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Background: Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective: We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods: This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results: Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators' guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions: This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users' perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth. Trial Registration: ClinicalTrials.gov NCT04693585 (Registration date: 05/01/21). [ABSTRACT FROM AUTHOR]

Background: Maternal healthcare service utilization is a pivotal indicator of a nation's progress in safeguarding the health and well-being of its women and children. In this context, women's empowerment emerges as a critical determinant influencing the utilization of maternal healthcare services. The study aims to assess the relationship between women's level of empowerment and utilization of maternal healthcare services among currently married women in India. Data and Methods: The study uses data from the fifth round of the National Family Health Survey conducted in 2019–2021 and analyzed 26,552 (15–49 aged) currently married women who had a live birth in the last 5 years preceding the survey. Additionally, univariate and bivariate analyses, multivariate logistic regression, and the SWPER index were used for the analysis. Results: Over the years, utilization of antenatal care, skilled birth attainment, and postnatal care has increased extensively in India. However, the study found that utilization of services was higher among empowered women, and it varies across the state with the extent of empowerment. State-level analysis shows that the extent of women empowerment was higher in Goa, followed by Tamil Nadu and Kerala, and lower in Jharkhand, followed by Tripura, so as the utilization of maternal and health care services. The extent of empowerment and utilization of services also varies by level of educational attainment, employment, and socio-economic status. Conclusion: There is a need for comprehensive strategies to enhance women's empowerment through education, employment, political participation, self-awareness, and reduction in gender-based violence and child marriages, which may improve awareness demand for better public health structure, and may ensure higher utilization of maternal healthcare services. Ultimately, these strategies may converse the higher maternal death and child mortality. Significance: What is already known about this subject? Existing literature in India mostly highlights a clear connection between women's autonomy and maternal healthcare services utilization. Women with higher autonomy, decision-making power, and mobility are more likely to use these services. However, in exploring the link between women's empowerment and maternal healthcare, some studies focus on education, employment, and media access among Indian mothers, sidelining broader empowerment dimensions. What this study adds? This study is likely the first to investigate the relationship between women's empowerment and the level of maternal healthcare service utilization in India. It covers key dimensions of women's empowerment, including Attitude to Violence, Social Independence, and Decision-making Power. Moreover, it is possibly the first Indian research paper to employ a survey-based women's empowerment index in this context. Notably, the assessment highlights Social Independence as a significant dimension. [ABSTRACT FROM AUTHOR]

Introduction: Intellectual disability (ID) is a neurodevelopmental disorder characterized by three main clinical conditions, i.e., cognitive deficiencies, impairments of adaptive function, and onset during the developmental period. The causes of ID include genetic abnormalities, as well as prenatal, perinatal, and postnatal environmental factors such as exposure to toxic agents, nutritional deficiencies, childhood brain infections, and maternal infections such as rubella and cytomegalovirus may lead to ID. The present study attempted to perform a detailed analysis of case histories of children with ID among North Karnataka region to examine the frequency of occurrence of risk factors which can cause onset of ID. Methods: Retrospective analysis of records of 1400 individuals who visited our Institute, for speech and language evaluation was analyzed. Among 1400 cases, there were 300 cases were selected for the study. Results: The risk factors identified in this study primely constitute of perinatal and postnatal factors and lower socioeconomic status. Conclusion: It may be implied from the results of the study that appropriate peri and postnatal health care interventions can help to reduce risks leading to ID. Utilizing this knowledge will help with both primary and secondary level prevention by raising public awareness of the probable causes of ID. It is also possible to identify these risk factors, detect ID early, and then intervene at the earliest. Furthermore, extensive researches focusing on a thorough evaluation of risk factors with respect to severity of ID need to be carried out. This will help in understanding the causative factors better, and hence, enhance the development of preventive strategies and planning of a better rehabilitation program. [ABSTRACT FROM AUTHOR]

