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Influences of women empowerment indices on demand for childcare services: Evidence from the Nigeria Demographic and Health Surveys

Dejun Z, Remi RA, Mouchun Y, Romanus O, Mihajlo J

Afr J Reprod Health, 2023 Oct 31;27(10):65-80.
PMID: 37915165 DOI: 10.29063/ajrh2023/v27i10.6

This study examined the effect of various dimensions of women's empowerment on childcare use in Nigeria, utilizing information from five rounds of the National Demographic and Health Surveys. The analysis made use of both binary and multinomial logistic regression. The findings show that women who share household choices with their spouses were more likely to undertake postnatal care for their babies in either private or public hospitals compared to self-medication/others/traditional. Also, women who owned houses and those who participate in economic activities are significantly more inclined to use postnatal services for babies in health facilities. By implication, women empowerment is a significant factor to consider in improving childcare services in Nigeria. This suggests that in order to improve the health of children, women's inputs in household decision-making should be accommodated, while efforts should be made to enhance household socioeconomic position, and support mothers to have formal education. The findings also suggest that promoting women's empowerment can play a crucial role in increasing the demand for formal childcare services.

Matched MeSH terms: Child Care*
Fulltext Child care patterns and preferences in urban peninsular Malaysia

Parameshvara Deva M, Kumara Deva M

Med J Malaysia, 1981 Dec;36(4):259-62.
PMID: 7334966
Matched MeSH terms: Child Care/trends*
The reasons mothers take children to a health centre. (Appraisal of work done at a health centre in the Federation of Malaya)

THOMSON FA

J Trop Pediatr Afr Child Health, 1962 Mar;7:107-12.
PMID: 13920974
Matched MeSH terms: Child Care*
The developmental niche: a theoretical framework for analyzing the household production of health

Harkness S, Super CM

Soc Sci Med, 1994 Jan;38(2):217-26.
PMID: 8140448

Recent efforts to promote child survival and development internationally have focused new attention on the importance of the household as a mediator of both environmental risks and programmatic interventions to promote better health. In this paper, we introduce a theoretical framework, the 'developmental niche,' derived from studies of children's behavior and development in different cultural contexts, as a tool for analyzing the household production of health. The developmental niche is conceptualized in terms of three basic components: (1) the physical and social settings of the child's everyday life; (2) culturally regulated customs of child care and child rearing; and (3) the psychology of the caretakers. The relevance of each of these components to the household production of health is illustrated through examples from research in several cultures, including Malaysia, Kenya, Bangladesh, India, and the U.S. Further discussion centers on three corollaries of the developmental niche framework that point to the interactive relationships among the three components, between the niche and the larger environment, and between the niche and the child (or any individual seen from a developmental perspective). It is suggested that this approach is useful for identifying and collecting relevant information on household-level factors that affect health outcomes, and thus for organizing more effective interventions. At a theoretical level, the developmental niche framework also facilitates understanding processes of mutual adaptation between the individual and the environment as they are filtered through the constraints of household settings, customs and caretaker psychologies.

Matched MeSH terms: Child Care
Mobile Health Applications for Pediatric Care: Review and Comparison

Morse SS, Murugiah MK, Soh YC, Wong TW, Ming LC

Ther Innov Regul Sci, 2018 05;52(3):383-391.
PMID: 29714538 DOI: 10.1177/2168479017725557

BACKGROUND: Despite the surge in mobile health (mHealth) applications (apps) about pediatric care in commercial app stores, to our knowledge, reviews of the quality of such apps are lacking. Consequently, it is a great challenge for health care professionals (HCPs) to identify appropriate and reliable mHealth apps for delivering health care services. Thus, we performed a structured review of the extant literature about mHealth apps in pediatric care and quality assessment of selected apps found in commercial app stores.
METHODS: A review and comparison of mHealth apps in pediatric care found in Google's Play Store (Android system) and Apple's App Store (iOS system) were performed. For the structured review of the available literature, Google Scholar, PubMed, IEEE Xplore Digital Library, and Science Direct online databases were used for the literature search. The assessment criteria used for comparison included requirement for Internet connection, size of application, information on disease, diagnostic tools, medical calculator, information on disease treatments, dosage recommendations, and drug interaction checker.
RESULTS: Fifty mHealth apps for general pediatric care and 8 mHealth apps for specific pediatric diseases were discussed in the literature. Of the 90 mHealth apps we reviewed, 27 that fulfilled the study criteria were selected for quality assessment. Medscape, Skyscape, and iGuideline scored the highest (score=7), while PediaBP scored the lowest (score=3).
CONCLUSIONS: Medscape, Skyscape, and iGuideline are the most comprehensive mHealth apps for HCPs as quick references for pediatric care. More studies about mHealth apps in pediatric care are warranted to ensure the quality and reliability of mHealth apps.

