proposed by the Joanna Briggs Institute. The databases PubMed, Biblioteca Virtual em Saúde (BVS), Biblioteca Digital Brasileira de Teses e Dissertações, Periódicos Capes and Google Scholar were consulted. Primary and secondary studies that mentioned the use of CH were included, without restrictions regarding design, year of publication or population, published in Portuguese, English or Spanish and gray literature (theses and dissertations). RESULTS A total of 129 studies were included, mostly descriptive, published as scientific papers. The Northeast region, the population of caregivers of children and the Primary Care scenario were observed in most studies; 47% of the studies used the CH as a source of data, the majority on vaccination. Despite the different criteria to define adequacy of completing the CH, the studies identified weaknesses in filling out all of its items, except for immunization. The utilization and/or completion of the CH were linked to various factors, including the availability of the CH, characteristics of the children (such as sex, age, prematurity and well-child appointments), attributes of the family members and caregivers (such as age, education, income, parity, work status, prenatal care, reading, note-taking and bringing CH to appointments) and features of the professionals (such as workplace, medical specialty, communication style, knowledge about the CH, requesting, guiding and note-taking). CONCLUSIONS The results reinforce the need to better understand which factors affect the distribution of the CH in the population, as well as pointing to the need for understanding its use and completion by the different care points. The need for intervention studies to improve the implementation of this tool and to include training on the use of the CH in the context of continuing health education becomes evident.
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Affiliation(s)
| | | | | | - Sonia Isoyama Venâncio
- Insper. Centro Brasileiro de Pesquisa Aplicada à Primeira Infância. São Paulo, SP, Brazil
- Secretaria de Estado da Saúde. Instituto de Saúde. São Paulo, SP, Brazil
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Freitas-Costa NC, Andrade P, Normando P, Salvatte Nunes KS, Raymundo CE, Ribeiro de Castro IR, Maria de Aquino Lacerda E, Farias DR, Kac G. Association of development quotient with nutritional status of vitamins B6, B12, and folate in 6-59-month-old children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019). Am J Clin Nutr 2023:S0002-9165(23)47384-4. [PMID: 37105522 DOI: 10.1016/j.ajcnut.2023.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/28/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Vitamins B6, B12, and folate are essential for the formation and maintenance of the human brain, but studies evaluating these vitamins with early childhood development (ECD) in children under five are limited and controversial. OBJECTIVE To evaluate the association between vitamins B6, B12, and folate concentrations/status and ECD. METHODS Data regarding 6,520 children aged 6-59 months (from the Brazilian National Survey on Child Nutrition [ENANI-2019]) were analyzed. ECD was assessed using the Survey of Well-being of Young Children's milestones questionnaire. Vitamin B6 concentration (nmol/L) was classified according to the tertile of the distribution and with the cutoff <20 nmol/L. Folate concentrations >45.3 nmol/L were classified as high, and vitamin B12 <150 pmol/L as deficient. The graded response model was used to estimate developmental age, and the developmental quotient (DQ) was calculated as the developmental age divided by chronological age. Multiple linear regression models were adjusted for confounders. RESULTS The DQ mean (95% confidence interval) for Brazilian children was 0.99 (0.97-1.01). Children aged 6-23 months (1.13 [1.10-1.16]) had a higher DQ mean than those aged 24-35 (0.99 [0.95-1.03]) and 36-59 months (0.89 [0.86-0.92]). Child age was inversely associated with DQ (β=-0.007; p<0.001). An interaction between child age and vitamin B12 deficiency in the DQ (β=-0.005; p<0.001) indicated that, in children aged 36-59 months, the DQ was markedly lower in children with B12 deficiency than in those without B12 deficiency. Vitamin B6 concentrations were directly associated with the DQ (β=0.0004; p=0.031) among children aged 24-59 months in the adjusted model. No association was observed between folate status and DQ. CONCLUSIONS In Brazil, the DQ is lower among older children, and those with vitamin B12 deficiency. Vitamin B6 status was directly associated with the DQ in children aged 24-59 months.
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Affiliation(s)
- Nathalia Cristina Freitas-Costa
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Andrade
- Institute of Applied Economic Research, Rio de Janeiro, Brazil
| | - Paula Normando
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Keronlainy Silva Salvatte Nunes
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos Eduardo Raymundo
- Institute of Collective Health, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elisa Maria de Aquino Lacerda
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Soysal Cimen H, Karaaslan BT. Expectant mothers and fathers' knowledge of nurturing care in a developing country. Front Pediatr 2022; 10:1024593. [PMID: 36483466 PMCID: PMC9722760 DOI: 10.3389/fped.2022.1024593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background The Nurturing Care Framework (NCF), which has been emphasized by the World Health Organization (WHO) in recent years and is among the United Nations Sustainable Development Goals (SDGs), expresses the conditions created to promote early childhood development (ECD). These conditions aim to provide opportunities for children in the Good Health, Adequate Nutrition, Responsive Caregiving, Security and Safety, and Opportunities for Early Learning (5 Components) by caregivers, primarily from low and middle-income countries (LMICs). The aim of this study is to examine the knowledge and awareness of expectant mothers and fathers in Turkey, about the NCF. Methods In this study, a cross-sectional, analytical research design was used. Nurturing Care (NC) knowledge and awareness levels of expectant mothers and fathers in the 2nd and 3rd trimesters of pregnancy were determined via the online form of "The Knowledge of Nurturing Care Inventory (KNCI)" prepared by the researchers. This form consists of 60 questions describing the 5 components mentioned above. The sample contains a total of 103 people, 91 (88.3%) women, and 12 (11.7%) men. Results Among the findings, the highest mean of knowledge level (13.76 ± 1.22) was found in Responsive Caregiving, and the lowest mean of knowledge level (4.35 ± 1.83) was found in Opportunities for Early Learning. The general level of knowledge on NC was found to vary statistically significantly depending on gender in favor of the women [t(101) = 3.27, p < .05], depending on educational status in favor of those with university and graduate education [F(2, 100) = 3.481, p < .05], depending on participation in pregnancy school training in favor of those who attended [t(101) = 2.349, p < .05], and depending on knowledge on how to support development in favor of those who know how to support [t(101) = 2.370, p < .05]. Conclusions As a result, expectant parents need information and support about the period when children can acquire the basic developmental milestones and about the developmental risk indicators. More research is needed to implement the NCF starting from the preconception period, especially in LMICs, so that the opportunities in early childhood (which is the time period when the brain architecture is shaped, and development is the fastest) are not missed.
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Affiliation(s)
- Hafize Soysal Cimen
- Child Development Master's Program, Institute of Health Sciences, Üsküdar University, Istanbul, Turkey
| | - Bedriye Tugba Karaaslan
- Department of Child Development, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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Pérez‐Escamilla R, Venancio S, Buccini G. Monitoring nurturing care environments for early childhood from the national to the municipal level. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 2:e13327. [PMID: 35231152 PMCID: PMC8968932 DOI: 10.1111/mcn.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
There is a dearth of indicators and management information systems to assess early childhood nurturing care environments. The Brazilian Early Childhood Care Friendly Municipal Index (IMAPI) is a robust tool to assess nurturing care environments at the local level. IMAPI was able to detect nurturing care inequities within and across regions. Further validation work is needed to confirm the utility of IMAPI for policymaking.
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Affiliation(s)
- Rafael Pérez‐Escamilla
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
| | - Sonia Venancio
- Research DepartmentSao Paulo Health InstituteSao PauloBrazil
| | - Gabriela Buccini
- Department of Social and Behavioral HealthUniversity of NevadaLas VegasNevadaUSA
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