BackgroundApproximately 80% of deaths attributed to malaria worldwide occurred mainly in Africa in 2015. Kenya is one of the major malaria endemic countries, making malaria the leading public health concern in this country. This study intended to document the prevalence of malaria and determine associated factors including socioeconomic status among children aged 6 months to 14 years in Kenya.MethodsThis study analyzed the secondary data extracted from the 2015 Kenya Malaria Indicator Survey (KMIS), a cross-sectional country representative survey. Associations of demographic, socioeconomic, community-based, and behavioral factors with the prevalence of malaria in children were analyzed using multivariable logistic regression analysis.ResultsData from 7040 children aged 6 months to 14 years were analyzed. The prevalence of malaria showed an upward trend in terms of age, with the highest prevalence among children aged 11–14 years. Prevalence was also higher among rural children (10.16%) compared to urban children (2.93%), as well as poor children (11.05%) compared to rich children (3.23%). The likelihood of having malaria was higher among children aged 10–14 years (AOR = 4.47, 95% CI = 3.33, 6.02; P < 0.001) compared with children aged under 5 years. The presence of anemia (AOR = 3.52, 95% CI = 2.78, 4.45; P < 0.001), rural residence (AOR = 1.71, 95% CI = 1.31, 2.22; P < 0.001), lack of a hanging mosquito net (AOR = 2.38, 95% CI = 1.78, 3.19; P < 0.001), primary education level of the household head (AOR = 1.15, 95% CI = 1.08, 2.25; P < 0.05), and other factors, such as the household having electricity and access to media such as television or radio, were also associated with the likelihood of infection.ConclusionThis study demonstrated the need to focus on awareness programs to prevent malaria and to use existing knowledge in practice to control the malaria burden in Kenya. Furthermore, this study suggests that improving the information available through the mass media and introducing behavior change communication and intervention program specifically for those of poor socioeconomic status will help to reduce malaria cases.

Supporting caregivers’ mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar–April 2017) in courtyard groups sessions and individual home visits with pregnant women (n = 11) and lactating mothers (of children <24 months) (n = 29). We conducted qualitative interviews with the participants (n = 8) and the community health workers who delivered the intervention (n = 2). Most participants reported willingness to attend the sessions if extended for 1 year, and recommended additional visual cues and interactive role-play activities to make the sessions more engaging. Participants and community health workers found it difficult to understand the concept of “unhealthy thoughts” in the curriculum. This component was then revised to include a simplified behavior-focused story. Community health workers reported difficulty balancing the required content of the integrated curriculum but were able to manage after the contents were reduced. The revised intervention is likely feasible to deliver to a group of pregnant and lactating mothers in a low-resource setting.

IntroductionIn low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.MethodsWe conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.ResultsIn July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54).ConclusionOur findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.Trial registration numberThe trial is registered in ISRCTN (ISRCTN16001234).

The COVID-19 pandemic threatens child development throughout the world as nutrition, routine healthcare, and the ability to provide nurturing care for young children are disrupted (Yoshikawa et al., 2020). In many low-and middle-income countries (LMICs), COVID-19 lockdowns have resulted in difficulties accessing essential healthcare,

Background Complications during pregnancy, childbirth, and following delivery remain significant challenges that contribute to maternal morbidity and mortality, thus affecting health systems worldwide. Group prenatal care (GPC) is an integrated approach incorporating peer support and health education that provides prenatal care in a group setting. The GPC approach was piloted in a district of Bangladesh to measure the feasibility and effectiveness of GPC compared to individual care. Understanding the experiences of women of receiving this grouped care approach is crucial to understand the perspectives, perception, and acceptability of the programme among mothers, which are lack in Bangladesh. The objective of the present study was to understand the core experiences and perspectives of mothers who participated in GPC sessions during their pregnancy period. Methods A qualitative research approach was used to understand the experiences of women receiving GPC. A total of 21 in-depth interviews were conducted in this study targeting pregnant mothers who attended all recommended GPC sessions. Face-to-face interviews were conducted by trained and experienced interviewers using a specific interview guideline to achieve detailed responses. Thematic analysis was conducted to analyse the data. Results Mothers appreciated receiving pregnancy care in group setting and expressed their preferences towards GPC compared to individual care. Themes included the comprehensiveness of GPC, prescheduled appointments and reduced waiting time, social gathering, coping with common discomforts, relationship with service providers, birth preparedness, and recommendations from participating mothers. The themes conveyed overall positive experiences of the participating mothers, with suggestions for further betterment of the programme. Nevertheless, the reported experiences of women involved in the study suggests that the inclusion of a specialist in group care, post-partum care, and family planning advice will be more beneficial in the GPC model. Conclusions The overall experiences of the women in the present study suggest that GPC is helpful for them, and it is useful to reduce complications during pregnancy. The GPC model promises movement towards family-supported care, as explained by the participants.