Matched MeSH terms: Child Care
Islamic Family Law Enactment 1987 (No. 3 of 1987), 20 May 1987

Annu Rev Popul Law, 1988;15:66.
PMID: 12289651

This Islamic Family Law Enactment of Pahang, Malaysia, is based on the model of the Islamic Family Law (Federal Territory) Act, 1984 (Annual Review of Population Law, Vol. 11, 1984, Section 250). It differs from that Law in the following major respects: 1) marriages between Muslims and non-Muslims are prohibited; 2) a wali Hakim (special guardian appointed by the Sultan) is authorized to consent to marriage if the wali (guardian) of the bride unreasonably withholds consent; 3) the grounds for divorce are fewer (failure to maintain and cruelty being omitted), although there is a general provision allowing divorce for any ground that is recognized as valid by Islamic law; 4) a son is to be maintained until the age of 15, not 18; and 5) a religious court, rather than a civil court, may order a putative father to maintain his illegitimate child.

Matched MeSH terms: Child Care*
Policy as normative influence? On the relationship between parental leave policy and social norms in gender division of childcare across 48 countries

Schindler S, Schuster C, Olsson MIT, Froehlich L, Hübner AK, Block K, et al.

Br J Soc Psychol, 2025 Apr;64(2):e12806.
PMID: 39439425 DOI: 10.1111/bjso.12806

In the present work, we addressed the relationship between parental leave policies and social norms. Using a pre-registered, cross-national approach, we examined the relationship between parental leave policies and the perception of social norms for the gender division of childcare. In this study, 19,259 students (11,924 women) from 48 countries indicated the degree to which they believe childcare is (descriptive norm) and should be (prescriptive norm) equally divided among mothers and fathers. Policies were primarily operationalized as the existence of parental leave options in the respective country. The descriptive and prescriptive norms of equal division of childcare were stronger when parental leave was available in a country - also when controlling for potential confounding variables. Moreover, analyses of time since policy change suggested that policy change may initially affect prescriptive norms and then descriptive norms at a later point. However, due to the cross-sectional nature of the data, drawing causal inferences is difficult.

Matched MeSH terms: Child Care*
Fulltext Psychosocial risks and mental health of preschool care providers in Kuala Lumpur, Malaysia: a cross-sectional study

Tham SW, Wong MF, Ismail MB, Ismail Bukhary NBB

BMC Psychol, 2025 Jan 09;13(1):25.
PMID: 39789657 DOI: 10.1186/s40359-024-02279-3

BACKGROUND: Child maltreatment in daycare is a public health issue. As childcare is stressful, high care provider negativity independently predicts more internalizing behaviour problems, affecting children's psycho-neurological development. This study aimed to determine psychosocial factors associated with the mental health of preschool care providers in Kuala Lumpur.
METHODS: A random cluster sampling cross-sectional survey was conducted in 2019. The study involved registered care providers for preschoolers under four years old without acute psychiatric illness. The Center for Epidemiologic Studies Depression Scale (Malay-CES-D) and Karasek's Job Content Questionnaires (Malay-JCQ) were used to assess depression symptoms and psychosocial job-related risks. Logistic regression (p care providers in Kuala Lumpur. The Social and Welfare Department can promote supportive supervision through skill training for supervisors, fostering a positive mental health environment for improving workers' mental health.

Matched MeSH terms: Child Care/psychology; Child Care/statistics & numerical data
Fulltext Knowledge and attitude about child abuse and its reporting among childcare providers in Kemas preschools in Kota Bharu and Tumpat

Siti Mariam Ja’afa, Azriani Ab Rahman, Wan Nor Ariffin Wan Mansor

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):108-108.
MyJurnal

Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.

