Challenges and Strategies in Maternal and Infant Health Care

Integrative Project
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Integrative Project
Introduction
Educating pregnant women has been positively associated with desirable maternal and infant healthcare outcomes. Educated pregnant women are more likely to be healthier than their illiterate counterparts. They can better take care of their infants and children because they are knowledgeable about health and nutrition. Healthcare providers are expected to guide pregnant women on improving the child’s healthcare outcomes, especially during the postpartum period.
Annotated Bibliography
Healthy People.gov. (2021, August 27). Maternal, Infant, and Child Health. Retrieved from /2020/topics-objectives/topic/maternal-infant-and-child-health
This article by Healthy People 2020 presents information about the importance, determinants, and emerging maternal and child health issues. The article reveals that improving maternal and child health in the United States is crucial because their health affects the health of future generations. It also reveals that access to healthcare, health insurance coverage, and economic opportunities, among others, affect maternal and child health. Some key issues identified in the article include racial disparities in the diagnosis and treatment of infertility and the use of a “life course” approach to reducing disparities.
The article draws from data from the Centers for Disease Control and Prevention as well as other credible journals relating to maternal and child health. It offers insights on what has been done and what needs to be done to improve maternal and child health.
Herval, A., Oliveira, D., Gomes, V., & Vargas, A. (2019). Health education strategies targeting maternal and child health: A scoping review of educational methodologies. Medicine (Baltimore), 98(26). https://dx.doi.org/10.1097/MD.0000000000016174
This article examines health education strategies that can be used to improve maternal and child health. The authors conduct a scoping review of research studies from various databases. The review reveals that education strategies applied before, during, and after the pregnancy are the most effective. Also, different educational strategies yield different outcomes, and as such, healthcare professionals need to identify and use those strategies that work best for individual patients.
This article is a valuable source of information for any project to improve maternal and child health because it synthesizes evidence from various studies.
Irving, D. (2021, July 1). Reducing disparities in infant mortality: Using big data to help babies at risk. Retrieved from Rand Corporation: /blog/rand-review/2021/07/reducing-disparities-in-infant-mortality-using-big.html
The author at the Rand Corporation presents an investigation of maternal and child health in the Pittsburgh area and indicates that this information represents America’s maternal and child health. The article reveals that black babies are more likely to die than white babies. Drawing on big data collected from the Pittsburgh area, the author reveals that identifying individual risk factors and providing early interventions can help improve maternal and child health and save lives.
Similar to the article by Healthy People 2020, Rand’s research identifies systemic disparities such as racism as the main issue affecting maternal and child health in America. This information is important as it will assist in developing better approaches to maternal and child health.
Jasny, E., Amor, H., & Baali, A. (2019). Mother’s knowledge and intentions of breastfeeding in Marrakech, Morocco. Archives de Pediatrie, 26(5), 285-289. https://doi.org/10.1016/j.arcped.2019.05.007.
The article focuses on factors that influence breastfeeding for pregnant women after birth. The authors depict that women’s breastfeeding knowledge, behavior, and attitudes significantly affect how they care for their young ones. Studies portray that exclusive breastfeeding within the first six months after birth has numerous advantages for infants. Researchers conducted a survey between September 2013 and June 2015 of 768 women participants. 48.2% and 30.1% of the participants were literate and illiterate, respectively. Consequently, researchers concluded that more educated women understood the importance of breastfeeding and how it contributes to the health of their infants compared to uneducated females.
The article has vital information showing that education facilitates the improvement of maternal and child health. In addition, researchers gathered first-hand information from the participants, which made it clear that literate women were more concerned about breastfeeding since they knew its benefits to their infants.
Jong, L., Pavlova, M., Winters, M., & Rechel, B. (2017). A systematic literature review on the use and outcomes of maternal and child healthcare services by undocumented migrants in Europe. European Journal of Public Health, 27(6), 990-997. https://doi.org/10.1093/eurpub/ckx181
These researchers investigate the utilization of maternal and child healthcare services among undocumented migrants in Europe and their overall health outcomes. Through a systematic review of studies published from 2007 to 2017, the researchers reveal the underutilization of maternal and child healthcare services among undocumented women. As a result, their health outcomes are also very poor. This underutilization is attributed to fear of deportation and a lack of knowledge about available services.
