Child Development and Public Health

For this week’s posting those who know me well might have assumed I would pick the health topic of mental health of mothers, fathers, and families in general since my first master’s degree is in Psychology.  I chose instead, the topic of immunizations. 

Immunization, according to Berger (2009), is “a process that stimulates the body’s immune system to defend against attack by a particular contagious disease.  Immunization may be accomplished either naturally (by having the disease) or through vaccination (often by having an injection)” (Berger, 2009, p. 150).

This is a topic in which I am very interested in because of my work with children over the years that have been diagnosed with conditions on the Autism Spectrum.  I also find this topic interesting because of the work I have done in the past with international exchange students from all over the world.  Each year there were some countries that did not have access to the immunizations needed for the students to be able to enter school in the U.S.  These students would need to get these immunizations as soon as they arrived in the U.S.  Fortunately for the students and their host families the scholarship the students were here on would pay for these immunizations.  If this was not the situation, I am not sure if these students would have been able to make the most of this opportunity as many of the students come from countries where the economy is not in great shape.

One country that I have never worked with and chose to research for this assignment is Sierra Leone.  Located in West Africa, Sierra Leone, according to Renner, et. al., (2005), has a population of 4.6 million.  The health indicators for Sierra Leone are poor.  According to Renner, et. al., (2005), an example of life expectancy at birth is 34.2 years; the probability of dying (per 100 live births) before the age of 5 years is 313 and between 15 and 59 years is 619.  The number of maternal deaths per 100,000 live births is 2000.  These dismal health indicators are a reflection of poor governance, poor macroeconomic performance, and poor national health system performance (Renner, et. al., 2005).

In Sierra Leone the Ministry of Health and Sanitation provides about 50% of health care services.  The remainder of services are provided by the private sector and national/international associations.  There are 13 health districts, each with a District Health Management Team responsible for the implementation, supervision and monitoring of health programs in the district.  According to Renner, et. al., (2005), Sierra Leone has a total of 31 government hospitals, 22 mission hospitals/clinics, 78 private hospitals/clinics and a network of 788 PHUs.  There are geographical inequities in the distribution of health facilities in the country which contributes greatly to the poor health indicators (Renner, et. al., 2005).

It is important, personally, to research and learn about such conditions as well as others in the public health of various countries.  If I am to become an effective advocate for those who need a voice, I need to understand the family’s roots.  I also feel it is important to have a greater understanding of other countries in order to have a well-balanced education.

References

Berger, K. S. (2009). In The developing person through childhood. New York: Worth. 

Renner, A., Kirigia, J., Zere, E., Barry, S., Kirigia, D., Kamara, C., & Muthuri, L. (2005). Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application. BMC Health Services Research, 577.

Childbirth - Around the World

Having been fortunate to be a host mom to students from all over the world has opened my eyes to so many differences in various cultures.  The one I will use for this posting is the research I found on health benefits and practices among Arab women.  Then I will add in what I found from hosting a terrific young girl from Oman this past year and what she told me about her beliefs.  This subject came up because one of her sister’s found out she was pregnant with her second child while she was staying with me.

I am sure views are different depending on which country and/or region the women of Arab decent are from but according to Kridli (2002), in the Arab culture the bride’s status in her husband’s household is technically not very stable until she gives birth to her first baby and proves she is fertile.  Afterward there is pressure to have a second child because of fear that an only child may die and leave the parents childless.  Once this happens the pressure diminishes unless both children are female.

Sons are highly valued in the Arab culture because they are a source of economic security for the parents in their old age and also provide physical security for the extended family as well as political strength and social prestige.  This high value on sons, however, can affect the Arab woman’s health status because she is expected to continue getting pregnant until she delivers one or more sons (Kridli, 2002).

Excessive planning can be seen by the Arab woman as negatively affecting the future so attending prenatal classes is not usually something they do.  Prenatal knowledge is usually gained from women in the family such as mothers or mother-in-laws.  The pregnant women also do not plan ahead for their labor and delivery.  Planning in this culture is seen as defying God’s will and is capable of bringing the “evil eye” to the mother and/or the baby.  The evil eye is believed to be brought on by an envious person who wishes to cause harm to another who receives something positive, such as having a healthy baby or delivering a son.  Therefore, in the Arab culture the baby shower occurs only after the baby is born, to avoid planning and the evil eye (Kridli, 2002).

Although, according to Kridli (2002), pregnancy is considered a healthy occurrence and a natural process, Arab culture dictates that pregnant women need to pay special attention to nutrition.  The women are expected to eat well and utilized all five food groups.  However, they are not supposed to eat spicy foods or any foods that may upset their digestive systems or foods that are sour.  The Arab culture believes that the baby is connected to the mother, strong-tasting food may hurt or cause discomfort to the baby since he or she will experience the same discomforts experienced by the mother.  Arab women who are pregnant are also exempted from daily fasting during the holy month of Ramadan (even though some women do choose to do so) (Kridli, 2002).

