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Murcia-Baquero LM, Sandoval-Pinto E, Guerrero CH, López Flores MDL, Sierra-Diaz E, Cremades R. The Phenomenon of Human Migration on the Breastfeeding Practices of Migrant Women: A Scoping Review. Cureus 2024; 16:e63614. [PMID: 39087178 PMCID: PMC11290891 DOI: 10.7759/cureus.63614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Human migrations and different migratory flows have been as old as the practice of breastfeeding (BF). The reasons for migrating, the conditions, and its protagonists are so diverse, often constituting situations of vulnerability and risk for health decision-making at both the individual and collective levels. The relationship between BF and human migration is totally dynamic and includes multiple factors, which is why there is a need to characterize territorially its prevalence rate and variability depending on the context. The migration profiles that can be configured from factors, such as schooling, employment, the host country's health system, and support networks, among others, have heterogeneity between countries that make it necessary to identify them. This study is an in-depth review of the report on the practice of BF in migrant women. The Arksey and O'Malley method was used to perform the PubMed and SciELO searches. The search terms were "exclusive breastfeeding (EBF)," "breastfeeding," "migrant women," and "human migration," and original articles published in English, Spanish, and Portuguese were included. Of the 43 selected articles, differences were found between the various migrant groups, in variables such as socioeconomic level, education, access to health services, maternal knowledge, father factor, culture, and intention to breastfeed. The heterogeneity of the practice of BF between countries, as well as in intraregional migratory flows, establishes different protective or risk factors depending on where the phenomenon develops and its conditions.
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Affiliation(s)
- Lina María Murcia-Baquero
- University Center for Health Sciences, Department of Public Health, University of Guadalajara, Guadalajara, MEX
| | - Elena Sandoval-Pinto
- University Center for Biological and Agricultural Sciences, Department of Cellular and Molecular Biology, University of Guadalajara, Guadalajara, MEX
| | - Christian H Guerrero
- University Center for Health Sciences, Department of Public Health, University of Guadalajara, Guadalajara, MEX
| | | | - Erick Sierra-Diaz
- University Center for Health Sciences, Department of Public Health, University of Guadalajara, Guadalajara, MEX
| | - Rosa Cremades
- University Center for Health Sciences, Department of Microbiology and Pathology, University of Guadalajara, Guadalajara, MEX
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Ekholuenetale M, Barrow A, Arora A. Skin-to-skin contact and breastfeeding practices in Nigeria: a study of socioeconomic inequalities. Int Breastfeed J 2022; 17:2. [PMID: 34980169 PMCID: PMC8725355 DOI: 10.1186/s13006-021-00444-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effects of breastfeeding practices on children's health are undoubtedly of great interest. However, inequalities in breastfeeding practices and mother and newborn skin-to-skin contact (SSC) exist in many resource-constrained settings. This study examined the regional prevalence and socioeconomic inequalities in exclusive breastfeeding (EBF), early initiation of breastfeeding and SSC in Nigeria. METHODS Data on 2936 infants under six months were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data on 21,569 children were analysed for early initiation of breastfeeding and SSC. Concentration index and curves were used to measure socioeconomic inequalities in EBF, early initiation of breastfeeding and SSC. RESULTS The prevalence of EBF, early initiation of breastfeeding and SSC were 31.8, 44.2 and 12.1% respectively. Furthermore, Ogun state had the highest prevalence of EBF (71.4%); while Bayelsa state had the highest prevalence of SSC (67.8%) and early initiation of breastfeeding (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and early initiation of breastfeeding across household wealth quintile and by levels of mothers' education in contrast to their rural counterparts. We quantified inequalities in early initiation of breastfeeding, EBF, and SSC according to household wealth and maternal education. The study outcomes had greater coverage in higher household wealth, in contrast to the lower household wealth groups; early initiation of breastfeeding (concentration index = 0.103; p = 0.002), EBF (concentration index = 0.118; p < 0.001), and SSC (concentration index = 0.152; p < 0.001) respectively. Furthermore, early initiation of breastfeeding (concentration index = 0.091; p < 0.001), EBF (concentration index = 0.157; p < 0.001) and SSC (concentration index = 0.156; p < 0.001) had greater coverage among mothers with higher educational attainment. CONCLUSION Low prevalence and socioeconomic inequalities in early initiation of breastfeeding, EBF and SSC were identified. We recommend that health promotion programs targeted and co-designed with disadvantaged mothers are critical to meet global breastfeeding targets. Also, future researchers should conduct further studies especially clinical control trials and qualitative studies to unravel the possible reasons for differences in the indicators.