By focusing on a vulnerable population (undocumented migrants), the author provides valuable insights to improve maternal and child health. It points to the use of interventions such as awareness creation to increase the utilization of services.
Perry, H., Rassekh, B., Gupta, S., Wilhelm, J., & Freeman, P. (2017). Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 1. rationale, methods and database description. Journal of Globa Health, 7(1). https://doi.org/10.7189/jogh.07.010901
This article investigates the effectiveness of community-based primary health care projects in improving maternal and child health in low-and middle-income countries. Through a review of research articles, programs and projects, the authors indicate that community-based approaches and interventions effectively improve maternal health and children aged five years and below.
The authors conclude that it is imperative to create stronger community-based initiatives to improve maternal and child health through evidence-based interventions, especially in areas with high maternal and child mortality rates. Moreover, the focus on evidence-based intervention enhances credibility and makes this work indispensable in improving maternal and child health.
Shimpuku, Y., Madeni, F. E., Horiuchi, S., Kubota, K., & Leshabari, S. C. (2019). A family-oriented antenatal education program to improve birth preparedness and maternal-infant birth outcomes: A cross sectional evaluation study. Reproductive Health, 16(107), 1-10. https://doi.org/10.1186/s12978-019-0776-8.
In developing countries, only a few percentages of women are educated, which poses significant challenges for them when they become pregnant. In that light, the article focuses on a family-oriented antenatal education program in Tanzania, which fosters Birth Preparedness and Complication Readiness. Since education is essential during pregnancy, the study aimed to educate pregnant females and their families about maternal and infant health. The study involved 194 participants, where 144 constituted the control group and 50 the intervention group. As a result, the birth outcomes for the intervention group experienced fewer neonatal complications and challenges in bringing up their infants than the control group.
By focusing on a developing country, the authors show the importance of an education program for pregnant women. As such, it is evident that educated women are more aware of how to lead healthy lives during pregnancy and how to look after their babies after birth.
Module 2
Introduction
Differential vulnerability, social stratification, cultural differences, and differential exposure are crucial contextual factors that can be used to diminish or exacerbate health inequities. Overall, health inequities can be addressed by ensuring that all people have access to quality medical services regardless of their ethnic background, level of education, income, social status, skin color, race, or geographical location.
Beck, A. F., Edwards, E. M., Horbar, J. D., Howell, E. A., McCormick, M. C., & Pursley, D. M. (2020). The color of health: How racism, segregation, and inequality affect the health and well-being of preterm infants and their families. Pediatric Research, 87, 227-234. https://doi.org/10.1038/s41390-019-0513-6.
Segregation, inequality, and racism significantly contribute to maternal and infant health outcomes together with their families. The article focuses on how the lower quality of healthcare, socioeconomic disadvantages, and increased risk affect infants’ well-being during preterm birth. Additionally, researchers propose proper interventions and study priorities to remedy the consequences of inequality, segregation, and racism. Structural racism depicts various forms of discrimination, including educational disparities, unhealthy environmental exposures, differential access to medical services, nutritional deficiencies, neighborhood deprivation, and economic inequalities.
The article is significant in my study since it portrays how racism, inequality, and segregation contribute to infants’ well-being. The authors depict that some of the factors that affect maternal and infant health are economic inequalities, nutritional deficiencies, educational disparities, and inaccessibility to healthcare services.
