OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83–4.05; some child care: β: 1.35, 95%CI: 0.17–2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.
OBJECTIVE:To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS:A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS:A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS:Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.
Abtract Objectives: to describe the knowledge of infant feeding on breastfeeding and the introduction of complementary feeding among mothers of children under one-year-old in São Luís, MA. Methods: a cross-sectional descriptive study using a single questionnaire, standardized by trained interviewers, who visited all the residents in 20 communities chosen by convenience. This questionnaire searched for socioeconomic, demographic information, care received during pregnancy, and the knowledge about infant feeding. The analysis was performed through the creation of knowledge scores, frequency listing, central tendency and dispersion measurements. Results: among the 709 interviewees, 53.5% presented satisfactory knowledge. The score on the percentage mean of knowledge on infant feeding was 66.7%. The specific score on the introduction of complementary feeding was 60.7% and breastfeeding was71.4%. The benefits of breastfeeding for the babies were better known than the advantages it confers on mothers. The worst result was related to porridge preparation,(13.5%). Conclusion: the proportion of mothers who did not know about the basic teachings of infant feeding is high. This can lead to reduce exclusive breastfeeding time, increase rates of improper introduction of food and drink, and in favor early weaning.
A Deus, que me deu força e coragem para não desanimar. Ao Prof. Dr. Wolney Lisboa Conde, meu orientador, pela oportunidade e confiança em mim depositada. A toda equipe envolvida no trabalho. Obrigada pela dedicação e esforço. À Profa. Isabela da Costa Ribeiro, pelo exemplo de dedicação e competência. Obrigada por sua amizade e suas palavras de incentivo.
The COVID-19 crisis is affecting millions of lives and has wreaked some of its greatest havoc and suffering among the vulnerable and marginalised populations of the world, many of whom belong to religious and faith-based communities. In times of crisis and difficulty, religion and faith are a source of hope and strength for many. In this paper, we underscore the critical role and impact that some faith-based organisations have had in the pandemic crisis response and management of three countries: Brazil, Indonesia and Sri Lanka. In Brazil, Pastoral da Criança is leveraging their mobile phone application to fight mis-information about COVID-19. In Indonesia, Muhammadiyah launched a COVID-19 command centre to support treatment in hospitals, to disseminate guidelines for religious activities backed by science, and to provide water, sanitation and hygiene packages, food and financial support to the most vulnerable and neglected. In Sri Lanka, Sarvodaya is working closely with religious and community leaders on risk communication and community engagement messages and is also providing hygiene care and economic relief packages to the marginalised. We further discuss some of the challenges these organisations have faced and propose recommendations for greater engagement with this group of global public health actors to maximise their contributions and impact in the crisis management of and response to future infectious disease outbreaks, epidemics or pandemics in low-resource settings.
Background: The first years of life are the most important for human development, which is influenced by diverse factors, such as childcare attendance. Yet, little is known about the longitudinal influence of childcare in diverse domains of development. The aim of the present study was to assess the development and to measure potential influences of childcare attendance in two-year-olds from the 2015 Pelotas (Brazil) Birth Cohort Study. Methods: The present study used longitudinal data from the 2015 Pelotas Birth Cohort. Childhood development at two-year-olds was assessed throughout INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). Childcare attendance was measured at ages 1 and 2 years old and categorized as: a) never went to childcare; b) attended some childcare (either at 12 or 24 months); c) always attended childcare (both 12 and 24 months). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analysis of childcare attendance and early childhood development were performed using linear regression. Results: Among the 3,870 infants included in the analyses, around 2/3 never went to childcare. In the crude analyses, any exposure to childcare was positively associated with development, except for in the motor domain. It was also perceived a trend positive association and higher mean values for the always category. In the adjusted analyses only children who always went to childcare had higher development scores in the total (β: 0.17, 95% CI: 0.06; 0.28), cognitive (β: 0.10, 95% CI:-0.003; 0.21) and language (β:0.10, 95% CI:-0.003; 0.21) domains, even after adjustment for stimulation variables. Conclusions: This study suggests that childcare may help improve early childhood development. The association was particularly strong for the total global development domain, even after adjusting for stimulation, but there was no association with motor development. Considering the low prevalence of children in childcare, and that it may support child development it is recommended to improve childcare opportunities in early childhood.
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