Parents’ experiences of an antenatal visit being part of a home visiting program in deprived areas

Abstract Background There are considerable health divides between residential areas in many Swedish cities. In more disadvantaged areas children grow up with poorer health outcomes than the country average. To meet the greater needs of children growing up in these areas through proportionate universalism, an extended home visiting program has been delivered. A novel part of this program has been the social worker and nurse later conducting home visits meeting the parents at the maternity care clinic before childbirth. The aim of this study was to explore parents’ experiences of that antenatal visit. Methods Semi-structured interviews were carried out with nine mothers and three fathers around 3 months postpartum. Nine of the participants were foreign-born and a translator was used for four of the interviews. The interviews were recorded and transcribed verbatim and the data was analyzed with thematic analysis with an inductive approach. Results The parents’ overall experiences are comprised in the main theme: ‘A feeling of security and care for the whole family'. This main theme is derived from the three following themes: 1) ‘Staff - a trustworthy source of information'. Parents perceived the staff as experienced and knowledgeable and appreciated obtaining information about practical things and about the Swedish system; 2) ‘Access to emotional support'. Several parents expressed the need for emotional support and valued that by meeting the staff they knew they had someone to turn to; 3) ‘Becoming familiar with the staff'. It was appreciated to know who will come to your home as this gave parents an increased sense of security. Conclusions Initiating the program through introducing home visiting staff at a scheduled antenatal visit benefited parents, by giving them useful information and social support. The visit also seems to be indirectly beneficial as it contributes to building trust for the staff and the rest of the program. Key messages • Initiating an extended home visiting program at a scheduled antenatal visit benefited parents, by giving them useful information and social support. • Initiating an extended home visiting program at a scheduled antenatal visit contributed to building parents’ sense of trust for the staff and the rest of the program.


Background:
The COVID-19 pandemic may have increased the need for help and support for adolescents with disabilities. At the same time, moving to distance learning can reduce access to support services. Despite this, little is known about this issue. Thus, we investigated differences in the unmet need for help and support between adolescents with and without disabilities during the COVID-19 pandemic.

Methods:
We analyzed large population-based data from the Finnish School Health Promotion study obtained during 2019 and 2021 (2019: n = 87,215; 2021: n = 91,560). The target group comprised adolescents from lower secondary schools in Finland (age: M = 15.3, SD = .64). Logistic regression models were applied to investigate differences in the unmet need for help and support between adolescents with and without disabilities.

Results:
During the pandemic, adolescents with disabilities reported insufficient help and support related to their learning and wellbeing from teachers, school curators and psychologists, and school nurses and doctors more often than other adolescents (p < .001). Adolescents with disabilities reported more often than others that distance learning involved insufficient learning support (p < .001). Between 2019 and 2021, an increasing proportion of adolescents with disabilities felt that they had received insufficient help and support related to their well-being from nurses, doctors, psychologists, school curators, and teachers. To summarize, the COVID-19 pandemic reduced access to support and assistance for adolescents, particularly those with disabilities.

Conclusions:
Policies in schools should be developed and resources secured so that support and help for adolescents with disabilities can be secured in exceptional circumstances. Insufficient support and assistance for adolescents with disabilities can impair their learning outcomes and health.

Key messages:
During the COVID-19 pandemic, adolescents with disabilities reported insufficient help and support related to their learning and well-being more often than other adolescents.
In times of crisis, support and help for adolescents with disabilities must be guaranteed.

Background:
There are considerable health divides between residential areas in many Swedish cities. In more disadvantaged areas children grow up with poorer health outcomes than the country average. To meet the greater needs of children growing up in these areas through proportionate universalism, an extended home visiting program has been delivered. A novel part of this program has been the social worker and nurse later conducting home visits meeting the parents at the maternity care clinic before childbirth. The aim of this study was to explore parents' experiences of that antenatal visit.

Methods:
Semi-structured interviews were carried out with nine mothers and three fathers around 3 months postpartum. Nine of the participants were foreign-born and a translator was used for four of the interviews. The interviews were recorded and transcribed verbatim and the data was analyzed with thematic analysis with an inductive approach.

Results:
The parents' overall experiences are comprised in the main theme: 'A feeling of security and care for the whole family'.
This main theme is derived from the three following themes: 1) 'Staff -a trustworthy source of information'. Parents perceived the staff as experienced and knowledgeable and appreciated obtaining information about practical things and about the Swedish system; 2) 'Access to emotional support'. Several parents expressed the need for emotional support and valued that by meeting the staff they knew they had someone to turn to; 3) 'Becoming familiar with the staff'. It was appreciated to know who will come to your home as this gave parents an increased sense of security.

Conclusions:
Initiating the program through introducing home visiting staff at a scheduled antenatal visit benefited parents, by giving them useful information and social support. The visit also seems to be indirectly beneficial as it contributes to building trust for the staff and the rest of the program.

Key messages:
Initiating an extended home visiting program at a scheduled antenatal visit benefited parents, by giving them useful information and social support.
Initiating an extended home visiting program at a scheduled antenatal visit contributed to building parents' sense of trust for the staff and the rest of the program.

Background:
In low-income nations, low birth weight (LBW) is still a major public health concern, which accounts for 96.5 % of global LBW cases. Any newborn weighing less than 2500g is considered LBW, which is associated with a 20-fold increase in the chance of dying during infancy. Despite the severity of the problem, in Sub-Saharan Africa the high rates of LBW have not diminished in the recent decade. The goal of this study is to evaluate the prevalence of LBW and its risk factors in Angola, as there is a pressing need to address LBW and its substantial health and social implications.

Methods:
We Conclusions: Education appears to have a significant impact on LBW, emphasizing the importance of addressing literacy in Public Health policies. Lack of iron supplementation and rural residence can also be used as indicators of poor health-care access. Understanding the factors informs decision-makers and should pave the way for more targeted intervention and more efficient LBW policy. Key messages: Intervention in socioeconomic factors and health access during pregnancy might have a high impact on the LBW problem. Addressing literacy as a major health determinant can guide a more efficient policy making and help stakeholders target their interventions.