Papers by Shelina Bhamani
I m a g e c r e d it to Fr ee pi k. co m
Covid-19 has disrupted the mental health services in 93% of the countries worldwide. Approximatel... more Covid-19 has disrupted the mental health services in 93% of the countries worldwide. Approximately 130 countries are affected catastrophically by Covid-19, which limits access to mental health services. Most vulnerable are children, pregnant women, and adults with limited access to mental healthcare. In highlighting the importance of mobilising resources, the WHO has given leaders around the world an opportunity to galvanise efforts. Maternal and children’s mental health are crucial factors that may have a lifelong impact. In a post-pandemic world, a renewed focus is required to develop sustainable policies and action plans to support new mothers and new-borns in the first 1,000 days of life. This viewpoint shares a reflective discourse on contextualising the need of investment in mental health in times of crisis and global pandemic and what needs to be catered to in the near future.
The Journal of Nutrition, Nov 30, 2023
Background: High-quality early childhood care and education (ECCE) programs can positively impact... more Background: High-quality early childhood care and education (ECCE) programs can positively impact children's development. However, as an unintended consequence, ECCE attendance may also affect children's nutritional status. Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan. Methods: This study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5-5.5 y (Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in 3 steps, and repeated cross-sectional surveys were conducted to assess the impact on children (age: 4.5-5.5 y) at 4- time points. ITT analyses with multilevel mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes. Results: The analysis included 3858 children with anthropometric data from 4 cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child height-for-age z score (mean difference: 0.13 z-scores; 95% confidence interval [CI]: 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, -0.29 weight-for-height z score (WHZ) (95% CI: -0.42, -0.15), -0.13 BMI z score (BMIZ) (95% CI: -0.23, -0.03), and -0.16 mid-upper arm circumference-for-age z score MUACZ (95% CI: -0.25, -0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and weight-for-age z score (WAZ) was greater in the survey round during the COVID-19 lockdown. Discussion: The LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (eg school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development.
SSRN Electronic Journal, 2022
The following editorial accentuates the role of responsive caregiving and efficacious parenting s... more The following editorial accentuates the role of responsive caregiving and efficacious parenting strategies, specifically during the first 1000 days of a child's life and early childhood development, especially for children in low-and middle-income countries. Adequate and potent parenting interventions proficiently contribute to the early years of a child's life and lead to overall positive outcomes in the future. This editorial aims to introduce the first-ever Hospital-based Early Childhood Development Parenting Readiness Program (ECD-PREP) initiated by the Department of Obstetrics and Gynaecology, Aga Khan University, and narrates the model in use. The program strongly advocates early childhood development, responsive parenting, and caregiving by integrating nurturing care into care practices and guaranteeing each child's holistic development and future well-being.
Background: Postnatal parental education is deficient yet necessary to enhance the implementation... more Background: Postnatal parental education is deficient yet necessary to enhance the implementation of evidencebased newborn care practices among families. Educating both mother and father is crucial for optimal childhood development, and interventions targeting families can improve childcare practices. Implementing these interventions through systematic policies and protocols in LMIC hospitals is essential. This study explores the perceptions of pregnant women, parents, and healthcare workers regarding parenting education in a tertiary care hospital in Karachi, Pakistan. Methods: In a qualitative study conducted in a tertiary care hospital in Karachi, Pakistan, participants included pregnant women, parents, and healthcare workers. The study used in-depth interviews with purposively selected participants, consisting of two individuals from each category. Interviews were conducted using a prepared guide, and data collection was performed by trained staff. Interviews were conducted until data saturation was achieved. The interviews were conducted in Urdu, transcribed, and translated into English. Thematic analysis was carried out manually. Results: The analysis of pregnant women's experiences identified themes of personal pregnancy experiences, support systems, and hospital facilities. Women discussed physical, emotional, and financial challenges during pregnancy. They valued support from family and physicians but expressed a need for better educational resources in hospitals. For parents with children under one-year-old, themes included personal experiences, hospital experiences, and educational resources. Parents faced emotional changes, financial challenges, and desired improved work-life balance. They appreciated outpatient care but found lacking in inpatient experiences, particularly in the NICU. Healthcare workers emphasized the role of parents, families, and hospitals, highlighting the importance of teaching and understanding family dynamics. Also suggested improvement in holistic approaches, mandatory educational programs, and integrating parenting readiness into primary care. Conclusion: Hospital-based postpartum parenting education enhance overall baby care. Expanding literature emphasizes the importance of high-quality parenting for lifelong development. Identifying efficient programs and Qeios, CC-BY 4.0 • Article,
