Effect of Adapted Interventions for Primary Child Health Care Services [Internet]

Excerpt

Pre-school child health services shall provide equitable services that caters to different families' circumstances and needs. This report is an overview of systematic reviews on the effects of adapted interventions for families with low socioeconomic status, ethnic minority families and teenage mothers, and interventions to promote interaction with the child for mothers with postpartum depression.

We included ten systematic reviews of high methodological quality. The findings show that:

1. Counselling, education and information about breastfeeding by health care workers adapted for low-income women can probably increase the proportion who initiate breastfeeding and who breastfeed at 3-6 months. Such interventions can perhaps also increase the proportion who initiate exclusive breastfeeding.

2. Home visiting programs for families with low socioeconomic status can probably reduce the prevalence of childhood injuries. It is uncertain whether it has any effect on uptake of childhood vaccinations.

3. Parent training programs adapted for socially disadvantaged families can perhaps prevent some externalizing behaviour of the child.

4. Support or outreach by lay health care workers for families with low socioeconomic status do probably not alter the proportion who initiate breastfeeding, but can perhaps considerably increase the prevalence of exclusive breastfeeding the first 6 months and who breastfeed the first year. Such interventions can probably also increase the uptake of childhood vaccinations, but has probably little effect on child fruit intake

Several of the study populations included ethnic minorities, but none of the systematic reviews addressed effects of interventions adapted for the needs of ethnic minorities. There is very limited documentation on whether parent training programs for teenage mothers and interventions for mothers with postnatal depression can improve aspects of mother-child interaction. Many of the studies were conducted in countries where the health services are organised differently from our country.

Due to aspects of study design and implementation or small studies, we had generally moderate to low confidence in the documentation. When we have low confidence in the documentation this does not mean that the interventions are ineffective, but that the documentation is limited to infer on the magnitude of any effects.

Keywords: Socioeconomic Factors; Vulnerable Populations; Minority Groups; Parents; Child; Preschool; Maternal-Child; Health Centers.