1. PERSONAL FACTORS
1.1. Children not meeting milestones
1.1.1. Older daughter, Amara, failed to play ball, drink from a cup, scribble, and walk backwards
1.1.2. Chandra's attention is hard to get. Potential risk for hearing troubles
1.2. Nadiya's Well-being
1.2.1. Feels tired, looks pale, and is thin
1.2.2. Feels sad, hopeless, and
1.2.3. Really wants to go on birth control
2. SOCIAL FACTORS
2.1. Need for support
2.1.1. Husband only comes home 1-2 times a week
2.1.2. Doesn't have any friends from the United States
2.1.3. Feels alone and isolated from outside world
3. STRATEGIES TO ADDRESS RISK FACTORS
3.1. Encourage mother-daughter connection
3.1.1. Talk and sing to Chandra with eye contact
3.1.2. Teach proper breastfeeding techniques
3.1.3. Address developmental concerns
3.1.4. "Tummy time" and self-feeding
3.1.5. Seasonal vaccinations and flu shots
3.2. Self-care for Nadiya
3.2.1. Consider continuing education, discuss benefits
3.2.2. Learn to drive, discuss benefits
3.2.3. Refer to doctor to prescribe birth control
3.2.4. Teach employable skills
3.2.5. Offer further support, communication, and follow ups
4. CONFLICTS
4.1. CLINICIAN
4.1.1. Concerns about not wanting to disrespect Nadiya's culture.
4.1.1.1. Must ask sensitive questions
4.1.1.2. Must learn and understand this culture
4.1.1.3. Adjusting to the family dynamic
4.1.1.4. Gets frustrated, sad, and angry about many of Nadiya's responses
4.2. CULTURAL
4.2.1. Patriarchal Household
4.2.1.1. Arranged marriage with little interaction between her and her husband
4.2.1.2. Seeks approval from sister and mother-in-law
4.2.1.3. 4 generations living in the household
4.2.1.4. Doesn't know anything about husband's job or income
5. RISK FACTORS
5.1. Family issues
5.1.1. Doesn't get along with mother-in-law
5.1.2. Feels unsafe
5.1.3. Pressure from in-laws to have a son
5.1.4. Relies on others to drive places
5.2. Mother-daughter connection
5.2.1. Doesn't want to breastfeed for more than 6 months
5.2.2. Breastfeeding is painful and time consuming