Responsive parenting is one of the most crucial elements in early childhood development. various ... more Responsive parenting is one of the most crucial elements in early childhood development. various platforms have reported that children provided with such interactions in the earliest years of life tend to thrive better in their early childhood and later life. However, parenting interactions are widely dependent upon parenting confidence and their knowledge and understanding regarding early years. Several initiatives focus on early childhood responsive parenting but there remains a vacuum of providing core support in the first six months of life. This support is essential and fundamental to establishing the foundations of early parent-child relationships. Healthcare settings could play a pivotal role in providing basic parenting education around newborn parenting and responsive caregiving. In this paper, we will discuss the model adopted in two of the primary and secondary healthcare settings of Pakistan and Afghanistan whereby we have implemented an early childhood newborn parenting education program. The descriptive paper details the concept taken to place parenting education as a center of women and children healthcare center, the content that is developed to provide training to the parents of newborns, the process applied to implement the parenting intervention training in both field sites, its financial implications and how the effectiveness and feasibility of this intervention are planned. Additionally, it could provide insights to the practitioners pertinent to how and what of implementation of parenting interventions in healthcare settings.
Background: Responsive interactions among caregivers and newborns are essential for positive and ... more Background: Responsive interactions among caregivers and newborns are essential for positive and optimal growth and development. The aim of this cross-sectional study was to develop and validate a short responsive interaction tool (SRIS) to assess caregiver responsiveness of newly delivered mothers.
Methods: The SRIS consists of twenty elements that are used to classify new-born handling, interactions, consoling techniques, engagement, and distress. High reliability and internal consistency were shown in the data gathered from 257 mothers (Cronbach's alpha=0.8354). The scale's one-dimensional structure was discovered through construct validity analysis, demonstrating the consistency of the scale's evaluation of response interactions.
Results: The results indicate that the valid and reliable instrument for gauging the responsiveness of caregivers during their initial contact with neonates. It provides a useful and approachable method with possible uses in healthcare settings and research for evidence-based parenting interventions.
Conclusions: To improve the tool's generalizability and usefulness in fostering early childhood development and parental engagement, further research is necessary to validate it across a variety of contexts.
Keywords: Early childhood development, Responsive interactions, Responsive caregiving, Parenting
Background:
Parents require support while caring for their newborns. Nurses can be supportive in ... more Background:
Parents require support while caring for their newborns. Nurses can be supportive in helping parents learn how to care for their newborns and their well-being and supporting their spouses and families based on the cultural and social norms of the local context of Pakistan. Newborn parent education programs play a crucial role in advancing the knowledge and skills of the nurses required for parent education. This research study aims to explore nurses' experiences as newborn parent educators after enrolling and implementing a pilot project of a newborn parent education program at a tertiary care university hospital.
Methods:
The exploratory qualitative research design was used to collect the responses from the four nurses at a tertiary care hospital in Karachi, Pakistan. Semi-structured interviews were conducted. Recorded interviews were transcribed, coded, and converted into themes.
Results:
The result is described under three themes, including nurses' knowledge, skills, and the importance of the program. The findings highlighted the significant role of nurses' knowledge in the health education of newborn parents toward holistic care. Obstetrics and Gynecology nurses are well-equipped with the health education and skills to care for patients and newborns. Advanced training will further equip them with concepts and skills of early childhood development.
Conclusion:
The study signifies that formal inclusion of such training in the curriculum and nursing trainings such as continuing professional development courses and activities is much needed with the endorsement of nursing leadership and faculty. It also highlights the role of policymakers in the investment of nursing education and practice in different health fields.
