This study aims to understand and critically analyse the knowledge and practices of child welfare professionals who play an important role in recognising, responding to and intervening in cases of child neglect. The study contributes towards a greater understanding of the complexities of the child welfare professionals’ (CWP) institutional practices when categorising cases as neglect. Three data collection methods were used; semi-structured interviews, an analysis of child protection case conference minutes and observation of social work practice. The complementary data sets produced revealed an understanding of CWP’s knowledge and practices which would not have been possible using a single method. The CWPs interviewed, from four professional groups, shared a typical image of a neglected child but this image did not coincide with all cases categorised as cases of neglect identified during the analysis of the Minutes and the observation of social workers’ practice. The exceptions to the typical image included young people, unborn children and children experiencing emotional neglect. The CWPs working in universal services talked about ‘building a picture’ of neglect since neglect was not always obvious. There were inter-professional differences around thresholds and the ‘level of neglect’ that warranted child protection intervention. The CWPs talked about their understanding of neglect being broader than the parents’, since their understanding included emotional neglect. This perceived difference in the CWPs’ understanding of neglect had implications for their interactions with parents and was seen as a challenging area of practice. The participant observation data showed that social workers used numerous features when carrying out assessments, including features relating to the parents, the children and the home environment. These features functioned in different ways depending on the context and which features co-existed. CWP practice was influenced by professional roles and personal values. Professional practice involved multiple interactions, and the crucial nature and impact of these interactions was key to understanding the process of categorising cases of neglect.

Background: Children's screen usage has increased in recent years and parents' screen usage has strong association with children's screen usage. When the specialist nurse works based on family-centered nursing, conversations about screen usage can include the whole family. Purpose: To describe specialist nurses' experiences of working with children’s screen usage in Child Health Services.  Method: The study was conducted with qualitative design with inductive approach. Totally 11 specialist nurses in Child Health Services were interviewed. Qualitative content analysis according to Graneheim and Lundman (2004) was used to analyze that data material. Results: The analysis of the interview material collected led to two categories, dialogue and reflection and the challenges of screen usage.  Within these categories seven subcategories were identified. There was an opportunity to talk about children's screen usage in parental groups and health visits. Specialist nurses described that there were challenges depending on the parents' approaches to screen usage and that the screen competed with children's other activities. Conclusion: This study showed the importance of specialist nurses in child health services bringing up the topic of screen through dialogue and reflection with children and parents. Screen usage was described as a difficult subject and there were challenges in the work. / Bakgrund: Barns skärmanvändning har ökat de senaste åren och föräldrars skärmanvändning har starkt samband med barns skärmanvändning. När specialistsjuksköterskan arbetar utifrån familjecentrerad omvårdnad kan samtal om skärmanvändning inkludera hela familjen. Syfte: Att beskriva specialistsjuksköterskors erfarenheter av att arbeta med barns skärmanvändning inom barnhälsovården. Metod: Studien genomfördes med kvalitativ design med induktiv ansats. Totalt intervjuades 11 specialistsjuksköterskor inom barnhälsovården. Kvalitativ innehållsanalys enligt Graneheim och Lundman (2004) användes för att analysera datamaterialet. Resultat: Analysen av det insamlade intervjumaterialet ledde fram till två kategorier, dialog och reflektion samt skärmanvändningens utmaningar. Inom dessa kategorier identifierades sju subkategorier. Det fanns möjlighet att samtala om barns skärmanvändning i föräldragrupper och vid hälsobesök. Specialistsjuksköterskor beskrev att det fanns utmaningar beroende på föräldrars inställningar till skärmanvändning samt att skärmen konkurrerade med barns andra aktiviteter. Slutsats: Denna studie visade vikten av att specialistsjuksköterskor inom barnhälsovården tar upp ämnet skärmanvändning genom dialog och reflektion med barn och föräldrar. Skärmanvändning beskrevs som ett svårt ämne och att det fanns utmaningar i arbetet.