Matched MeSH terms: Child Care
Knowledge and practice concerning the use of oral rehydration salts among mothers living in urban slum areas of Kuala Lumpur

Osman A

Family Physician, 1991;3:28-30.

A study was conducted in an urban slum area of Kuala Lumpur, the capital of Malaysia, to determine the health status of the children under 6 years old and the knowledge and practice associated with diarrhoeal diseases and use of oral rehydration salts (ORS) among mothers in the area. It was seen that the health status of the children was poor with one fifth of them born underweight, 33% experiencing more than 6 spells of illness per year and a high percentage of them suffering from diarrhoeal diseases (4.3%). Child care practice was associated with urban lifestyles with early weaning, short term breast-feeding and early introduction of solid and bottle feeding. Knowledge and practice of mothers concerning child care was inadequate to support healthy living. Knowledge of diarrhoeal diseases and the effectivenss of oral rehydration salts was poor. Only 47.7% of mothers knew about ORS and 27.8% ever used it when their chidlren suffered from diarrhoea. Health care system dependence was shown by the high percentage of mothers immediately bringing to a doctor's attention (75.6%).

Matched MeSH terms: Child Care
Fulltext A survey among guardians on child restraint system (CRS) usage In central peninsular Malaysia

Noor Faradila, P., Aqbal Hafeez, A., Azhar, H., Rohayu, S., Akmalia, S., Mohd Syazwan, S., et al.

Malaysian Journal of Public Health Medicine, 2016;16(101):1-6.
MyJurnal

Children are much more likely than adults to get serious injuries in car crashes due to their softer bones, weaker neck muscle and fragile bodies. Child restraint system (CRS) can help in reduce injury and prevent fatality in the event of a crash. Thus the aim of this paper is to gauge the prevalence of CRS usage among guardians of children age below 11 years old. A survey to addressed guardians knowledge on CRS usage, practice and their views on fitting child restraints system to their vehicles were carried out among parents and carers who are caring children aged 11 years old and below. Seventy-four percent (74%) out of 500 respondents cited they have used CRS, however only 40% of them is currently using CRS with their children. Respondent in Kuala Lumpur and younger guardians reported twice likely to use CRS. In addition, graduate respondents are 1.5 times more likely to use CRS for their children. In conclusion, high incorrect usage rate and understanding of the CRS could promote additional injury towards the children in a car crash. Many initiatives could be introduced before the implementation of the CRS law in Malaysia such as awareness, community-based programs and CRS clinics that aim to guide guardians on the correct and effective way of installing the CRS device in their car.

Matched MeSH terms: Child Care
Children abused while in the care of child-minders: the Malaysian scene

Marret, M.J., Aili, H., Koh, M.T.

Malaysian Journal of Paediatrics and Child Health, 2000;12(1):42-47.
MyJurnal

This paper looks at some of the problems encountered when cases of abuse and injuries occur in children placed in child care in an urban community in Malaysia. It is based on the study of 37 children referred to our hospital's Child Protection Services over the past four years for injuries and incidents where the child-minders came under suspicion. They constituted 12% of the 285 children referred to the Child Protection Team during that period for evaluation of suspected child abuse. Twenty six children had experienced physical trauma. Fifty eight percent of these were young infants with cranial injuries or limb fractures but no history to explain their occurrence. Four had superficial injuries from accidents secondary to inadequate supervision. The other 11 children had been sexually abused. The perpetrators in 73% of cases were either the husbands or sons of the child-minder. Ninety five percent of the incidents occured at home-based nurseries. Prospects of any punitive measures were remote in most instances due to uncertainty about the perpetrator, or insufficient corroborative evidence required in sexual abuse cases. There were three documented cases where the family refused to lodge a police report or co-operate with investigations out of a reluctance to implicate or offend the child-minders who were mainly neighbours, relatives or friends in 58% of cases. Ninety seven percent of the facilities were unregistered, making surveillance for recurrent incidents and adherence to safety standards difficult. These incidents were almost certainly an underestimate of the problem. Training of child-care providers, improved legislation and enforcement as well as education of parents to choose suitable facilities are issues which need to be tackled.