Background: Maternal and child health (MCH) care is one of the essential routine healthcare services, which got affected during the coronavirus disease 2019 (COVID-19) pandemic. Modeled projections had anticipated an 8.3%-38.6% rise in maternal mortality from different countries globally. In view of limited studies pertaining to issues related to accessing MCH services in the event of a pandemic, this study was carried out on pregnant and postnatal mothers in Odisha, India. Methods: An explorative qualitative study through 36 in-depth interviews (IDIs) was conducted among 16 (44.4%) antenatal and 20 (55.5%) postnatal mothers in six of thirty districts of Odisha, India, from February to April 2021. The districts and blocks were randomly selected for better representativeness. The IDIs were conducted using a predesigned and pretested guide among mothers who had undergone delivery or availed of antenatal, postnatal, or child health services from October 2020 to April 2021. The IDIs were conducted till data saturation. The data were analyzed using MAXQDA software. Results: The average age of mothers was 27.6 (+/- 2.2) years. Among the participants, 16 (44.4%) were antenatal and 20 (55.6%) were postnatal mothers; 19 (52.8%) were primipara and 17 (47.2%) were multipara. The majority explained that they received enormous support including door-to-door services from the community health workers (CHWs) even during the difficult times of the pandemic. Reduced transportation facility and fear of contracting the infection were reasons behind the unwillingness to visit health facilities and preference for home delivery. Furthermore, the pandemic had physical, mental, social, and financial impacts among pregnant and postnatal women. Conclusion: The unprecedented COVID-19 pandemic has affected access to MCH services by antenatal and postnatal mothers. Health system preparedness and appropriate strategies including better community engagement and participation could avert such challenges in the future. [ABSTRACT FROM AUTHOR]

This study had focused on exploring the cultural traditions and beliefs surrounding the ante-natal, post-natal, and postpartum periods. Pregnancy and childbirth are significant life events that are associated with different cultural beliefs and practices, which can vary across regions, ethnicities, and religions. Understanding these cultural traditions and beliefs, is important for healthcare providers to provide culturally sensitive care to pregnant and postpartum women. This study had used mixed method research design to explore the cultural traditions and beliefs surrounding the ante-natal, post-natal, and postpartum periods. The study was conducted on 110 subjects in the Nauni and its adjacent environs in the state of Himachal Pradesh, India. It involved in-depth interviews and focus group discussions with pregnant women and with the women who have at least one child and their families. The data collected was analyzed using thematic analysis to identify common cultural traditions and beliefs related to pregnancy and childbirth. The study aimed to provide insight into how cultural beliefs and practices influence healthcare-seeking behaviors, decision-making, and perceptions of care during the ante-natal, post-natal, and postpartum periods. The findings of this study can inform the development of culturally appropriate healthcare interventions and policies to improve maternal and child health outcomes. [ABSTRACT FROM AUTHOR]

Background: As India reduced maternal mortality by 50% in the last decade, the mental health of mothers has slowly started catching our attention. Increased participation of women in the economic sector and awareness of women's rights has added to this process. Perinatal depression has been associated with negative birth outcomes and poor child development. The paucity of research from eastern India poses challenges for physicians and hinders effective medical interventions. Aim: To investigate the effect of antenatal and postnatal depression on child development at 12 months of age. Method: In total, 174 mothers were administered Bengali Edinburgh Postnatal Depression Scale (EPDS-B) for assessment of antenatal and postnatal depression. Developmental Assessment Scale in Indian Infants (DASII) was administered to assess the motor and cognitive development of their children (n = 153) at 12 months. Result: The prevalence of antenatal and postnatal depression was 28.7% and 16.7%, respectively. Antenatal depression predicted postnatal depression (β = 0.631). Mothers with AD scored significantly low on family support measures (P = 0.012). Children of mothers with AD had low motor and cognitive attainment at the age of 12 months (P = 0.022). Conclusion: Screening and treatment of mental health need to be included in the antenatal care routine to facilitate appropriate child development. [ABSTRACT FROM AUTHOR]