Keywords: nurse; newborn; parent; education; experience
Background: High-quality early childhood care and education (ECCE) programs can positively impact... more Background: High-quality early childhood care and education (ECCE) programs can positively impact children's development. However, as an unintended consequence, ECCE attendance may also affect children's nutritional status.
Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan.
Methods: This study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5-5.5 y (Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in 3 steps, and repeated cross-sectional surveys were conducted to assess the impact on children (age: 4.5-5.5 y) at 4- time points. ITT analyses with multilevel mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes.
Results: The analysis included 3858 children with anthropometric data from 4 cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child height-for-age z score (mean difference: 0.13 z-scores; 95% confidence interval [CI]: 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, -0.29 weight-for-height z score (WHZ) (95% CI: -0.42, -0.15), -0.13 BMI z score (BMIZ) (95% CI: -0.23, -0.03), and -0.16 mid-upper arm circumference-for-age z score MUACZ (95% CI: -0.25, -0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and weight-for-age z score (WAZ) was greater in the survey round during the COVID-19 lockdown.
Discussion: The LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (eg school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development.
Research Square (Research Square), Feb 5, 2024
Background:The growth and development of the unborn child in the womb is affected by various inte... more Background:The growth and development of the unborn child in the womb is affected by various internal and external factors. Auditory stimuli play a crucial factor in the development of the fetus therefore this study aims to explore the perceptions and barriers of pregnant women about conversation with the fetus. Materials and Methods:This qualitative study used manual methods of thematic analysis through purposive sampling. In depth and semi structured questionnaire online survey were distributed among 66 urban area pregnant women. Results: Three major themes were extracted from the date. ( ) Perceived signi cance of talking to baby in womb with 3 sub themes including Cognitive, parental, and fetal development, (2) Description of connection between in utero and outside world including External Sensory Stimulus, mother gestures and Movement of the fetus and (3) Barriers to talking to baby in womb including language, Psychological and Physical Social barriers Conclusion: The ndings suggested that the parents had a fundamental understanding of the importance of communication with the fetus and its impact on cognitive growth. However, there are various physical and social barriers that act as hindrance in building communication with the fetus. It is recommended to organize awareness sessions including in prenatal periods that motivate and teach parents on building communicating relations with the fetus.
BMC Women's Health, Dec 3, 2023
Background Antenatal Education equips parents with knowledge for safe maternal health and infant ... more Background Antenatal Education equips parents with knowledge for safe maternal health and infant care. It also reduces fear and anxiety during childbirth. ANE curriculum can vary according to country and institute. It can include classes focusing on childbirth, pain relief techniques, mode of birth, parenting, breastfeeding, breathing techniques, etc. Although ANE is widely practiced in developed countries, there is no standard program in developing countries like Pakistan. This study aims to improve antenatal education at a tertiary care hospital in Karachi, Pakistan potentially proposing an upgraded curriculum as a national standard. Methods This multiphase study used mix-method design was conducted in the Obstetrics and Gynaecology Department of a tertiary care hospital of Karachi, Pakistan from 2019 to 2021. Phase 1 of the study included reviewing and comparing the hospital's antenatal curriculum with existing literature, followed by Phase 2, which was a desk review of attendance and patient feedback. The 3 rd phase involved IDIs (in depth interviews) from health care workers (Obstetrics experts) to understand their perspectives regarding the ANE and the conducted classes. For phase one, gaps were identified and reported theoretically. For phase two, the annual attendance was recorded and participants' satisfaction with the classes assessed. Qualitative data from phase 2 and 3 was converted into themes and sub-themes. The audit showed a decline in the attendance of antenatal classes due to the pandemic and consequent shift to online sessions. The low attendance in online courses could be attributed to various factors. Patient feedback was generally positive, with a majority expressing high satisfaction levels. Expert feedback highlighted the need for additional topics such as mental health and COVID in pregnancy, as well as fathers' involvement. The curriculum was updated to include these topics and made more interactive with printed handouts for parents. A standardized antenatal education covering various topics surrounding pregnancy, childbirth, and postnatal care must be available to parents nationwide.