Matched MeSH terms: Child Care
Fulltext Top Mobile Applications in Pediatrics and Children's Health: Assessment and Intelligent Analysis Tools for a Systematic Investigation

Jazayeri SMHM, Jamshidnezhad A

Malays J Med Sci, 2019 Jan;26(1):5-14.
PMID: 30914890 DOI: 10.21315/mjms2019.26.1.2

The development of intelligent software in recent years has grown rapidly. Mobile health has become a field of interest as a tool for childcare, especially as a means for parents of children with diverse diseases and a resource to promote their health conditions. Current systematic review was conducted to survey the functionalities of available applications on the mobile platform to support pediatrics intelligent diagnosis and children healthcare. Results which met the inclusion criteria (such as patient monitoring, decision support, diagnosis support) were obtained, assessed and organised into a checklist. In this study, 379 potential apps were identified using the search feature in Apple App Store and Google Play Store. After careful consideration of the selected apps, only three (Google Play Store) and one (iTunes Store), fulfilled all the general inclusion criteria and special criteria, such as intelligence tools. The results showed that Artificial Intelligence (AI) was used minimally in diagnostic apps due to a limited amount of mobile hardware and software, such as the reliable programming of intelligent algorithms.

Matched MeSH terms: Child Care
Fulltext Ethnicity and infant mortality in Malaysia

Dixon G

Asia Pac Popul J, 1993 Jun;8(2):23-54.
PMID: 12287522

PIP: Malaysian infant mortality differentials are a worthwhile subject for study, because socioeconomic development has very clearly had a differential impact by ethnic group. The Chinese rates of infant mortality are significantly lower than the Malay or Indian rates. Instead of examining the obvious access to care issues, this study considered factors related to the culture of infant care. Practices include the Chinese confinement of the mother in the first month after childbirth ("pe'i yue") and Pillsbury's 12 normative rules for Malaysian Chinese care. Malay practices vary widely by region and history. Indian mothers are restricted by diet. Data-recording flaws do not permit analysis of Sarawak or Sabah. The general assumption that Western medicine favors better health for mothers and infants is substantiated among peninsular communities, however, there are also negative impacts which affect infant mortality. The complex interaction of factors impacting on infant mortality reported in seven previous studies is discussed. A review of these studies reveals that immediate causes are infections, injuries, and dehydration. Indirect causes are birth weight or social and behavioral factors such as household income or maternal education. Indirect factors, which are amenable to planned change and influence the biological proximate determinants of infant mortality, are identified as birth weight, maternal age at birth, short pregnancy intervals or prior reproductive loss, sex of the child, birth order, duration of breast feeding and conditions of supplementation, types of household water and sanitation, year of child's birth, maternal education, household income and composition, institution of birth, ethnicity, and rural residence. Nine factors are identified empirically as not significant: maternal hours of work in the child's first year, maternal occupation, distance from home to workplace, presence of other children or servants, incidence of epidemics in the child's first year of life, community types of sanitation, prices and availability of infant foods, and access to various types of medical care. Future empirical study should consider factors such as class differences, place of residence, or extent of illiteracy as underlying or related to ethnicity. Policy-makers should be aware that future decline in infant mortality rates may depend on the blending of traditional with modern practices.

Matched MeSH terms: Child Care*
Fulltext Validation of Infant and Young Child Feeding Questionnaire for the Assessment of Knowledge, Attitudes and Practices among Child Care Providers: The IYCF-CCPQ

Zakria NM, Tengku Ismail TA, Wan Mansor WNA, Sulaiman Z

Int J Environ Res Public Health, 2019 06 17;16(12).
PMID: 31213022 DOI: 10.3390/ijerph16122147