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Affiliation(s)
- Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
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Chiang WL, Chiang TL. Mediating effects of early health on the relationship between early poverty and long-term health outcomes of children: a birth cohort study. BMJ Open 2021; 11:e052237. [PMID: 34916314 PMCID: PMC8679079 DOI: 10.1136/bmjopen-2021-052237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study analyses the mediating effects of early health prior to age 3 on the association between early poverty and the health outcomes of children at age 12. DESIGN Population-based longitudinal birth cohort study. SETTING Taiwan Birth Cohort Study (TBCS), 2005-2017. PARTICIPANTS 16 847 TBCS children born in 2005 and followed up at 18 months, 3, 5, 8 and 12 years with available data on poverty and health status. MAIN OUTCOME MEASURES Child's general health, measured by the mothers' ratings of their child's health, and hospitalisation experience at 12 years of age. RESULTS Among the TBCS children, the prevalence of fair/poor health and hospitalisation was 20.8% and 2.5% at age 12. The ORs of experiencing fair/poor health and hospitalisation at age 12 were 1.33 (95% CI 1.21 to 1.45) and 1.35 (1.07 to 1.69) for early poverty, respectively. When early poor health was added in the multiple logistic regression models, the effects of early poverty were attenuated on poor general health and no longer significant on hospitalisation for children aged 12 years. Mediation analysis showed that 50%-87% of the total effect of early poverty on health at age 12 was mediated by early health status before age 3. CONCLUSIONS Our findings suggest that poor health in early life plays as a significant mediator in the relationship between early poverty and the long-term health outcomes of children. Universal health coverage thus should be achieved to prevent the adverse health effects of poverty throughout the life course, as one of the most important strategies for children growing up in poverty.
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Affiliation(s)
- Wan-Lin Chiang
- Department of Health and Welfare, University of Taipei, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
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Iglesias-Rosado B, Leon-Larios F. Breastfeeding experiences of Latina migrants living in Spain: a qualitative descriptive study. Int Breastfeed J 2021; 16:76. [PMID: 34627323 PMCID: PMC8502090 DOI: 10.1186/s13006-021-00423-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 09/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background The migratory flows in Spain have changed due to the arrival of a diverse migrant population. Among the new migrants the Latino collective predominate with more than half being women of childbearing age. There are no previous studies exploring breastfeeding experiences of migrants in a country where their mother tongue is spoken. This study aimed to explore Latina migrants’ breastfeeding experiences in a Spanish-speaking country. Methods A descriptive qualitative study was carried out in the main province in southern Andalusia between November 2019 and June 2020. The study used intentional sampling. The study participants were contacted by video calls and data were collected through a semi-structured in-depth interview (n = 19). The interviews were transcribed and analysed by thematic analysis. Results The nineteen participants were aged between 22 and 43 years old and came from six different countries in Latin America. The two main categories that emerged were breastfeeding facilitators and barriers, divided into ten interrelated sub-categories: working conditions; precarious socioeconomic conditions; lack of support (health professionals, family and society); physiological changes, pain and fatigue; ignorance and wrong beliefs; support networks (partner, health professionals and family); host country versus home country; religious practices/worship; appropriate attitude, knowledge and experience; and breastfeeding support groups. Most of the study participants stated that their breastfeeding experiences were influenced by barriers such as work and by facilitators such as peer support. Conclusions More support from caregivers and more sensitivity to cultural diversity were demanded by the women and well-trained professionals are needed to enable breastfeeding for a longer time. This paper provides caregivers, such as nurses, more knowledge about the care demanded by migrant women to ensure a longer breastfeeding experience. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00423-y.
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Affiliation(s)
- Blanca Iglesias-Rosado
- Department of Social Psychology, Psychology School, University of Seville, Seville, Spain
| | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
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Chang LY, Lin YH, Lin SJ, Chiang TL. Cohort Profile: Taiwan Birth Cohort Study (TBCS). Int J Epidemiol 2021; 50:1430-1431i. [PMID: 34263321 DOI: 10.1093/ije/dyab048] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsuan Lin
- Surveillance, Research and Health Education Division, Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Bektas I, Arkan G. The Effect of Perceived Social Support of Syrian Mothers on Their Infant Feeding Attitudes. J Pediatr Nurs 2021; 57:e40-e45. [PMID: 33059967 DOI: 10.1016/j.pedn.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study was conducted to investigate the effect of perceived social support of mothers who were Syrian refugees in Turkey on attitudes toward feeding their babies. DESIGN AND METHOD This study used a cross-sectional design and investigated the demographic characteristics, perceived social support, and infant feeding attitudes of the mothers who migrated from Syria and came to the Health Education Center for Immigrants to receive healthcare services. RESULTS The mean age of the mothers (n = 150) who participated in the study was 24.51 + 5.84 years, and the mean duration of their stay in Turkey was 4.12 ± 1.57 years. The mean number of pregnancies of the mothers was 2.62 ± 1.4, and the mean number of children was 2.33 ± 1.28. As a result of the analysis, we have determined that thesub-dimension of perceived social support from a special person significantly affects the continuation of breastfeeding of mothers during the first six months (p < 0.05). The perceived social support of mothers and other variables in the model were found to explain 14.6% of the breastfeeding attitude. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The attitudes of Syrian mothers toward feeding their babies were affected by perceived social support from a special person. It is recommended to aidsocial support systems for immigrant women to develop positive attitudes toward breastfeeding.
