Study On Intervention Effect Of Early Child Development In Rural Area

ObjectiveTo know early child development(ECD)intervention implementation,including ECD training and health education,and to know ECD intervention effect,including ECD knowledge of maternal and child health(MCH)personnel,improvement in nursing knowledge and attitudes,behavior of mothers,and analysis of risk factor in nursing behavior of mothers;search for the methods and accessible approach of ECD health education,and provide for more reference to carry out ECD in other rural area.MethodsThe investigation covers 4 project counties,2 control counties in both Jilin province and Xinjiang autonomous region,4 project counties are the intervention group,2 control counties are the control group.The evaluation objects are(1)MCH personnel in sampling counties,townships and villages,and(2)mothers of healthy children aged 18-36 months.The survey methods include quantitative questionnaire: a general ECD Questionnaire for MCH personnel.,and a Questionnaire on Rearing Knowledge for Mothers,and qualitative group interview.The t test is used to compare two groups of mean and standard deviation,χ~2 test used to compare two rates,and analysis of variance used to single risk factor.The significant variable in statistics is used to multi-linear regression model.SPSS 13.0 software is used in the data analysis.Results1.General information:Totally,125 MCH personnel and 545 mothers of children aged 18-36 months are interviewed.There are 94 MCH personnel and 360 mothers in the intervention group.There are 31 MCH personnel and 185 mothers in the control group.2.ECD implementation:Personnel trainings have separately been practiced at county,township and province levels in the intervention area.MCH personnel spread ECD knowledge to parents of children through putting up posters,blackboard,school of pregnant women,and parents' school,face-to-face education.For the 360 mothers in the intervention area,97.8%of them have got the ECD materials distributed by township MCH personnel,96.3%of them have accepted the guidance from MCH personnel,91.1%think the contents of ECD materials pretty good,96.1%think the knowledge good for rearing children,88.9%of them usually take care of children in the light of guidance of MCH workers.3.Awareness rate of ECD knowledge:For the 125 MCH personnel,awareness rate of ECD knowledge is 86.2%in the intervention group,and 45.2%in the control group.For the 545 mothers,awareness rate of ECD knowledge is 91.7%in the intervention group,and 75.7%in the control group.The awareness rate of ECD knowledge in the intervention group is higher than that in the control group (P＜0.001).Score of MCH knowledge is the dependent variable,adjust the main influence factors,such as work place,nationality,education degree,the result shows that the ECD intervention improves the awareness rate of MCH personnel knowledge.4.Mothers' rearing behavior:Mothers' average score is 52.42±4.364 in intervention group,and 45.78±6.70 in control group.There is a statistically significant difference(P＜0.000).The score of project counties is higher than that of control counties,The score of intervention group is higher than that of control group in mother-child communication,child recognition-stimulating,mother-to-child daily taught,which demonstrates that mothers in intervention group more usually apply ECD guide to their rearing practices than mothers in control group.Compared to baseline data,in intervention group the average family possession amounts of books, toys are higher than those in control group.Score of mothers' rearing behavior is the dependent variable,adjust the main influence factors,such as nationality,education degree and the character,the result shows that the variable,rearing according to the guide,is the most important factor of change of mother's rearing behavior.The better the mother master the knowledge,the greater the mother's rearing behaviors change. More teaching times devoted by MCH,mother's character of extroversion,and family harmony,can stimulate the change of mother's rearing behaviors. Conclusion1.The ECD intervention improves the MCH personnel awareness rate of ECD knowledge,and advances the mothers' rearing knowledge and behavior.It shows that health education on ECD intervention is effective.Therefore,ECD education can be just informed to parents in daily life and work time,ECD should become one of routine services of child health care,and promote ECD expansion in broad extents.2.ECD intervention effect is associated with multiple factors including mothers' demographic and social characteristics(nationality,education degree and the character,etc),and guidance service supplied by MCH personnel for morhers. Therefore,integrated ECD intervention health education is carried out based on the evaluation.