The validation of a new questionnaire is essential to improving its credibility in the assessment and collection of evidence. This study aimed to validate a newly developed infant and young child feeding questionnaire for child care providers (IYCF-CCPQ) to measure the knowledge, attitudes, and practices regarding infant and young child feeding among them. A cross-sectional study was conducted with 200 child care providers who were involved in handling children less than two years old in child care centers in the northeastern part of Peninsular Malaysia. The IYCF-CCPQ was self-administered and consists of three domains: Knowledge (104 items), attitude (90 items), and practice (42 items). The dichotomous-scale items in the knowledge domain were analyzed using a two-parameter logistic model of item response theory (2-PL IRT). The Likert-type-scale items in the attitude section were assessed using exploratory factor analysis (EFA). The items in the practice section were assessed descriptively. Internal consistency by marginal reliability was assessed in the knowledge domain, and Cronbach's alpha coefficient was used for the attitude domain. The marginal reliability values were 0.91 and 0.74 for the knowledge domains related to breastfeeding/formula feeding and complementary feeding, respectively, and the Cronbach's alpha values were 0.89 and 0.90 for the attitude domains related to breastfeeding/formula feeding and complementary feeding, respectively. The analysis showed good psychometric properties (discrimination, difficulty index, factor loading, and communalities) and good reliability. The IYCF-CCPQ is valid for use assessing the knowledge, attitudes, and practices among Malaysian child care providers regarding infant and young child feeding.

Matched MeSH terms: Child Care/statistics & numerical data*
Assessment of growth and feeding practices in children with cleft lip and palate

Gopinath VK, Muda WA

Southeast Asian J Trop Med Public Health, 2005 Jan;36(1):254-8.
PMID: 15906679

Feeding difficulties in cleft lip and palate (CLP) infants is commonly observed and is the most traumatic experience the family has to face. These infants are undernourished and have compromised growth. The purpose of this study was to 1) assess general health and growth parameters in children with CLP and in normal children; and 2) investigate the feeding methods of CLP infants and normal infants. A total of 221 children from birth to six years of both sexes, with CLP (60 children) and normal (161 children) were selected. The CLP and normal children were divided into three subgroups by age. The practice of feeding the infants in subgroup I was assessed using standard piloted questionnaires. The assessment of growth was done at baseline and at six months in all the subgroups.The general well being of the children was assessed by noting the number of common infections. Results showed that a significantly higher percentage of mothers with normal babies (p < 0.01) had a positive attitude towards breast feeding. When compared to normal children, CLP children were more susceptible to infections (p < 0.05) and measured significantly lower on the height growth curve(p < 0.05). Hence, height can be used to monitor growth in CLP children.

Matched MeSH terms: Child Care/methods*
Assessing the needs of caregivers of children with disabilities in Penang, Malaysia

Tan SH

Health Soc Care Community, 2017 03;25(2):447-457.
PMID: 26833929 DOI: 10.1111/hsc.12325

Disability in a child not only affects the child but also presents socioeconomic and psychological impacts to the child's family. This study aims to describe the service needs of caregivers of children with disabilities in the state of Penang, Malaysia, and to determine the child and family characteristics predisposing to having more caregiver needs. A cross-sectional survey was conducted between February and June 2013 among caregivers of children aged 0-12 years with disabilities registered with the Penang Department of Social Welfare. Caregivers completed a self-administered mailed questionnaire containing a 20-item Caregiver Needs Scale (CNS). Each item in the CNS was rated on a 5-point Likert scale ranging from 'help not at all needed' to 'help extremely needed'. A total of 273 surveys were available for analysis (response rate 34.0%). The CNS contained four domains. The 'Help getting Information and Services for child' domain had the highest mean score (3.61, 95% CI: 3.46, 3.77) followed by 'Help with Finances' (3.29, 95% CI: 3.13, 3.45) and 'Help Coping with child' (3.11, 95% CI: 2.97, 3.25), while the 'Help getting Childcare' domain had the lowest mean score (2.30, 95% CI: 2.13, 2.47). Multivariate regression analysis identified caregivers of younger children and with more severe disability as having more caregiver needs in all domains. Besides that, caregivers of children with learning disability needed more help getting information and help with coping. Caregivers of children with learning and multiple disabilities needed more help getting childcare compared to children with other disability. Caregivers of Indian ethnicity, who had less than a tertiary education and who themselves had medical problems needed more help with finances. The findings on caregiver needs in this study can help inform planning of family support services for children with disabilities in Penang, Malaysia.