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Affiliation(s)
- Ilknur Bektas
- Dokuz Eylul University, Faculty of Nursing, Department of Pediatric Nursing, Turkey.
| | - Gulcihan Arkan
- Dokuz Eylul University, Faculty of Nursing, Department of Public Health Nursing, Turkey
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Li YF, Lin SJ, Chiang TL. Timing of rapid weight gain and its effect on subsequent overweight or obesity in childhood: findings from a longitudinal birth cohort study. BMC Pediatr 2020; 20:293. [PMID: 32532342 PMCID: PMC7291582 DOI: 10.1186/s12887-020-02184-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children. METHODS Data were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity. RESULTS A total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36 months (RWG birth-6 months: OR = 2.6, 95% CI: 2.3-2.8; RWG 18-24 months: OR = 3.7, 95% CI: 2.9-4.6), 66 months (RWG birth-6 months: OR = 2.2, 95% CI: 2.0-2.4; RWG 18-24 months: OR = 2.3, 95% CI: 1.8-2.8), and 8 years of age (RWG birth-6 months: OR = 1.7, 95% CI: 1.6-1.9; RWG 18-24 months: OR = 2.4, 95% CI: 2.0-3.0). CONCLUSIONS Childhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.
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Affiliation(s)
- Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare in Taiwan, Taipei, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 620, No. 17, Xu-Zhou Road, Taipei, Taiwan, 10055, Taiwan.
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Paca-Palao A, Huayanay-Espinoza CA, Parra DC, Velasquez-Melendez G, Miranda JJ. [Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries]. GACETA SANITARIA 2019; 35:168-176. [PMID: 31787405 DOI: 10.1016/j.gaceta.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/01/2019] [Accepted: 09/04/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. METHOD Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. RESULTS The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. CONCLUSION Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.
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Affiliation(s)
- Ada Paca-Palao
- Facultad de Salud Pública y Administración Carlos Vidal Layseca, Universidad Peruana Cayetano Heredia, Lima, Perú; Ex Beca Naval Medical Research Unit, NAMRU-6; CRONICAS Centro de Excelencia de Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú; Ministerio de Educación, Lima, Perú
| | - Carlos A Huayanay-Espinoza
- CRONICAS Centro de Excelencia de Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Diana C Parra
- Program of Physical Therapy and Department of Surgery, Institute for Public Health, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - J Jaime Miranda
- CRONICAS Centro de Excelencia de Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
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Chiang JK, Lee YC, Kao YH. Association between palliative care and end-of-Life care for patients with hematological malignancies: A population-based study. Medicine (Baltimore) 2019; 98:e17395. [PMID: 31577748 PMCID: PMC6783235 DOI: 10.1097/md.0000000000017395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
To date, few studies have examined the end-of-life (EOL) care for patients with hematological malignancies (HMs). We evaluated the effects of palliative care on the quality of EOL care and health care costs for adult patients with HMs in the final month of life.We conducted a population-based study and analyzed data from Taiwan's Longitudinal Health Insurance Database, which contains claims information for patient medical records, health care costs, and insurance system exit dates (our proxy for death) between 2000 and 2011.A total of 724 adult patients who died of HMs were investigated. Of these patients, 43 (5.9%) had received only inpatient palliative care (i-Pal group), and 19 (2.6%) received home palliative care (h-Pal group). The mean health care costs during the final month of life were not significantly different between the non-Pal and Pal groups (p=0.315) and between the non-Pal, i-Pal, and h-Pal groups (p=0.293) either. By the multivariate regression model, the i-Pal group had lower risks of chemotherapy, ICU admission, and receipt of CPR, but higher risks of at least two hospitalizations and dying in hospital after adjustments. The h-Pal group had the similar trends as the i-Pal group but lower risk of dying in hospital after adjustments.Patients with HMs who had received palliative care could benefit from less aggressive EOL cancer care in the final month of life. However, 8.6% patients with HMs received palliative care. The related factors of more hospitalizations and dying in hospital warrant further investigation.
