津巴布韦农村妇女的母性能力与育儿行为有关。
Maternal Capabilities Are Associated with Child Caregiving Behaviors Among Women in Rural Zimbabwe.
机构信息
Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
出版信息
J Nutr. 2021 Mar 11;151(3):685-694. doi: 10.1093/jn/nxaa255.
BACKGROUND
Young children require high-quality care for healthy growth and development. We defined "maternal capabilities" as factors that influence mothers' caregiving ability (physical and mental health, social support, time, decision-making autonomy, gender norm attitudes, and mothering self-efficacy), and developed survey tools to assess them.
OBJECTIVES
We hypothesized that mothers with stronger capabilities during pregnancy would be more likely to practice improved care behaviors after their child was born.
METHODS
We assessed maternal capabilities among 4667 pregnant women newly enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. Several improved child-care practices were promoted until 18 mo postpartum, the trial endpoint. Care practices were assessed by survey, direct observation, or transcription from health records during postpartum research visits. We used logistic regression to determine the predictive association between maternal capabilities during pregnancy and child-care practices.
RESULTS
Mothers with more egalitarian gender norm attitudes were more likely to have an institutional delivery [adjusted OR (AOR), 2.06; 95% CI, 1.57-2.69], initiate breastfeeding within 1 h of delivery (AOR, 1.38; 95% CI, 1.03-1.84), exclusively breastfeed (EBF) from birth to 3 mo (AOR, 2.55; 95% CI, 1.95-3.35) and 3-6 mo (AOR, 1.75; 95% CI, 1.36-2.25), and, among households randomized to receive extra modules on sanitation and hygiene, have soap and water at a handwashing station (AOR, 1.76; 95% CI, 1.29-2.39). Mothers experiencing time stress were less likely to EBF from birth to 3 mo (AOR, 0.79; 95% CI, 0.66-0.93). Greater social support was associated with institutional delivery (AOR, 1.53; 95% CI, 1.37-1.98) and, among mothers randomized to receive extra complementary feeding modules, feeding children a minimally diverse diet (AOR, 1.18; 95% CI, 1.01-1.37). Depressed mothers were 37% and 33%, respectively, less likely to have an institutional delivery (AOR, 0.63; 95% CI, 0.44-0.88) and a fully immunized child (AOR, 0.67; 95% CI, 0.50-0.90).
CONCLUSIONS
Interventions to reduce maternal depression, time stress, inadequate social support, and inequitable gender norms may improve maternal child caregiving.
背景
幼儿需要高质量的护理，以促进其健康成长和发育。我们将“产妇能力”定义为影响产妇照护能力的因素（身心健康、社会支持、时间、决策自主权、性别规范态度和育儿自我效能感），并开发了评估工具。
目的
我们假设在怀孕期间能力较强的产妇，在孩子出生后更有可能采取改进的护理行为。
方法
我们在新参加卫生、环境卫生、婴幼儿营养功效（SHINE）试验的 4667 名孕妇中评估了产妇能力。在产后研究访问期间，通过调查、直接观察或从健康记录转录，推广了几项改进的儿童保健措施，直至产后 18 个月，即试验终点。通过调查、直接观察或从健康记录转录来评估护理行为。我们使用逻辑回归来确定怀孕期间产妇能力与儿童保健实践之间的预测关联。
结果
具有更平等性别规范态度的母亲更有可能进行机构分娩（调整后的比值比（AOR），2.06；95%可信区间，1.57-2.69），在分娩后 1 小时内开始母乳喂养（AOR，1.38；95%可信区间，1.03-1.84），从出生到 3 个月（AOR，2.55；95%可信区间，1.95-3.35）和 3-6 个月（AOR，1.75；95%可信区间，1.36-2.25）纯母乳喂养，并且在接受卫生和环境卫生额外模块的家庭中，洗手站有肥皂和水（AOR，1.76；95%可信区间，1.29-2.39）。经历时间压力的母亲从出生到 3 个月的纯母乳喂养可能性较小（AOR，0.79；95%可信区间，0.66-0.93）。更多的社会支持与机构分娩相关（AOR，1.53；95%可信区间，1.37-1.98），并且在接受额外补充喂养模块的母亲中，喂养孩子的饮食种类最少（AOR，1.18；95%可信区间，1.01-1.37）。抑郁的母亲进行机构分娩的可能性分别降低了 37%和 33%（AOR，0.63；95%可信区间，0.44-0.88），孩子完全免疫接种的可能性分别降低了 37%和 33%（AOR，0.67；95%可信区间，0.50-0.90）。
结论
减少产妇抑郁、时间压力、社会支持不足和不平等性别规范的干预措施可能会改善产妇的育儿能力。
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