Legal Policy of Child Marriage In the Covid-19 Pandemic Period

The increase in marriage dispensation applications that occurred during the Covid-19 pandemic also caused the high number of child marriage. Nevertheless, this has been strictly required in Law Number 16 of 2019 concerning Amendments to Law Number 1 of 1974 concerning Marriage (Marital Law), the minimum age limit for men and women is 19 years, and requirements of irregularities for this age that must meet urgent criteria and sufficient support evidence. This is done, to reduce underage child marriages as a form of enforcing the principle of children's best interests. This paper describes the complexity of underage children's marriage during the Covid-19 pandemic period, as a convenience requirement of marriage dispensation has been set rigid in the Marriage act. The method used in this paper is normative by using several approaches: the statute approach, conceptual approach, and case approach. The results of the government's policy during the Covid-19 pandemic period which brought massive changes to the community's order had an impact on the collapse of the family economy. This resulted in the mass number of the child's marriages in the pandemic period. The research findings of this study deliver to children's rights violations through child marriages. The risk of decreasing individual economies, maternal and infant health, and household violence become unavoidable considering the psychological conditions of children who are immature in marriage.

Study on the Impact of Online Courses for Pregnant and Lying-In Women on Maternal and Infant Health during the Epidemic

The sudden outbreak of the new crown pneumonia has brought online learning from a supporting role to the center of the teaching stage in an instant. On the basis of the feasibility analysis and demand analysis of the microcourse learning system, this paper uses Sina cloud server to build the WeChat public platform learning online course and designs and implements the microcourse learning system function based on the microcourse public platform. We completed the recording, editing, publishing, and testing of microclass courses and provided services for teachers and pregnant women's microclass learning in order to achieve better learning results. A total of 151 people regularly participate in maternity school courses, accounting for 30.4%. There are 190 people who have never attended the maternity school course, accounting for 38.2%. There are 156 people who occasionally participate in maternity school courses, accounting for 31.4%. The top five sources of health information during pregnancy are books, maternity schools, experience of elders, the Internet, and television. The results of one-way analysis of variance showed that pregnant women of different ages had statistically different scores in the dimensions of knowledge and ideas ( P < 0.05). There are statistical differences in the scores of pregnant women with different economic incomes in this dimension ( P < 0.05). The women with economic income ≥5000 yuan/month have the highest scores, and those with economic income ≥5000 yuan/month have the lowest scores. The scores of pregnant women who participated in the maternity school were significantly higher than those who did not participate in the maternity school ( P < 0.05). There are statistical differences in the scores of maternal and child health basic skills among pregnant women of different age groups ( P < 0.05). The women aged ≥35 years old have the highest scores, and those aged 20–24 years old have the lowest scores. The differences in the scores of pregnant women with different economic incomes in this dimension are statistically significant ( P ＜0.05). The women with economic income ≥5000 yuan/month have the highest score, and those with economic income<2000 yuan/month have the lowest score. Participation in maternity schools has an impact on the scores of this dimension. Pregnant women who regularly participate in maternity schools have the highest average scores, and those who do not participate in maternity schools have the lowest average scores.

Development and Feasibility of a Group, Household Level Intervention To Improve Preconception Nutrition in Nepal

Background: In a setting such as Nepal with malnutrition and persistent poor maternal and infant health outcomes, developing interventions to improve the nutrition of preconception and pregnant women is essential. Aside from factors related to access and knowledge about diverse and adequate diets, inequitable gender norms and women’s low status and autonomy also feed into a lack of emphasis on women’s nutrition.Methods: In this paper we describe the three phases of the design of an intervention for newly married women, their husbands, and mothers-in-law in rural Nepal. We first discuss findings from a mixed methods formative phase, and how that fed into the design of the intervention itself, in close partnership with community members. We the describe the intervention, and findings from a mixed methods feasibility and acceptability pilot among 90 participants.Results: Our formative work highlighted not just lack of awareness about nutrition, but also how factors such as women eating last, and limited mobility, played into poor diets. Low lack of communication and household and community inequitable gender norms were also important factors. Thus we designed Sumadhur, an intervention that brought groups of households (newly married wife, husband, and mother-in-law) together weekly for 4 months to strengthen relationships and gain knowledge through interactive content. We found Sumadhur to be highly feasible and acceptable by all respondents, with most (83%) attending 80% of sessions or more, the majority (73%) of participants reported “no difficulties” in attending sessions, and 99% reporting that they would like it to continue. Pre/post surveys showed a decrease in the proportion of women of women eating last and increase in knowledge about nutrition in preconception and pregnant. Qualitative interviews suggested that respondents felt it made large impacts on their lives, in terms of strengthening relationships and trust, understanding each other, and changing behaviors.Conclusions: We show how a designing an intervention in close partnership with the target recipients and local stakeholders can lead to an intervention that is able to target complicated and culturally held practices and beliefs, positively benefit health and wellbeing, and that is very well received.Trial registration: ClinicalTrials.gov NCT04383847, registered 12/05/2020https://clinicaltrials.gov/ct2/show/results/NCT04383847?view=results

