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Child health care utilization in families with young or single mothers in a Swedish county
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Allmänpediatrisk forskning/Sarkadi)
Karolinska institutet, Stockholm University, Sweden. (CHESS)
Karolinska institutet, Stockholm University, Sweden. (CHESS)
2013 (English)In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 17, no 1, 17-29 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Young age and lone parenthood are risk factors for impaired health among mothers and their children. Due to the higher risks of negative influences on physical and mental health, young and single mothers should be of special concern to the Child Health Services (CHS). In the present study, we investigated consumption patterns of child health care services among young and single mothers in Uppsala County, Sweden to study whether they are reached by the universal CHS program and if selective or indicative measures were administered in daily CHS practice.

Methods:

Register data on CHS contacts and socio-demographic indicators were collected for 10,692 infants, born in1998-2006.

Results:

Small differences in contact pattern and immunization status, between young versus older, and single versus cohabiting mothers, were detected. However, both young (RR 0.64) and single (RR 0.80) mothers had significantly lower rates of participation in parental group.

Conclusions:

The CHS were successful in implementing the universal preventive child health programme for all families, including families with young or single mothers. There was no indication, however, of an established selective preventive strategy aimed at these high risk families. Programs for strengthening the support provided to vulnerable families by the CHS are needed.

Place, publisher, year, edition, pages
2013. Vol. 17, no 1, 17-29 p.
Keyword [en]
Child health; health services research; infant; mothers; parent participation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-170029DOI: 10.1177/1367493512450624ISI: 000315563700003PubMedID: 23197384OAI: oai:DiVA.org:uu-170029DiVA: diva2:508190
Available from: 2012-03-07 Created: 2012-03-07 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Lika för alla?: Social position och etnicitet som determinanter för amning, föräldrars rökvanor och kontakter med BVC
Open this publication in new window or tab >>Lika för alla?: Social position och etnicitet som determinanter för amning, föräldrars rökvanor och kontakter med BVC
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Child Health Services (CHS) in Sweden are offered free of charge to all Swedish parents with children 0-5 years of age.  The regular service schedule includes home visits, health examinations, vaccinations and participation in parenting groups. The CHS should pay extra attention to disadvantaged families.

The aim of this thesis was to investigate to what extent the CHS reaches groups of families with special needs, e.g. immigrant families, low income families, young and single mothers, with universal or selective measures, as well as to investigate the variation of two determinants of child health, second hand smoke and breastfeeding, in these groups of families. The thesis also aimed at investigating validity of data in the county CHS quality database (Basta). The thesis is based on data from Basta together with several national registers.

The CHS equally reached all families with infants with the universal program except for participation in parenting group. Foreign born, young, single and low-income mothers had lower participation rates. Smoking rates were lower in foreign-born than in Swedish-born mothers and higher for foreign-born than in Swedish-born fathers. Smoking was more common among single and low income parents and young mothers. Young and single mothers had lower breastfeeding rates at 6 months. At 12 months the breastfeeding rates were higher among foreign-born mothers. The validity test of data in the Basta database showed sensitivity values for immunizations, breastfeeding and smoking at 90-100 % and for any home visit, participation in parenting group at any time, a minimum number of 6 visits at the Child Health Centre (CHC) and a minimum number of 11 visits at the CHC at 88 - 96 %. The sensitivity value for the exact match of number of CHC visits (+/- 3 visits) was 88 %.

Conclusions: The universal programme was equally distributed in different immigrant and socio-demographic populations. However, the results did not indicate equality according to the assumption that some families need more input than others in order to achieve equity of outcome.

Individual data routinely collected from CHS records to a quality database provides data of good quality that can be used for both quality surveillance and research.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 125 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 752
Keyword
Ethnic, infants, smoking, socio-economic status, second hand smoke, breastfeeding, child health services, child health care, health services research, mothers, parent participation, supportive care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-170037 (URN)978-91-554-8305-0 (ISBN)
Public defence
2012-05-04, Sal IX, Universitetshuset, Övre Slottsgatan 2, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-04-12 Created: 2012-03-07 Last updated: 2012-04-19

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