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Childcare is an essential part of early life environment that has a significant influence on lifelong physical and mental health. This study aimed to examine the relationship between development, growth and frequency of illness in different types of care.

This cross-sectional study recruited 177 children aged 30–36 months and their caregivers. Of these 66 were being cared for at home and 111 were attending out-of-home day-care facilities. An interview form, growth measurement and the Denver Developmental Screening Test II were collected. The association between child developmental, growth and illness variables was analyzed with Chi-square, Fisher's exact and Mann–Whitney U tests.

This study found that the development and growth results did not show statistically significant differences between the home-care and day-care groups. The number of minor illnesses was significantly lower in home-care children than in day-care children (OR = 0.33, 95% CI = 0.15-0.72).

This study indicated that the risk of infection is increased in the children attending day care. Provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

As the number of women's participation in the labor market has increased rapidly over the past decades, so did the number of children in nonparental care. The study findings reflect that the development of a day-care center for children was unclear, whereas the risk of infection was increased. Therefore, provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

The purpose of this paper is to determine the factors associated with DF occurrence in recurrence villages in Chiang Rai, Thailand.

A case-control study was conducted between June 2017 and December 2017. A validated questionnaire was used to detect the factors associated with recurrence of DF. χ² and logistic regression were used to detect the associations between variables at α=0.05.

In total, 213 cases and 436 controls were recruited into the analysis. Cases were recruited from 20 DF recurring villages, while controls were recruited from 20 non-DF recurring villages in Chiang Rai province. At community level, three variables were associated with recurrence of DF; size of the village (p=0.007), number of villagers (p=0.009), tribe (p=0.043) and distance to a hospital (p=0.003). Three variables were associated with DF at personal and family levels in multivariate model: children whose parents worked as daily employees, and government officers and traders were more likely to have DF 1.56 (95%CI=1.22–2.48) and 4.31 (95%CI=4.66–9.38) times greater than of those whose parents’ worked as agriculturists, respectively; children aged less than one year were 2.89 (95%CI=2.17–4.33) times more likely to have DF than those aged=6 and children who were under standard growth and over standard growth were more likely to have DF than those standard growth 1.61 (95%CI=1.18–2.53) and 7.33 (95%CI=4.39–10.37) times, respectively.

This is the original research article which was conducted in detecting the factors associated with recurrence of DHF in Northern Thailand.

The prevalence of stunting in children under five years old is high (37.9 percent). The health advantage of breast milk as a prevention is recognized. The purpose of this paper is to examine the relationship of early initiation to breastfeeding, wherein a child is breastfed within an hour of birth, as a means of preventing stunted growth in 6–59 month old children in Jambi province, Indonesia.

This paper used data from the 2015 National Nutrition Survey in Jambi province. A total of 2,502 children aged 6–59 months were analyzed by binary logistic regression.

The results showed that as many as 27.5 percent (95% CI: 25.2–29.9) children aged 6–59 months were stunted and 54.1 percent (95% CI: 51.1–57.1) had not been introduced to breastfeeding soon after birth. The analysis showed that delayed initiation to breastfeeding is a significant factor in stunting amongst 6–59 month old children. (p=0.024; AOR=1.3; 95% CI: 1.0–1.6). Other results of the analysis showed a significant association between water source and birth weight issues as causes for stunting.

Research revealed that delayed initiation into breastfeeding results in a 1.3 times higher risk of stunting. Furthermore, early initiation to breastfeeding reduces the risk of consuming polluted river water that is a health risk and cause of stunting.

This paper aims to fill a gap in the existing literature by shedding the light on four main issues. First, the relationship between child-at-risk protection and sustainable development and the key factors contributing to the failure or success of child-at-risk protection systems. Second, the main characteristics and limitations of the current institutional arrangements of the child-at-risk protection system in Egypt. Third, the budget allocations to child protection-relevant entities in Egypt. Fourth, the way forward to enhance the effectiveness of the child-at-risk protection system in Egypt.

The methodology used in this paper is of a qualitative nature. The authors relied on desk review of the international and national reports (including the un-published ones) and the relevant literature on the topic. Additionally, the authors reviewed the relevant laws and regulations and analyzed the fiscal data extracted from Egypt’s State budget. Also, semi-structured interviews were conducted with some officials from the different governmental entities covered by the study.

From the institutional perspective, the authors find that the current child-at-risk protection system in Egypt needs effective institutional arrangements, as it is attributed with the limited activation of the child protection committees, lack of coordination mechanisms and overlapping mandates with regards to case management. Hence, the authors propose two institutional approaches that could help in enhancing the performance of the current system. While the first approach has decentralized nature, the other is centralized. From the fiscal perspective, the authors analyze the trend and composition of the budget allocations to the child protection-relevant entities in Egypt. They show that such allocations are relatively small especially when items not related to child protection are excluded.