Dunn, A. B., Jordan, S., Baker, B. J., & Carlson, N. S. (2017). The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN. The American journal of maternal child nursing, 42(6), 318–325. https://doi.org/10.1097/NMC.0000000000000373
The considerations in maternal health and labor include the colonization of pathogens, the use of antibiotics, and the use of essential maternal procedures. Maternal health is dependent on the balance of the microorganisms in the mother to have an excellent maternal and child outcome. Microorganisms can penetrate and multiply in the uterus, resulting in newborn infection. The pathogens are transferred from the mother to the child as an early inoculation process, leading to chronic diseases in the child. These pathogens can colonize the umbilical cord, fetal membranes, placenta, and amniotic fluid. Gram-positive and gram-negative bacteria have been shown to cause infection. Remarkably, some of the identified pathogens include Escherichia coli, Bacteroidetes, and Prevotella tannerae. The pathogens can also translocate from other body parts to the female reproductive tract (i.e., from the gastrointestinal tract) (Dunn et al., 2017).
The most common route of birth is vaginal, comprising 68% of the cases. This process allows the child to pass through the vaginal canal and expose the pathogens that colonize the area. Lactobacillus species are often found in the vagina, helping maintain vaginal fluid pH to prevent the colonization of other bacteria. Good microflora passed to the child is essential for the development of the immune system. However, those that are pathogenic may cause infection in the child. By contrast, children born via caesarian section tend to have less good microflora, resulting in the immune system’s underdevelopment. These children often develop allergies (Dunn et al., 2017).
Antibiotic use may disturb the balance of reproductive tract microflora, allowing for the growth of pathogenic bacteria due to the reduction of protective microflora such as Lactobacillus species and Bifidobacteria. During labor, obstetricians prescribe antibiotics to reduce the possibility of infection after birth for both the mother and child. The issue was that these could cross the placental-fetal barrier and may affect the growth of the child. In addition, studies have shown that the child’s gastrointestinal tract undergoes dysbiosis secondary to the disruption in the natural flora due to intrapartum antibiotic administration. Lastly, procedures that can cause dysbiosis include intrauterine fetal heart rate measurement, cervical examination, urinary catheterization, antibiotic administration, kangaroo hug, and breastfeeding. (Dunn et al., 2017).
Ferretti, P., Pasolli, E., Tett, A., Asnicar, F., Gorfer, V., Fedi, S., … Segata, N. (2018). Mother-to-infant microbial transmission from different body sites shapes the developing infant gut microbiome. Cell Host & Microbe, 24(1), 133-145. https://doi.org/10.1016/j.chom.2018.06.005.
One integral aspect of maternal and infant health is the microbiome. Microbes support multiple functions in humans, among them facilitating nutrient absorption. Specifically, numerous studies have made it clear that extensive microbial colonization starts postpartum. Several factors are associated with the development of the infant microbiome, including gestational age at birth, infant feeding method, and infant and maternal usage of antibiotics (Ferretti et al., 2018). Educated women know how some of the factors mentioned above influence maternal and infant health.
The article is essential in my study since it shows several things that affect the microbiome, which is an integral aspect of maternal and infant health. Although the mode of transmission of microbe is not well-known, it is evident that education plays a significant role in improving babies’ health after birth.
Module 3
Introduction
The researchers investigated the vitamin D levels of the mother and the infant and the latter’s predisposition for vitamin D deficiency (VDD) and nutritional rickets (NR) associated with low levels of dietary calcium during pregnancy (Fiscaletti et al., 2017).
Fiscaletti, M., Stewart, P., & Munns, C. F. (2017). The importance of vitamin D in maternal and child health: a global perspective. Public health reviews, 38(1), 1-17. https://doi.org/10.1186/s40985-017-0066-3
Calcium and Vitamin D are important in the growth and development of the skeletal system. Children and pregnant women have a higher risk than the general population of having these deficiencies. VDD results in osteomalacia, a condition resulting from the demineralization of the trabecular and cortical bones. It is often used in adults. Hence, appropriate for pregnant women. Conversely, the histological changes in VDD can be found in NR, which is a pediatric disease that causes dysfunction in chondrocyte maturation. It leads to the defective mineralization of growth plates. Thus, NR patients are characterized by skeletal abnormalities and short...