Peter Rajini, Kumar K Anil
School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
WHO South East Asia J Public Health. 2014 Jul-Dec;3(3):254-265. doi: 10.4103/2224-3151.206748.
The extended care model of the United Nations Children's Fund (UNICEF) identifies knowledge/beliefs, nutritional status, mental health, control of resources/autonomy, workload/time constraints and social support as important caregiver resources for childcare. The aim of this paper is to examine the role of mothers' caregiving resources in child-care practices in slums.
A cross-sectional study was conducted in 10 slums of Hyderabad, to appraise the caregiving practices and health status of children under 5 years. Data were collected from 506 households, selected through multistage stratified random sampling, and data relating to 451 children aged 6-59 months were analysed. Four caregiving practices were studied: psychosocial stimulation, as assessed by the Home Observation Measurement of the Environment inventory; hygienic care rated by spot-check observation; and meal frequency and dietary diversity based on maternal recall. The role of the mother's caregiving resources was examined using bivariate and multivariate logistic regression analyses.
More than 50% of the children received good psychosocial stimulation and close to 60% had good hygienic care. About 75% of the children aged 6-23 months had the recommended minimum meal frequency and 13% had the recommended dietary diversity. Mother's media exposure (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.35-3.77), participation in household budgeting (OR 2.19, CI 1.25-3.83) and husband's support (OR 2.04, CI 1.28-3.24) were predictors of psychosocial stimulation. Mother's younger age (OR 1.11, CI 1.04-1.18), poor media exposure (OR 1.95, CI 1.15-3.29), dissatisfaction with life (OR 1.84, CI 1.05-3.24), workload (OR 1.79, CI 1-3.18) and having no money for their own use (OR 1.52, CI 0.95-2.45) placed children at higher odds for receiving poor hygienic care. Leisure time (OR 2.75, CI 1.25-6.06) and participation in budgeting (OR 1.97, CI 1-3.86) were predictors of meal frequency.
Mother's workload, poor media exposure, dissatisfaction with life, lack of husband's support and absence of economic autonomy are constraints to good child care in slums.
联合国儿童基金会（UNICEF）的扩展护理模式将知识/信念、营养状况、心理健康、资源控制/自主权、工作量/时间限制和社会支持确定为育儿过程中重要的照料者资源。本文旨在探讨母亲的照料资源在贫民窟儿童照料实践中的作用。
在海得拉巴的10个贫民窟进行了一项横断面研究，以评估5岁以下儿童的照料实践和健康状况。通过多阶段分层随机抽样从506户家庭收集数据，并对451名6至59个月大儿童的数据进行分析。研究了四种照料实践：通过家庭环境观察测量量表评估的心理社会刺激；通过抽查观察评定的卫生保健；以及基于母亲回忆的进餐频率和饮食多样性。使用双变量和多变量逻辑回归分析来研究母亲照料资源的作用。
超过50%的儿童获得了良好的心社会刺激且近60%的儿童得到了良好的卫生保健约75%的6至23个月大儿童达到了建议的最低进餐频率，13%的儿童达到了建议的饮食多样性。母亲的媒体接触（比值比[OR]2.25，95%置信区间[CI]1.35 - 3.77）、参与家庭预算编制（OR2.19，CI1.25 - 3.83）和丈夫支持（OR2.04，CI1.28 - 3.24）是心理社会刺激的预测因素母亲年龄较小（OR1.11，CI1.04 - 1.1）、媒体接触不足（OR1.95，CI1.15-3.29）、对生活不满意（OR1.84，CI1.05 -3.24）工作量大（OR1.79，CI1 - 3.18）以及没有可自由支配的钱（OR1.52，CI0.95 - 2.45）会使儿童获得不良卫生保健的几率更高。休闲时间（OR2.75，CI1.25 - 6.06）和参与预算编制（OR1.97，CI1 - 3.86）是进餐频率的预测因素。
母亲的工作量、媒体接触不足、对生活不满意、缺乏丈夫支持以及缺乏经济自主权是贫民窟良好儿童照料的制约因素。