Effects of a four-year health systems intervention on the use of maternal and infant health services: results from a programme evaluation in two districts of rural Chad

Background Attendance of maternal and infant care services in rural Chad are consistently low. Our study aimed to assess the use of antenatal (ANC) and postnatal care (PNC) services, health facility delivery and infant health services after 4 years of a health systems intervention for improving the infrastructure, supplies, training and sensitization for maternal and infant health in two districts of rural Chad. Methods Data from a repeated cross-sectional household survey conducted in Yao and Danamadji in 2015 and in 2018 were analyzed. A stratified two-stage cluster sampling methodology was applied to achieve a representative sample of the rural settled and mobile population groups in the study area. A generalized linear model was applied to determine the health care utilization rates. Multivariate regression models were used to assess the association between the programme intervention and utilization outcomes of selected maternal and infant health services. Results Complete datasets were available for 1284 households at baseline. The endline analysis included 1175 households with complete survey data. The use of at least one ANC amongst pregnant women increased in both settled communities (from 80% in 2015 to 90% in 2018) and amongst mobile pastoralist communities (from 48% in 2015 to 56% in 2018). The rate of home delivery among settled communities and mobile pastoralists changed little between baseline and endline and remained high for both population groups. Individuals that were covered by the health systems intervention were however significantly more likely to attend ANC and less likely to give birth at home. PNC services only showed improvements amongst the settled communities (of 30%). Infants’ reported health outcomes and vaccination coverage considerably improved; the latter especially among mobile pastoralist (from 15% in 2015 to 84% in 2018). Conclusion A combination of health systems strengthening interventions was associated with an increased use of certain maternal and infant health services. However, to facilitate equitable access to and use of health care services in particular in times of increased vulnerability and by certain population groups in hard-to-reach areas, reinforced health education and culturally adapted communication strategies, including gender-specific messaging will be needed over a sustained period.

Rituals and Embodied Cultural Practices at the Beginning of Life: African Perspectives

Cultural beliefs and practices find expression through rituals. Rites of initiation or passage are some of the most common rituals among the indigenous African societies. Pregnancy and Childbirth are not only biological events, but also socially and culturally constructed with associated symbols that represent the social identities and cultural values of Africans. Birth is a rite of passage, and children are perceived as special gifts from the Supreme Being. As such, pregnancy and childbirth are special events cherished and celebrated through varied rituals. Drawing on empirical literature and relevant commentaries, this paper aims to discuss selected rituals and embodied practices surrounding the start of life (pregnancy, birth, and early motherhood). The paper will specifically focus on the following aspects: pregnancy rituals; birth songs and dancing; the omugwo (care after birth); the cord and placenta rituals; and the naming ceremony. Some of the pregnancy rituals are purificatory in nature and therefore beneficial for maternal and infant health. The celebrations surrounding the birth of a child are community events, marked with singing and dancing. Following childbirth, the new mothers are not expected to participate in house chores to allow them time to recuperate. In all, discourses concerning the beginning of life, i.e., pregnancy and the periods surrounding it, are filled with rituals which are embodiments or expressions of cultural values, customs, and beliefs.

Development and Feasibility of a Group, Household Level Intervention To Improve Preconception Health in Rural Nepal.