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Affiliation(s)
- Jui-Kun Chiang
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
| | | | - Yee-Hsin Kao
- Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
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A Scoping Review of the Health of East and Southeast Asian Female Marriage Migrants. J Immigr Minor Health 2019; 22:182-211. [PMID: 31152303 DOI: 10.1007/s10903-019-00901-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The number of female marriage migrants in East and Southeast Asia has grown significantly over the past three decades. However, little is known about the health of this population. Following Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) framework, a scoping review of English language research databases was used to synthesize knowledge on the health of Asian marriage migrants. This will be used to inform recommendations for health care practice and research. Fifty-five eligible studies were included and presented using five identified categories-mental health, women's health and maternal-child health, public health, general well-being, and social challenges. Overall, studies consistently document that marriage migrants experience worse health outcomes, multiple barriers to health care services, and multilevel social challenges compared with the native population in the receiving countries.
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Dennis CL, Shiri R, Brown HK, Santos HP, Schmied V, Falah-Hassani K. Breastfeeding rates in immigrant and non-immigrant women: A systematic review and meta-analysis. MATERNAL AND CHILD NUTRITION 2019; 15:e12809. [PMID: 30884175 DOI: 10.1111/mcn.12809] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/28/2019] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
Breastfeeding benefits mothers and infants. Although immigration in many regions has increased in the last three decades, it is unknown whether immigrant women have better breastfeeding outcomes than non-immigrants. The aim of this study was to conduct a systematic review and meta-analysis to determine whether breastfeeding rates differ between immigrant and non-immigrant women. We searched Medline, Embase, PsycINFO, CINAHL and Google Scholar, 1950 to 2016. We included peer-reviewed cross-sectional and cohort studies of women aged ≥16 years that assessed and compared breastfeeding rates in immigrant and non-immigrant women. Two independent reviewers extracted data using predefined standard procedures. The analysis included 29 studies representing 1,539,659 women from 14 countries. Immigrant women were more likely than non-immigrants to initiate any (exclusive or partial) breastfeeding (pooled adjusted prevalence ratio 1.13, 95% confidence interval [CI] 1.07-1.19; 11 studies). Exclusive breastfeeding initiation was higher but borderline significant (adjusted prevalence ratio 1.20, 95% CI 1.00-1.45; 5 studies, p = 0.056). Immigrant women were more likely than non-immigrants to continue any breastfeeding between 12- and 24-week postpartum (pooled adjusted risk ratio 2.04, 95% CI 1.79-2.32; 3 studies) and > 24 weeks (adjusted risk ratio 1.33, 95% CI 1.02-1.73; 6 studies) but not exclusive breastfeeding. Immigrant women are more likely than non-immigrants to initiate and maintain any breastfeeding, but exclusive breastfeeding remains a challenge for both immigrants and non-immigrants. Social and cultural factors need to be considered to understand the extent to which immigrant status is an independent predictor of positive breastfeeding practices.
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Affiliation(s)
- Cindy-Lee Dennis
- Faculty of Nursing, University of Toronto, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Hilary K Brown
- Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Hudson P Santos
- School of Nursing, University of North Carolina, Chapel Hill, USA
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Cheng KW, Chiang WL, Chiang TL. In utero and early childhood exposure to secondhand smoke in Taiwan: a population-based birth cohort study. BMJ Open 2017; 7:e014016. [PMID: 28674129 PMCID: PMC5734351 DOI: 10.1136/bmjopen-2016-014016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study provides secondhand smoke (SHS) exposure data in utero and after birth when children were at 18 months, 36 months and 66 months old, and it identifies risk factors for the early childhood SHS among 18-month-old infants living in smoker and non-smoker households. STUDY DESIGN The data come from the Taiwan Birth Cohort Study, a longitudinal survey of a birth cohort born in 2005. This study used the survey wave when children were 18 months old (n=18 845) for statistical analysis of early childhood SHS exposure. Logistic regression was used to identify the risk factors of the SHS exposure. RESULTS Approximately 62% of the 18-month-old infants lived in a household with at least one smoker, with the father being the smoker in 84% of those households. Among these infants living in a smoker household, 70% were exposed to SHS and 36% were exposed to heavy SHS in utero, and the prevalence was approximately 66% and 17% after birth for SHS and heavy SHS, respectively. The number and the existence of smokers in the household, parents' smoking status, father's educational attainment and being a first-born baby are strong predictors of early childhood heavy SHS exposure. CONCLUSIONS Encouraging families to have a smoke-free home environment, empowering women to ensure their perspectives and rights are embedded into tobacco control efforts and educating families about the health risks from childhood SHS exposure, especially among people living in households with smokers, will protect non-smoking adults and children from SHS exposure.
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Affiliation(s)
- Kai-Wen Cheng
- Institute for Health Research and Policy and Department of Economics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Wan-Lin Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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