Early childhood is a crucial developmental phase of a child’s well-being, which lays the foundati... more Early childhood is a crucial developmental phase of a child’s well-being, which lays the foundation for their future
growth. Lack of good oral practices may cause dental issues during this fundamental phase of development and
have a long-lasting impact on a child’s overall well-being. This cross-sectional study was conducted at a tertiary
care hospital in Karachi, Pakistan, to explore oral health knowledge and practices among the caregivers of young
children. A sample of 94 participants, including parents, caregivers, early childhood educators, and healthcare
professionals (HCPS), was included through a convenient sampling technique. An online survey questionnaire
was administered, which covered various aspects of oral hygiene practices to prevent common oral diseases
among children. All statistical analyses were performed using SPSS 22.0. Statistical significance was accepted
as p ≤0.05. Results of the study revealed no significant differences in oral health knowledge and practices based
on age and gender. However, comparisons based on profession and roles showed a significant difference. Most
participants agreed on the importance of regular oral hygiene practices. However, their opinions differed on certain
oral hygiene practices, including the frequency of brushing and the timing of the first dental visit. This study
underscores the importance of targeted education and interventions to improve oral health outcomes during the
critical developmental phase of childhood.
Research Square (Research Square), Nov 7, 2023
The phenomenon of children raising children, or older children caretaking for younger children is... more The phenomenon of children raising children, or older children caretaking for younger children is underinvestigated and can signi cantly impact child development and family wellbeing outcomes. The perceptions and practices of 150 parents towards sibling caretaking in rural Pakistan were explored through mixed methods surveys and interviews. 73% of parents assign sibling caretaking responsibilities to their daughters primarily, and 89% ask the eldest child to care for younger siblings, while only 2% reported never assigning this responsibility to a child. Caretaking responsibilities include feeding, bathing, disciplining, and putting the younger siblings to sleep. 95% reported assigning these responsibilities to their eldest child as their personal choice; 79% reported sibling caretaking is aligned with traditional practices/beliefs, although 89% agreed it is unrelated to religious obligations. The ndings hold implications for provision of nurturing care services for young children to support their health, education, childcare, social engagement in resource-constrained settings where children are expected to care for their siblings.
International journal of women empowerment, Oct 18, 2022
Background: Maternal-fetal attachment is a multidimensional phenomenon and product of diverse phy... more Background: Maternal-fetal attachment is a multidimensional phenomenon and product of diverse physiological, psychological, and socio-emotional factors. The prenatal period is crucial in forming this bond and further predicts postnatal attachment. Methodology: The present research was conducted using a cross-sectional survey design. Sixty-six participants filled out the survey regarding practices, perceptions, and attitudes toward maternal-fetal attachment after attending an online session on "Talking to the Baby in the Womb." Results: Analysis revealed that participants talk to their baby in their tummy. Wondering when the baby starts thinking, feeling, and hearing within also aids in forming a maternal-fetal relationship. A statistically significant difference (p=0.013) was found between HCP and PW in terms of attitude towards feeding the baby and perception of a mother giving up on the baby (p=0.04). The following research allows us to study the differences in the practices between healthcare providers and pregnant women so that interventions can be designed accordingly.
Academy of Education and Social Sciences Review
This study aimed to learn about the climate change perspectives of parents. Convenience sampling ... more This study aimed to learn about the climate change perspectives of parents. Convenience sampling was employed to collect the data from individuals who were attending the climate change and parenting seminar online. This survey was sent as a pre survey questionnaire and the data of the parents who consented were used. There was no significant difference found with respect to gender, age or qualification in the climate belief, whereas significant difference was found in intention with respect to gender, qualification, and socioeconomic status. Furthermore, the findings stipulated the mean of beliefs (μ =1.72 and SD= 0.92) and the average mean of (μ =3.36 and SD= 0.86) in the intentions of people regarding climate change related attitude. Whereas the participants intention towards not investing time in solving the environmental issue shows strong agreement (μ=4.22.). The findings of the study share the insights of providing training to the parents of young children, so that they can ha...