Introduction: Proper positioning and attachment play a key role in exclusive breastfeeding. Whereas incorrect breastfeeding techniques lead to poor milk transfer and early discontinuation of breastfeeding. Objectives: 1. To assess the breastfeeding techniques among postnatal mothers and to identify the factors associated with improper positioning and poor attachment. 2. To prioritize the action points to improve the poor breastfeeding practices according to the viewpoint of the staff nurses. Materials and Methods: A hospital-based mixed-methods study was carried out in Puducherry for 6 months. In quantitative phase, 99 postnatal mothers were interviewed consecutively and breastfeeding techniques were observed based on Baby Friendly Hospital Initiative and Integrated Management of Neonatal and Childhood Illness guidelines. In qualitative phase, 45 staff nurses ranked the action points to improve the poor breastfeeding practices. Bivariate and multivariate analyses were employed. Mean rank and Kendalls' Concordance Coefficient were calculated for the ranked data. Results: About 28.3% and 27.3% of mothers demonstrated improper positioning and poor attachment, respectively. Young mothers, housewives, <10 days old infants, and failure to receive breastfeeding counseling were associated with poor breastfeeding techniques. Poster displays, healthcare workers' training, targeted counseling, and assistance were the priority action points suggested by the staff nurses. Conclusion: Maternal age, maternal occupation, infants' age, and breastfeeding counseling influenced breastfeeding techniques. The prioritized action points need to be implemented to achieve the level of Baby Friendly Hospital. [ABSTRACT FROM AUTHOR]

In India reproductive health is a major concern especially in economically weak families belonging to scheduled caste (SC). The present study is aimed at drawing a systematic factual knowledge about the socio-economic conditions and reproductive health profile of rural women of Chasi village of district Bulandshahr, Uttar Pradesh, India. A total of 100 married women of age group: 15-45 years, were interviewed using schedule/guide and purposive sampling method. Majority (82%) of the women were housewives and half (52%) were illiterate. Monthly family income of 70% of the respondents was between Rs. 5001 to Rs. 10,000/-. More than half (60%) of respondents were married in early age group of 15-20 year whereas 35% respondents were married in age group of 21-25 years. Majority (55%) of the respondents gave birth to the first child in early age of 15-20 years and 65% respondents have 3-5 children. 55% of the respondents found sources of consultation treatment in government hospital. Significant number (40%) of respondents were found to have consulted made (Dai) and most of (60%) the deliveries have been conducted at home by untrained Dai. A half of the respondents felt weakness during prenatal period.40% of respondents suffered from lower abdominal pain, 30% respondents suffered from several headache and 25% of respondents suffered from back pain, swelling stitches pain or infection. However,40% of the respondents told that their babies were normal during prenatal period, 25% of respondents have experienced the premature delivery. It was observed that a large number of respondents (46%) take the rest of one month after delivery and one third (29%) respondents take the rest for only 15 days after delivery. This study reveals that the majority of the women lack proper care, consultation and hygiene before, during and after the child birth. This study strongly recommends the formulation and implementation of emphatic strategies to improve reproductive status of women in rural areas. [ABSTRACT FROM AUTHOR]

Over a quarter of UK births are to women who were born outside of the UK. Black and Minority Ethnic (BME) women are disproportionately affected by poor mental health and inequitable access to mental health care in the perinatal period, yet the influence of the migrant status (mothers' UK vs. non-UK birth) is poorly understood. This study aimed to explore the relationship between ethnicity, migration and mental health indicators among mothers participating in a large nationally representative cohort study. This is a secondary analysis of data from the Millennium Cohort Study. Logistic regression quantified the crude and adjusted effects of self-reported ethnicity and migrant status on prevalence of psychological distress and treatment for anxiety/depression at 9-month and 5-year postpartum. We found substantial variation in the prevalence of distress according to ethnicity and migrant status, with Indian and Pakistani women at greatest risk. Despite equal or greater risk, BME and migrant women were less likely to report treatment for anxiety/depression. Mutually adjusted analyses showed ethnicity to be a stronger predictor of both outcomes than migrant status; however, at 5 years, being a migrant independently predicted lower odds of treatment, for a statistically similar level of distress. Migrant women are likely to be at high risk of poor mental health in the perinatal period and beyond, yet may face significant barriers to accessing mental health care. A better understanding of ethnicity and migration as interrelated risk factors for perinatal mental ill-health is needed to help National Health Service organisations develop policy and practice that is flexible and responsive to diversity. • Migrant and ethnic minority mothers are at increased risk of psychological distress. • But are less likely than non-migrant/white British women to be treated for anxiety/depression. • Ethnicity was a stronger predictor than migrant status of these differences. [ABSTRACT FROM AUTHOR]