Background: In a setting such as Nepal with malnutrition and persistent poor maternal and infant health outcomes, developing interventions to improve the nutrition of preconception and pregnant women is essential. Aside from factors related to access and knowledge about diverse and adequate diets, inequitable gender norms and women’s low status and autonomy also feed into a lack of emphasis on women’s nutrition.Methods: In this paper we describe the three phases of the design of an intervention for newly married women, their husbands, and mothers-in-law in rural Nepal. We first discuss findings from a mixed methods formative phase, and how that fed into the design of the intervention itself, in close partnership with community members. We the describe the intervention, and findings from a mixed methods feasibility and acceptability pilot among 90 participants.Results: Our formative work highlighted not just lack of awareness about nutrition, but also how factors such as women eating last, and limited mobility, played into poor diets. Low lack of communication and household and community inequitable gender norms were also important factors. Thus we designed Sumadhur, an intervention that brought groups of households (newly married wife, husband, and mother-in-law) together weekly for 4 months to strengthen relationships and gain knowledge through interactive content. We found Sumadhur to be highly feasible and acceptable by all respondents, with most (83%) attending 80% of sessions or more, the majority (73%) of participants reported “no difficulties” in attending sessions, and 99% reporting that they would like it to continue. Pre/post surveys showed a decrease in the proportion of women of women eating last and increase in knowledge about nutrition in preconception and pregnant. Qualitative interviews suggested that respondents felt it made large impacts on their lives, in terms of strengthening relationships and trust, understanding each other, and changing behaviors.Conclusions: We show how a designing an intervention in close partnership with the target recipients and local stakeholders can lead to an intervention that is able to target complicated and culturally held practices and beliefs, positively benefit health and wellbeing, and that is very well received.Trial registration: ClinicalTrials.gov NCT04383847, registered 05/12/2020https://clinicaltrials.gov/ct2/show/results/NCT04383847?view=results

The Role of Oxytocin and the Effect of Stress During Childbirth: Neurobiological Basics and Implications for Mother and Child

The neuropeptide oxytocin acts as a hormone and a neuromodulator, influencing a multitude of human social behaviors, including reproduction. During childbirth and the postpartum period, it plays a key role in regulating and controlling processes that ensure a safe birth and the health of mother and child. Especially the onset of labor, the progress of labor and initial breastfeeding are mediated by oxytocin. In the maternal brain it controls the initiation of the mother–infant bond and the mother’s emotional responses towards her child. In this review we summarize the current state of knowledge about the role of oxytocin during the different aspects and mechanisms of human childbirth, combining research from human and animal studies. Physiological and psychological stress during childbirth and lactation can have negative effects on the progress of labor, breastfeeding and bonding. We discuss how maternity caregivers can support the positive effects of oxytocin and minimize the effects of stress. Furthermore, we highlight aspects of the basic neurobiological principles and connections where further research is needed to improve our understanding of the regulation and the effects of oxytocin to support maternal and infant health.

Assessing Social Determinants of Health in a Prenatal and Perinatal Cultural Intervention for American Indians and Alaska Natives

American Indians and Alaska Natives (AIANs) refer to cultural traditions and values to guide resilient and strength-based practices to address maternal and infant health disparities. Methods: A case study of a culturally-based educational intervention on AIAN maternal and child health. Results: Cultural teachings have successfully been applied in AIAN behavioral interventions using talking circles and cradleboards, but maternal and child health interventions are not well-represented in peer-reviewed literature. Zero publications included interventions centered around cradleboards and safe sleep. Discussion: There is a need for rigorous published research on culturally based interventions and effectiveness on health outcomes for mothers and babies. Conclusions: This paper discusses how a cradleboard educational intervention incorporates national guidelines to address maternal and infant health while mediating social determinants of health.

Repercussions of Stress during Pregnancy and Beyond

Stress, anxiety and depression are the disorders of brain but these affect even unborn child (foetuses). Various phobias affect expecting mothers. All these happen due to stress hormone Cortisol which is secreted during stress. This along with cortisol and other stress hormones lead to endocrine disorders like Graves’ disease, gonadal dysfunction, psychosexual dwarfism and obesity. Stress can also alter the clinical status of many preexisting endocrine disorders such as precipitation of adrenal crisis and thyroid storm. Stress during pregnancy changes hormonal milieu which affect the fetal environment and results in inflammatory conditions that have implications for maternal and infant health.