Journal of the Pakistan Medical Association
Covid-19 has disrupted the mental health services in 93% of the countries worldwide. Approximatel... more Covid-19 has disrupted the mental health services in 93% of the countries worldwide. Approximately 130 countries are affected catastrophically by Covid-19, which limits access to mental health services. Most vulnerable are children, pregnant women, and adults with limited access to mental healthcare. In highlighting the importance of mobilising resources, the WHO has given leaders around the world an opportunity to galvanise efforts. Maternal and children’s mental health are crucial factors that may have a lifelong impact. In a post-pandemic world, a renewed focus is required to develop sustainable policies and action plans to support new mothers and new-borns in the first 1,000 days of life. This viewpoint shares a reflective discourse on contextualising the need of investment in mental health in times of crisis and global pandemic and what needs to be catered to in the near future. Keywords: First 1,000 days of life, Maternal health, Women’s health.
Various external factors influence a child's growth in-utero. Recent studies aim to investiga... more Various external factors influence a child's growth in-utero. Recent studies aim to investigate how external stimuli, specifically auditory stimuli, affect an unborn child's development. Data was gathered through an online survey approach, and the investigation was carried out utilizing a descriptive qualitative study methodology. The participants were asked to participate in the research survey and fill out a semi-structured questionnaire at the conclusion of the workshop, which is when the data was gathered. A total of 66 pregnant couples took part in the study. Thematic analysis was used manually to accomplish the analysis. This study investigates how parents feel about conversing with their unborn child. Interestingly, the findings were able to demonstrate that the parents had a fundamental understanding of the significance of such communication in relation to the fetus's cognitive growth elements. According to the participants' comments, there may be a limit to ...
BMJ Open Quality
Obstetric triage has become one of the most crucial innovations in the field of perinatal care in... more Obstetric triage has become one of the most crucial innovations in the field of perinatal care in the past 15 years. In lower- middle- income countries (LMICs), the pregnant patients are seen in a conventional way based on the time of their arrival; this divergent, unbalanced and inequitable approach results in delayed initial evaluation, prolonged length of stay (LOS) and affected clinical outcomes.This project aimed at implementing an effective and efficient obstetric triage system with improved throughput and care processes within six months to facilitate timely decision making according to the individualized needs of pregnant patients.A pre-implementation audit was completed for the core evaluation of existing obstetric triage services, followed by a fishbone analysis. Following the Donabedian model for quality care, a quality improvement project was initiated to redesign the obstetric triage system. The project strategy was implemented as part of six PDSA (Plan- Do -Study- Act)...
International Journal Of Community Medicine And Public Health, 2020
Background: The emergence of COVID-19 and its pandemic nature has exacerbated fears worldwide. Pr... more Background: The emergence of COVID-19 and its pandemic nature has exacerbated fears worldwide. Pregnant women are considered a vulnerable group during the COVID-19 pandemic because the physiological changes make them more susceptible to infections. Pregnant women are found expressing much of the fear related to their course of pregnancy, the in-utero transmission of the disease, and questions related to infection control in healthcare settings. Hence, the purpose of this paper was to explore the fears faced by pregnant women related to COVID.Methods: It was a cross-sectional survey among 201 pregnant women attending antenatal clinics of Aga Khan University Hospital. The survey tool contains demographic variables and a 7-item scale of “Fear in COVID” which is pre tested in the Iranian population. The survey form was made on google drive and sent to pregnant females on WhatsApp.Results: 201 pregnant women mostly belonging to middle and low socioeconomic class were enrolled. The majori...
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Papers by Shelina Bhamani
Methods: The SRIS consists of twenty elements that are used to classify new-born handling, interactions, consoling techniques, engagement, and distress. High reliability and internal consistency were shown in the data gathered from 257 mothers (Cronbach's alpha=0.8354). The scale's one-dimensional structure was discovered through construct validity analysis, demonstrating the consistency of the scale's evaluation of response interactions.
Results: The results indicate that the valid and reliable instrument for gauging the responsiveness of caregivers during their initial contact with neonates. It provides a useful and approachable method with possible uses in healthcare settings and research for evidence-based parenting interventions.
Conclusions: To improve the tool's generalizability and usefulness in fostering early childhood development and parental engagement, further research is necessary to validate it across a variety of contexts.