Some Arab women tend to go to the hospital as soon as the first contractions are detected, fearing that something may go wrong to jeopardize the life of the baby.  Also, finding out the sex of the baby before birth is not usually done for religious reasons based on the Quran’s statement that “no one knows what is in the womb but God.”  Because of this those women with a strong religious background may ask the healthcare worker not to inform them about the sex of the baby (Kridli, 2002).

In my discussions with my student this past year (whom I consider another daughter) I found out that a babies age is counted as soon as they are conceived.  Her sister also did go get an ultrasound which showed that she is having a second girl.  I was told that this would mean another baby at some point in order to have a son.  The diet of her sister fits in with the research done by Kridli (2002) as do a lot of the beliefs about prenatal classes, etc…  There was reluctance to bring back gifts for the unborn baby, I am assuming it is because of planning so far ahead is not really part of the process as Kridli (2002) stated.  Though once we started looking at the baby items, I swear she bought out the store.  I also made a baby blanket for the baby even though they typically only use swaddling blankets for the babies. 

I learned so much about the differences in the cultures where pregnancy and childbirth are concerned.  I believe an understanding of these differences is really important for all of us but especially healthcare workers here in the U.S. as it will help with forming a positive bond and allow the proper prenatal care to be obtained.  Positive support systems from all sides are essential and will hopefully put an end to pre-conceived ideas about this culture and others.

Reference

Kridli, S. (2002). Health beliefs and practices among Arab women. MCN: The American Journal of Maternal Child Nursing, 27(3), 178-182. Retrieved from EBSCOhost.

Childbirth - My Personal Experience

Each of my three personal experiences with pregnancy and childbirth were so different in some ways and similar in others. 

The similarities are the prenatal care I made sure I got as well as making sure I took care of myself.  Even at a young age I somehow instinctively knew this was important for their futures.

With my first child I was 17 when I was pregnant and 18 when he was born.  I remember not having a clue I was pregnant until one day when I walked into the house and smelled onions cooking with a roast.  I swear I turned green as I had to rush out of the room to get sick.  Once I found out that I was pregnant I stopped all caffeine and made sure I ate all the right foods, went to all my doctor appointments etc… (Almost all the right foods.  I was totally addicted to tootsie pops during my pregnancy and always had some wherever I went.)  I was amazed at the changes that seemed to be happening each day and would sit for hours just rubbing my stomach, listening to music, reading etc… to this little unborn miracle.  Unfortunately, all did not stay so positive.  While at a cookout in July 1985 (six weeks before my due date) a drunken man had pushed down his pregnant wife in a drunken rage.  When I went to help her up the same man turned on me and I was basically thrown onto a hood of one of the cars.  I went into labor that night and have never been so scared in my life.  After 12 hours of labor there became a complication with my son’s heart rate and he needed to be delivered via an emergency c-section.  He weighed 5 lbs. 14 oz. and was 17 inches long.  Pretty good for a six-week premature baby.  I was told by the doctors that he would more than likely be academically and/or physically behind his entire life and was given references to what services were available at that time.  I am happy to say that my son ended up being tenth in his graduating class without even trying and is today approximately 6 ft. 2 in. tall.

My second child I was 19 when I was pregnant and about six weeks away from 20 when she was born.  This time I knew when I was pregnant before the doctor’s would even give me an official pregnancy test.  It was the smell on onions cooking again.  This time around the morning sickness stayed with me during the entire pregnancy and I also had some minor issues with my heart which needed a monitor.  I decided once again to make sure I ate the right foods, etc… (Except with this one it was strawberry sundaes.)  With the second pregnancy it was harder to sit and relax but I still spent a lot of time just sitting and rocking in my rocking chair listening to music, reading, and rubbing my stomach calming down little elbows, feet, hands, and knees.  Five weeks prior to my due date there were some complications and I had to rush to the hospital.  Fortunately, labor was able to be stopped and I made it almost to my due date.  It was a good thing my water had not broken prior to me going to the hospital.  As soon as it did my daughter was born 20 minutes later.  Her entire labor and delivery only took three hours. Unfortunately, I was given a pain shot too close to delivery and my daughter ended up with the effects of it when she was first born.  I needed to follow up with various doctors during her first three years of life, but fortunately there were no issues because of this.  But at the end I had this beautiful little girl with reddish blond hair (7 lbs. 9 oz. and 20 in.).  I remember thinking, “Now our family is complete.” 

Surprise!  Along comes my last child.  I was 20 when I found out I was pregnant with him and 21 when he was born.  Of course it was those darn onions again that made this known very quickly into the pregnancy.  So I did all the right foods, etc… again (except for the craving for anything with cheese).  I really had a tough time trying to relax but did my best and spent a lot of time just sitting and enjoying being pregnant.  I knew this was my last one as the decision was already made I was not coming home from the hospital without making sure of this.  I had three children at 21 years of age and just knew this was it.  Unfortunately, I had problems with blood pressure with this pregnancy and was forced to spend as much time off my feet as I could.  I actually made my due date and was a day late with this pregnancy.  At the end, here was an 8 lb. 10 oz., 21 in. baby boy with tons of dark hair.  Now I knew the family was complete.