Introduction: Adequate antenatal counseling combined with postnatal lactation support is likely to improve exclusive breastfeeding rates.Objective: To assess the impact of a postnatal video based health education program in promoting exclusive breastfeeding among primiparous mothers.Methods: This interventional study was done in a tertiary care teaching hospital, south India. Primiparous mothers in one postnatal ward (group A) received routine lactation counseling. A similar group of primiparous mothers in another postnatal ward (group B) were administered a video based health education program on exclusive breastfeeding in the local language Tamil in addition to the routine lactation counseling. The exclusive breastfeeding rates of these two groups of mothers were compared. Their knowledge and perceptions after intervention were also compared using a pretested questionnaire.Results: Among 878 primiparous mothers, 94% fed colostrum and 43% initiated breastfeeding within one hour of delivery. Correct attachment was noted with 96% and 13% had lactation issues. Group B had marginally better exclusive breastfeeding rate at six months but not statistically significant. Mothers in group B had a statistically significant better knowledge score post-intervention compared to those in Group A. Use of gripe water was more in group A compared to group B.Conclusion: The video based health education program when combined with routine lactation counseling improved the knowledge regarding exclusive breastfeeding among postnatal primiparous mothers better than with routine lactation counseling alone. However, both interventions had similar effect on exclusive breastfeeding rate at six months. [ABSTRACT FROM AUTHOR]

Background: Domestic violence is a leading cause of social morbidity and may increase during and after pregnancy. In high-income countries screening, referral and management interventions are available as part of standard maternity care. Such practice is not routine in low- and middle-income countries (LMIC) where the burden of social morbidity is high., Methods: We systematically reviewed available evidence describing the types of interventions, and/or the effectiveness of such interventions for women who report domestic violence during and/or after pregnancy, living in LMIC. Published and grey literature describing interventions for, and/or effectiveness of such interventions for women who report domestic violence during and/or after pregnancy, living in LMIC was reviewed. Outcomes assessed were (i) reduction in the frequency and/or severity of domestic violence, and/or (ii) improved physical, psychological and/or social health. Narrative analysis was conducted., Results: After screening 4818 articles, six studies were identified for inclusion. All included studies assessed women (n = 894) during pregnancy. Five studies reported on supportive counselling; one study implemented an intervention consisting of routine screening for domestic violence and supported referrals for women who required this. Two studies evaluated the effectiveness of the interventions on domestic violence with statistically significant decreases in the occurrence of domestic violence following counselling interventions (488 women included). There was a statistically significant increase in family support following counselling in one study (72 women included). There was some evidence of improvement in quality of life, increased use of safety behaviours, improved family and social support, increased access to community resources, increased use of referral services and reduced maternal depression. Overall evidence was of low to moderate quality., Conclusions: Screening, referral and supportive counselling is likely to benefit women living in LMIC who experience domestic violence. Larger-scale, high-quality research is, however, required to provide further evidence for the effectiveness of interventions. Improved availability with evaluation of interventions that are likely to be effective is necessary to inform policy, programme decisions and resource allocation for maternal healthcare in LMIC., Trial Registration: Systematic review registration number: PROSPERO CRD42018087713.