Keywords: Early childhood development, Responsive interactions, Responsive caregiving, Parenting
Parents require support while caring for their newborns. Nurses can be supportive in helping parents learn how to care for their newborns and their well-being and supporting their spouses and families based on the cultural and social norms of the local context of Pakistan. Newborn parent education programs play a crucial role in advancing the knowledge and skills of the nurses required for parent education. This research study aims to explore nurses' experiences as newborn parent educators after enrolling and implementing a pilot project of a newborn parent education program at a tertiary care university hospital.
Methods:
The exploratory qualitative research design was used to collect the responses from the four nurses at a tertiary care hospital in Karachi, Pakistan. Semi-structured interviews were conducted. Recorded interviews were transcribed, coded, and converted into themes.
Results:
The result is described under three themes, including nurses' knowledge, skills, and the importance of the program. The findings highlighted the significant role of nurses' knowledge in the health education of newborn parents toward holistic care. Obstetrics and Gynecology nurses are well-equipped with the health education and skills to care for patients and newborns. Advanced training will further equip them with concepts and skills of early childhood development.
Conclusion:
The study signifies that formal inclusion of such training in the curriculum and nursing trainings such as continuing professional development courses and activities is much needed with the endorsement of nursing leadership and faculty. It also highlights the role of policymakers in the investment of nursing education and practice in different health fields.
Keywords: nurse; newborn; parent; education; experience
Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan.
Methods: This study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5-5.5 y (Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in 3 steps, and repeated cross-sectional surveys were conducted to assess the impact on children (age: 4.5-5.5 y) at 4- time points. ITT analyses with multilevel mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes.
Results: The analysis included 3858 children with anthropometric data from 4 cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child height-for-age z score (mean difference: 0.13 z-scores; 95% confidence interval [CI]: 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, -0.29 weight-for-height z score (WHZ) (95% CI: -0.42, -0.15), -0.13 BMI z score (BMIZ) (95% CI: -0.23, -0.03), and -0.16 mid-upper arm circumference-for-age z score MUACZ (95% CI: -0.25, -0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and weight-for-age z score (WAZ) was greater in the survey round during the COVID-19 lockdown.
Discussion: The LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (eg school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development.
growth. Lack of good oral practices may cause dental issues during this fundamental phase of development and
have a long-lasting impact on a child’s overall well-being. This cross-sectional study was conducted at a tertiary
care hospital in Karachi, Pakistan, to explore oral health knowledge and practices among the caregivers of young
children. A sample of 94 participants, including parents, caregivers, early childhood educators, and healthcare
professionals (HCPS), was included through a convenient sampling technique. An online survey questionnaire
was administered, which covered various aspects of oral hygiene practices to prevent common oral diseases
among children. All statistical analyses were performed using SPSS 22.0. Statistical significance was accepted
as p ≤0.05. Results of the study revealed no significant differences in oral health knowledge and practices based
on age and gender. However, comparisons based on profession and roles showed a significant difference. Most
participants agreed on the importance of regular oral hygiene practices. However, their opinions differed on certain
oral hygiene practices, including the frequency of brushing and the timing of the first dental visit. This study
underscores the importance of targeted education and interventions to improve oral health outcomes during the
critical developmental phase of childhood.
Methods: The SRIS consists of twenty elements that are used to classify new-born handling, interactions, consoling techniques, engagement, and distress. High reliability and internal consistency were shown in the data gathered from 257 mothers (Cronbach's alpha=0.8354). The scale's one-dimensional structure was discovered through construct validity analysis, demonstrating the consistency of the scale's evaluation of response interactions.
Results: The results indicate that the valid and reliable instrument for gauging the responsiveness of caregivers during their initial contact with neonates. It provides a useful and approachable method with possible uses in healthcare settings and research for evidence-based parenting interventions.
Conclusions: To improve the tool's generalizability and usefulness in fostering early childhood development and parental engagement, further research is necessary to validate it across a variety of contexts.