I attribute the fact that my children were able to grow up healthy and are doing so well because I was fortunate enough to have the various supports and prenatal care during these important times of growth and development.  I had some tough pregnancies but each of the children is doing terrific at the ages of 26, 23, and 22 at the moment.  My youngest has type I diabetes but that is the only health issue with any of the children.  I am truly blessed and fortunate to have each of them.

Next Chapter

It is amazing that the next class has begun already in this next chapter of my educational journey.  I want to wish all my classmates good luck and I am looking forward to working and learning with each of you over the next eight weeks.

Examining Codes of Ethics

NAEYC Position Statement

Ideals contained in the NAEYC Position Statement that are meaningful to me in my professional life consist of the following:

I-1.3 – To recognize and respect the unique qualities, abilities, and potential of each child.

This ideal is very important as each child and family are unique individuals and these unique qualities and abilities need to be respected.  Without this respect it would be impossible for each child in my daycare to be offered the tools necessary to reach their full potential regardless of their abilities/special needs.

I-1.5 – To create and maintain safe and healthy settings that foster children’s social, emotional, cognitive, and physical development and that respect their dignity and their contributions.

This ideal is very important as it changes (with the exception of the safe, healthy environment, respect dignity, and their contributions) as the children and their needs change.  At any time the emotional, cognitive, and physical needs of the children in my care can change.  Thus it is up to me as the owner/daycare provider to make sure changes are made to the environment and/or curriculum when the need arises.

I-1.9 – To advocate for and ensure that all children, including those with special needs, have access to the support services needed to be successful.

This ideal is very important, as I have learned during the past twenty-one years, because there are times when the families are afraid to speak up and rock the boat with the various systems in place that are supposed to help their children.  Many of the systems and their employees are overbooked, overworked, and underpaid.  I consider it my job to keep my eyes open, learn all I can about the various systems, and help when I am needed.  There are times when it takes a lot of research before I will add my voice, but once I know I am right there is no stopping me for the most part. 

DEC Code of Ethics

I.4 – We shall serve as advocates for children with disabilities and their families and for the professionals who serve them by supporting both policy and programmatic decisions that enhance the quality of their lives.

This section of the DEC Code of Ethics is very important to me to keep in mind as I will be learning the public policy aspect of advocacy during this part of my educational journey. I have no problem speaking up for the children and their families, but I also need to learn the public policy aspect of advocacy.  Without all the pieces to the puzzle, I may inadvertently do an injustice to a child or family I am advocating for.  Lack of knowledge is not an acceptable reason in my mind.

References

NAEYC. (2005, April). Code of ethical conduct and statement of commitment. Retrieved June 14, 2011, from http://www.naeyc.org/files/naeyc/file/positions/PSETH05.pdf

The Division for Early Childhood. (2000, August). Code of ethics. Retrieved June 14, 2011, from http://www.dec-sped.org/

WORDS OF INSPIRATION AND MOTIVATION FROM THE FIELD OF EARLY CHILDHOOD EDUCATION

Sources of inspiration and motivation which strike a cord within each of us come from various sources when we least expect them as well as during our educational jouney.  I have listed five such quotes that really started me thinking.

"The most important thing is to enjoy

your children, to love them, be fair and

just with them.  If you do that they're

pretty likely to come out all right."

                                                                    ~ Abigail Eliot

“…the new idea – was program.  I had visited

many day nurseries in Boston as a social worker.

I can remember them even now:  dull green

walls, no light colors, nothing pretty – spotlessly

 clean places, with rows of white-faced listless

 little children sitting, doing nothing.  In the new

 nursery school, the children were active, alive, choosing.”

                                                                     ~Abigail Eliot

“Our ability to incorporate the cultural strengths and the

distinctive ways that families, specifically fathers, contribute to

educational accomplishments of their preschool children is

severely constrained by major gaps and inadequacy in our

research literature.  Before early childhood programs can tap

these fathers’ or families’ potential to enhance children’s

development, research needs to define father and family

involvement more precisely and to examine the culturally rich

dimensions of children’s early care and education experiences.”

                                                                            ~ Aisha Ray, Ph.D.

“…I think I had a built in passion that it was important to make a

real contribution to the world and to fix all the injustices that existed

in the world and I wanted to do that through teaching.”

                                                                                ~ Louise Derman Sparks

“It’s not all about you, you have to take your ego

out of it and think about what is best for this child.”

                                                                                             ~ Renatta M. Cooper

Favorite Book

"I'm Gonna Like Me" by Jamie Lee Curtis and Laura Cornell, is one of my favorite books to use in my daycare curriculum. This is a great book that focuses on the importance of a child liking themselves for who they are.  As a child's self-esteem grows so does other aspects of their social-emotional and cognitive growth.