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All children in England should receive a health review at 2–21/2 years, with the Ages and Stages Questionnaire third edition (ASQ-3) used to collect public health surveillance data on child development. However, practitioners also value tools that assess individual children’s development—consistent with ASQ-3’s original purpose. Concerns about licensing costs and barriers to digitalisation have prompted interest in alternative tools to the ASQ-3 in England.
To inform policy, we conducted a rapid scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify tools that can measure or assess early child development.
Searched PubMed, PsycINFO and Web of Science from January 2012 to November 2022, with targeted search update November 2024.
We included English-language studies published after January 2012 that described or evaluated tools in English which could measure or assess early child development in children
We extracted key features and reliability, validity, sensitivity and specificity of tools which could feasibly be implemented at the 2–21/2-year review (eg, including multiple age versions and
We identified 112 unique publications describing 34 tools; six met our feasibility criteria for the 2–21/2-year review (reported in 53 studies). Only ASQ-3 and CREDI offer domain-specific scoring—a government priority. ASQ-3 moderately detects mild delays and performs better for severe delays in at-risk groups. Caregiver Reported Early Development Instruments (CREDI) was designed for public health surveillance, and we do not yet know how it performs for individual assessment.
ASQ-3 and CREDI are most promising for use at the 2–21/2-year review. However, we lack UK-based validation and norming studies, even for ASQ-3. Ultimately, careful implementation and integration into existing systems will determine a tool’s value for identifying developmental needs, supporting families and producing high quality data for public health surveillance.
To evaluate the impact of digital supportive supervision (DiSS) for maternal and child healthcare on utilisation of services in Rajasthan state of India, as well as exploring the perceived enablers and barriers to the implementation of DiSS.
We employed a sequential mixed-method study design. Routine monthly service data from April 2016 to March 2023 were analysed using an interrupted time-series (ITS) analysis with a control group, followed by qualitative in-depth key-informant interviews.
The study is set at the primary healthcare level in Rajasthan state in India, where maternal health, child health and nutrition (MCHN) sessions are conducted at village level to deliver essential maternal and child health services.
Based on the proportion of MCHN sessions supervised digitally, two districts demonstrating high DiSS uptake were selected as intervention districts, and two matched districts were identified as comparator districts, creating a quasi-experimental design. Using routine data extracted from the pregnancy, child tracking and health services database, a segmented regression analysis using ITS was undertaken to assess temporal changes in service utilisation. For the qualitative component, we purposively sampled supervisors in intervention districts (ranked by DiSS supervisory volume) and conducted interviews until thematic saturation (n=18).
The intervention involved digitising the traditional paper-based supportive supervision of MCHN sessions in Rajasthan through a DiSS tool. Supervisors across state, district, block and sector levels used smartphones or tablets to record MCHN session data offline, which was automatically analysed and reported on dashboards on submission.
The study aims to measure the change in the monthly rate of MCHN service uptake following the rollout of DiSS in Rajasthan state.
Pentavalent and inactivated-polio vaccine uptake significantly improved in the intervention group, while no change was observed in the comparator group. Both groups showed significant improvement in the iron and folic acid supplementation among pregnant women and uptake of BCG, Hepatitis B birth dose and Measles vaccines among children, with greater increase in the intervention group. Notably, pneumococcal-conjugate-vaccine uptake declined significantly in the comparator group, whereas no significant change occurred in the intervention group. Limited digital literacy during the initial rollout and compatibility restriction of the digital application to Android devices were chief barriers. Among the enablers, its user-friendly interface, offline functionality, GIS-based monitoring and automated report generation were reported to enhance the timeliness, accountability and efficiency of supportive supervision. This, in turn, strengthened the feedback loop, empowering programme managers to promptly identify and address any shortcomings.
DiSS has the potential to strengthen the healthcare system and significantly improve the utilisation of MCHN services.
To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.
Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.
Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.
Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.
This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.
Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.
Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.
Objetivo: describir las facilidades y dificultades de los técnicos de enfermería para realización del electrocardiograma (ECG) después del entrenamiento en servicio. Métodos: investigación cualitativa, realizada en una unidad cardiovascular de un Hospital Universitario de Salvador - Bahía, Brasil, con 10 técnicos de enfermería. Resultados: el análisis permitió identificar tres categorías: formación como facilitador de la práctica asistencial; uso adecuado de ECG en la rutina de servicio después del entrenamiento; escasez de recursos materiales necesarios para realizar el ECG. Los resultados mostraron que además de los beneficios para los usuarios del servicio, el curso de ECG también puede ofrecer al profesional algunas ventajas, como un mayor conocimiento y un aprendizaje favorecido. Conclusión: las facilidades fueron descritas como ampliación del conocimiento y favoreciendo el aprendizaje de las técnicas correctas para la realización del procedimento, conduciendo a una disminución de errores y el uso adecuado del dispositivo. Las dificultades estaban relacionadas con la escasez de materiales y las precarias condiciones de algunos dispositivos.
FreshRSS 