Browsing by Autor "Deborah E. Bender"

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Assessment of infant and early childhood development in a periurban Bolivian population
(Lippincott Williams & Wilkins, 1994) Deborah E. Bender; CARRIE AUER; Joan Baran; SUSAN RODRIGUEZ; Rune J. Simeonsson
A study was conducted of infant development in Quintanilla Area, a group of recently settled communities in periurban Cochabamba, Bolivia. The research was a substudy of a larger investigation supported by the World Health Organization (WHO) into the changing patterns of breast-feeding and child spacing. 400 mothers with children aged 6-18 months were enrolled in the WHO study and interviewed in the household setting during June-July 1991. The infant development substudy administered the Bayley Scales of Infant Development (BSID) to a convenience sample of 18 boys and 12 girls of these mothers. With a mean score of 100 and a standard deviation of 15, the BSID provides a Mental Development Index and a Psychomotor Developmental Index. Scores more than 1.5 standard deviations below the mean can be indicative of developmental delay. Three boys and three girls, or 20% of the infants in this study were found to have scores more than 1.5 standard deviations below the mean and may therefore be considered to potentially be developmentally disabled. Compared to the US, a larger proportion of children in this study was disabled. 20% is also at the high end of UNICEF and UNESCO estimates. The authors note that one third of the mothers of children with suspected disabilities received no prenatal care, but each of these women was attended by a physician at the birth of the child. No prenatal care and the attendance of a physician at delivery, in this environment, is often indicative of an high-risk delivery potentially including conditions such as placenta previa, prolonged labor, and asphyxiation of the newborn. High-risk delivery may also be the result of trauma associated with traditional practices such as manteo, during which a pregnant woman is swung and bounced in a blanket or hammock with the goal of repositioning the fetus. The authors also caution the possibility that convenience sampling and small sample size may have over-identified children with developmental delays compared to other children of their same cultural background.
Neonatal feeding practices in Periurban Bolivia
(Taylor & Francis, 1999) Margaret F. McCann; Deborah E. Bender; Ruben Arandia; Jennifer Flynn; Erica Colmenares
Early initiation of breastfeeding offers numerous benefits, but in many cultures the first suckling is delayed and the infant is instead given various prelacteal foods. Mothers residing in periurban areas of two Bolivian cities were interviewed regarding their neonatal feeding practices. Virtually all infants were breastfed, but the first breastfeed was typically delayed for more than 1–2 hours after birth; about 15% did not suckle for at least 24 hours. When asked whether they gave colostrum, three‐quarters of mothers answered affirmatively, although some who initiated breastfeeding on the first day answered negatively. Of those who did not give colostrum, many said they refrained because of concern that it would harm the infant. Advice from medical professionals was variously cited as the reason for giving or for not giving colostrum. Herbal teas were commonly fed in the first few days. Education programs should encourage mothers to begin breastfeeding immediately after birth and to not feed their newborns any other foods.
Perceptions of Quality of Reproductive Care Services in Bolivia: Use of Photo Prompts and Surveys as an Impetus for Change
(Taylor & Francis, 2008) Deborah E. Bender; Ana Fernández Santander; Wilson Patiño; Melanie R. Wasserman
Surveys are sometimes used to assess women's perceptions of the quality of reproductive health care, but less empowered women may feel uncomfortable expressing their views in this method. We demonstrate the use of a participatory approach, combining a standard survey with an innovative photonarrative method. Women in Cochabamba, Bolivia, were asked to participate in exit surveys (n = 108). A subsample did photonarratives (n = 20). The survey showed rural women had less access to care, but photonarratives revealed the cause - fear. Women asserted quality of care was high, but photonarratives contradicted survey results. Staff used photonarratives to select action items for quality improvement.
Rural origin as a risk factor for maternal and child health in periurban Bolivia
(Elsevier BV, 1993) Deborah E. Bender; Tirsa Rivera; Donna Madonna