Keywords: Early childhood development, Responsive interactions, Responsive caregiving, Parenting
Parents require support while caring for their newborns. Nurses can be supportive in helping parents learn how to care for their newborns and their well-being and supporting their spouses and families based on the cultural and social norms of the local context of Pakistan. Newborn parent education programs play a crucial role in advancing the knowledge and skills of the nurses required for parent education. This research study aims to explore nurses' experiences as newborn parent educators after enrolling and implementing a pilot project of a newborn parent education program at a tertiary care university hospital.
Methods:
The exploratory qualitative research design was used to collect the responses from the four nurses at a tertiary care hospital in Karachi, Pakistan. Semi-structured interviews were conducted. Recorded interviews were transcribed, coded, and converted into themes.
Results:
The result is described under three themes, including nurses' knowledge, skills, and the importance of the program. The findings highlighted the significant role of nurses' knowledge in the health education of newborn parents toward holistic care. Obstetrics and Gynecology nurses are well-equipped with the health education and skills to care for patients and newborns. Advanced training will further equip them with concepts and skills of early childhood development.
Conclusion:
The study signifies that formal inclusion of such training in the curriculum and nursing trainings such as continuing professional development courses and activities is much needed with the endorsement of nursing leadership and faculty. It also highlights the role of policymakers in the investment of nursing education and practice in different health fields.
Keywords: nurse; newborn; parent; education; experience
Objective: We evaluated the effect of a center-based ECCE intervention on child nutritional outcomes in rural Pakistan.
Methods: This study utilized data from a stepped-wedge cluster randomized controlled trial of a center-based ECCE program that trained female youth to run high-quality preschools for children aged 3.5-5.5 y (Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) program) in rural Sindh, Pakistan. The program did not include any school meals. A total of 99 village clusters were randomized to receive the LEAPS intervention in 3 steps, and repeated cross-sectional surveys were conducted to assess the impact on children (age: 4.5-5.5 y) at 4- time points. ITT analyses with multilevel mixed-effect models were used to estimate the effect of the intervention on child anthropometric outcomes.
Results: The analysis included 3858 children with anthropometric data from 4 cross-sectional survey rounds. The LEAPS intervention was found to have a positive effect on child height-for-age z score (mean difference: 0.13 z-scores; 95% confidence interval [CI]: 0.02, 0.24). However, there was a negative effect on weight-based anthropometric indicators, -0.29 weight-for-height z score (WHZ) (95% CI: -0.42, -0.15), -0.13 BMI z score (BMIZ) (95% CI: -0.23, -0.03), and -0.16 mid-upper arm circumference-for-age z score MUACZ (95% CI: -0.25, -0.05). An exploratory analysis suggested that the magnitude of the negative effect of LEAPS on WHZ, BMIZ, and weight-for-age z score (WAZ) was greater in the survey round during the COVID-19 lockdown.
Discussion: The LEAPS intervention positively affected child linear growth but had negative effects on multiple weight-based anthropometric measures. ECCE programs in low- and middle-income country settings should evaluate the integration of nutrition-specific interventions (eg school lunch, counseling on healthy diets) and infection control strategies to promote children's healthy growth and development.
growth. Lack of good oral practices may cause dental issues during this fundamental phase of development and
have a long-lasting impact on a child’s overall well-being. This cross-sectional study was conducted at a tertiary
care hospital in Karachi, Pakistan, to explore oral health knowledge and practices among the caregivers of young
children. A sample of 94 participants, including parents, caregivers, early childhood educators, and healthcare
professionals (HCPS), was included through a convenient sampling technique. An online survey questionnaire
was administered, which covered various aspects of oral hygiene practices to prevent common oral diseases
among children. All statistical analyses were performed using SPSS 22.0. Statistical significance was accepted
as p ≤0.05. Results of the study revealed no significant differences in oral health knowledge and practices based
on age and gender. However, comparisons based on profession and roles showed a significant difference. Most
participants agreed on the importance of regular oral hygiene practices. However, their opinions differed on certain
oral hygiene practices, including the frequency of brushing and the timing of the first dental visit. This study
underscores the importance of targeted education and interventions to improve oral health outcomes during the
critical developmental phase of childhood.