The paper analyzes the main characteristics and limitations of the current institutional arrangements of the child-at-risk protection system in Egypt. Moreover, it proposes two alternative institutional approaches to deal with such limitations and enhance the effectiveness of the current system. The paper also provides an analysis of the budget allocations to the child protection-relevant entities in Egypt. These issues have not been addressed sufficiently in the Egyptian context.

The purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.

This cross-sectional study recruited 153 children and their mothers. Weight, height and hemoglobin levels of the children were measured. A structured questionnaire based on the World Health Organization's indicators for assessing infant and young child feeding practices was used to collect data on parents' socioeconomic status, household characteristics, hygiene and sanitation practices, mothers' knowledge on feeding practices such as child's meal frequency and dietary diversity and child morbidity within the past two weeks. Predictors of child nutritional status were determined using multinomial logistic regression analysis.

Underweight in the children was significantly predicted by maternal knowledge on protein foods (AOR = 0.045, p = 0.008), time of initiation of complementary feeding (AOR = 0.222, p = 0.032) and maternal age (AOR = 9.455, p = 0.017). Feeding child from separate bowls (AOR = 0.239, p = 0.005), minimum meal frequency per child's age (AOR = 0.189, p = 0.007) and time of initiation of complementary feeding (AOR = 0.144, p = 0.009) were significant determinants of stunting among the children. Exclusive breast feeding (AOR = 7.975, p = 0.012) and child's past morbidity (AOR = 0.014, p = 0.001) significantly contributed to anemia among the children.

This is a cross-sectional study and cannot establish causality. The small sample size also limits the generalizability of study findings. However, findings of the study highlight factors which could potentially influence the high rate of child undernutrition in the study setting.

This study identifies determinants of undernutrition in the East Mamprusi district, an underresourced area in Ghana. This information could inform the development/reformulation of locally sensitive key messages and targeted intervention strategies to curb the high levels of child undernutrition in the East Mamprusi district of Ghana.

This study identifies maternal care practices as key potential drivers of undernutrition in a low-resource setting known for high prevalence of child undernutrition. It suggests insight for large-scale studies on the predictors of child undernutrition in Northern Ghana and other resource-poor settings.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The purpose of this paper is to determine the effectiveness of a modified HBM-based intervention to reduce body mass index (BMI) for age in overweight junior high school students.

A cluster-randomized controlled trial was conducted in the first and second years of a junior high school in the center of Thailand. In total, 24 classrooms were randomly assigned to a modified health belief model intervention arm (HBMIA), and 24 classrooms were randomly assigned to a traditional school health education arm (control). In total, 479 students who were overweight (BMI forage = median +1 SD, aged 12–15 years) participated in the study. The HBMIA used the health belief model (HBM) as a motivator for behavioral strategies that included modifying diet and participating in physical activity. BMI, health knowledge and behavior for preventing obesity were recorded at baseline and at six months. A multilevel regression model was performed to calculate mean difference between HBMIA and control group.

The students who participated in the HBMIA showed a decrease in BMI of 1.76 kg/m², while those who participated in the control showed an increase in BMI of 1.13 kg/m², with a mean difference of –2.88 kg/m² (95% CI =–3.01 to –2.75), an improvement in health knowledge (mean difference 27.28; 95% CI =26.15–28.41) and an improvement in health behavior (mean difference 23.54; 95% CI =22.60–24.48).

A modified HBM-based intervention to reduce BMI for age is effective in overweight junior high school students.

This paper describes the parent–child relationships of upper-middle-class Chinese parents and their adolescent children who were “parachuted” to the United States for private high schools. With parents remaining in China and children in the United States, thousands of miles away, such a transnational educational arrangement complicates the already volatile parent–child relationships during the adolescent years. Through ethnographic interviews of 41 students and 33 parents, I demonstrate different forms of child–parent relationships in a transnational education setting: those who found that the further physical and temporal distance has brought the parent–child relationship closer through frequent communications, children who experienced “accelerated growth” yet questioned the necessity, and delicate parent–child relationships due to increasing transnational cross-cultural or intergenerational differences. These types of parent–child relationships are not comprehensive of all the lived experiences of the “parachute generation,” yet they shed new light on transnational education and the unintended emotional dimensions of educational migration. In a transnational context for an economically well-off group, parental absence or separation of children and parents is no longer a clear-cut concept and has different layers of meanings, taking into account the frequency of communication, duration of spring and winter breaks and the existence of third-party agents such as for-profit intermediaries (or educational consultants) and host families. The diverse patterns of parent–child relations reveal the heterogeneity and complexities of “doing family” across geographic spaces and global educational hierarchies, as well as the roles of communication technologies, the tempo of mobilities and educational intermediaries.