Matched MeSH terms: Child Care
Female employment and fertility in Peninsular Malaysia: the maternal role incompatibility hypothesis reconsidered

Mason KO, Palan VT

Demography, 1981 Nov;18(4):549-75.
PMID: 7308536

Multivariate analysis of the 1974 Malaysian Fertility and Family Survey tests the hypothesis that an inverse relationship between women's work and fertility occurs only when there are serious conflicts between working and caring for children. The results are only partly consistent with the hypothesis and suggest that normative conflicts between working and mothering affect the employment-fertility relationship in Malaysia more than spacio-temporal conflicts do. The lack of consistent evidence for the hypothesis, as well as some conceptual problems, lead us to propose an alternative framework for understanding variation in the employment-fertility relationship, both in Malaysia and elsewhere. This framework incorporates ideas from the role incompatibility hypothesis but views the employment-fertility relationship as dependent not just on role conflicts but more generally on the structure of the household's socioeconomic opportunities.

Matched MeSH terms: Child Care
Fulltext Persediaan sebelum kehamilan di kalangan etnik India di Semenyih Selangor

Rosnah, S., Wan Aishah, W.N.

Malaysian Journal of Community Health, 2010;16(2):29-35.
MyJurnal

Introduction: Pre-pregnancy care is an important strategy in prevention of adverse maternal and fetal health as well as continuity of good child care. In multi-ethnicity country such as Malaysia there are many cultural, religion and beliefs related to certain life stages.
Methodology: A cross sectional study was conducted among the Indian ethnic group to assess the prevalence and factors associated with pre-pregnancy care. A study was conducted in Taman Manickavasangam Hulu Langat Selangor among the age group of 18-45 year old women.
Result: There were 90 respondents participated in self administered questionnaires. There were 65 respondents (72.2%) married, 24 (26.7%) single and one widow (1.1%). Using a scoring method of analysis (high and low) showed that 55 (61.1%) have high score in knowledge on pre-pregnancy care. The prevalence of pre-pregnancy care practice showed that 63 (70%) scored as high practice. Using correlation analysis showed that there was a significant association between the practice score and increasing age (P=0.03). However, only history of previous pregnancy showed a significant association with the pre-pregnancy care practice and no association found between the practice and knowledge score.
Conclusion: Prepregnancy care helps in screening risk factors of women before conception. This will help in prevention of adverse effect on maternal and foetal. Giving awareness on the importance of having prepregnancy care screening may help women to continue practicing good antenatal care.

Matched MeSH terms: Child Care
Risk factors for acute lower respiratory tract infections in hospitalised children in Kelantan

Choo, C.M., Quah, B.S., Rostenberghe, H.V., Choo, K.E.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):1-7.
MyJurnal

A case control study was conducted to identify the risk factors for acute lower respiratory tract infections (ALRI) in hospitalised children in Kelantan. One hun-dred and twenty children aged one month to five years hospitalised for ALRI were matched by age with 120 children as controls. Data on demography and expo-sure to putative risk factors were collected by interview-ing parents or caretakers. Anthropometric measure-ments were also carried out to assess the nutritional sta-tus of the children. For each risk factor studied, the odds ratios for exposure and disease were calculated by using univariate analysis followed by multiple logistic regression analysis to determine those factors which remained significant.
The presence of sibling(s) who coughed at home (OR 12.1, 95% CI 5.2-28.1), crowding in bedroom (OR 4.4, 95% CI 2.1-9.0), weight-for-age < 3rd percentile (OR 9.0, 95% CI 3.1-25.8), lack of breast feeding (OR 9.4, 95% CI 2.3-38.4) and incomplete immunisation (OR 4.5, 95% CI 1.7-12.1) were significant indepen-dent risk factors for ALRI. Other factors like poverty, maternal education level, male sex, low birth weight, history of atopy, family history of asthma and indoor air pollution were not associated with an increased risk of ALRI.
This study showed that poor nutritional status, inap-propriate child care practices and poor living conditions, particularly those related to crowding, predispose to ALRI in Kelantanese children necessitating hospital admission. A change in these factors may reduce the morbidity and mortality of childhood ALRI in Kelantan.

Matched MeSH terms: Child Care

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