This study analyzed data from Dallas Public Schools and Dallas Youth and Family Centers (YFCs) to explore variables associated with referrals to and utilization of Youth and Family Centers. Data from students enrolled in third, eighth or tenth grade during the 1996-1997, 1997-1998 and 1998-1999 school years were analyzed to determine the reasons for YFC referral and utilization, and to compare standardized test scores and attendance. Of the 6956 students in third, eighth and tenth grades initially referred to YFCs during those three school years, 5173 (74.3%) made at least one YFC visit. The 5173 students made an average of 2.69 visits and accessed an average of 1.18 services per year. Medical visits accounted for 42.5% of YFC visits, and mental health visits accounted for 46% of YFC visits. Results of logistic regression analyses indicate a significant difference for utilization upon referral and continued use of the YFC when the constant is compared to a set of predictor variables. For both analyses, the predictor variables were Chapter I status, LEP status, reason for referral, gender, special education status, ethnicity, distance from home school to referral YFC, food stamp eligibility and referral source. While outcome data regarding attendance and scores on standardized tests was limited to records available, results suggest that mean reading scores for eighth graders were significantly higher during Year 1 for the group that accessed YFC services. School attendance was better for eighth graders who made continued use of a YFC. Use of medical services by third graders was associated with a gain in attendance rather than a slight loss for the third graders who did not access medical services upon referral. Results of this study were limited by missing data for several records. The competitive atmosphere of health care service delivery and the practical need to know about service delivery at the sites should make data management a priority.

PURPOSE Explore the competencies required by the child nurse practitioners in the child nursing practice in order to refine the current competencies in a programme for Child Nursing Science presented at a Nursing Education Institution in Gauteng. DESIGN AND METHOD A quantitative, non-experimental, descriptive, exploratory and applied research design was used. A structured self reported questionnaire was constructed based on the competencies derived from the current programme for Child Nursing Science used at the Nursing Education Institution, the Specialist Paediatric and Child Health Nurse by the Australian Confederation of Paediatric and Child Health Nurses and the World Health Organization Children’s Nursing Curriculum. The structured self reported questionnaire was distributed to 110 child nurse practitioners working in child nursing practices in Gauteng and a total of 82 responded. FINDINGS All competencies were regarded as important, except for competencies related to research, family-centred child care, complementary and traditional child care practices, evidence-based practice, mentoring and play activities. CONCLUSION Findings were used to refine the current competencies in a programme for Child Nursing Science / Health Studies / M.A. (Health Studies)

No description available.

Bakgrund: Vaccin är en av de främsta framgångarna i medicinhistorien. Vaccinmotstånd klassas som ett av de tio största hoten mot global hälsa. Motstånd förekommer i hela världen i alla sociala grupper av olika anledningar. Syfte: Beskriva BHV-sjuksköterskors erfarenheter av att möta föräldrar som avstår från att vaccinera sina barn enligt det allmänna vaccinationsprogrammet. Metod: En kvalitativ intervjustudie. Semistrukturerade intervjuer hölls med åtta BHV-sjuksköterskor i mellansvenska kommuner. Innehållsanalys med induktiv ansats användes för att analysera resultatet. Resultat: Resultatet mynnade ut i tre huvudkategorier: orsaker till att avstå från vaccination, orsaker till att genomföra vaccination samt erfarenheter från mötet. Respektive huvudkategori baserades på följande subkategorier: tveksamhet, personliga skäl, felaktig information, information baserad på vetenskap och beprövad erfarenhet; individuell anpassning, bygga relation och tillit, svårt möte samt starkt ställningstagande. Slutsats: BHV-sjuksköterskornas erfarenheter är att mötet med vaccinkritiska föräldrar är svårt. Föräldrarna har ofta tagit del av felaktig information. BHV-sjuksköterskorna försöker med hjälp av personlig anpassning och respekt för föräldrarna förse dem med korrekt information, allt för att bibehålla en god relation. / Background: Vaccines are one of the key successes in the history of medicine. Vaccine hesitancy is ranked as one of the ten biggest threats to global health. Hesitancy occurs throughout the world in all social groups for various reasons. Aim: Describe child health services nurses experiences of meeting parents who refrain from having their children vaccinated. Method: A qualitative interview study. Semi-structured interviews were held with eight child health services nurses in communities in mid Sweden. Content analysis with an inductive approach was used to analyze the results. Results: Three main categories were found, reasons for refraining from vaccination, reasons to go through with vaccination and experiences from the meeting. The main categories were based on the following subcategories, doubt, personal reasons, incorrect information, information based on science and proven experience, individual adaptation, building relationship, and trust, difficult meeting, and strong position. Conclusions: The experience of the child health services nurses is that the meeting with vaccine-critical parents is difficult. The parents have often received incorrect information. The child health services nurses, by using individual adaptation, and meeting the parents with respect, try to provide them with correct information, all in order to maintain a good relationship.

The purpose of this study was to describe the utilisation of maternal and child health (MCH) care services by mothers from four selected health facilities in the Balaka District of Malawi. A non- experimental quantitative descriptive research was conducted to determine the knowledge of mothers with regard to MCH services and to identify factors that impact on the utilisation of the MCH care, based on the Andersen’s behavioral model of health services utilization. A combination of proportionate stratified sampling and convenience sampling was used and data was collected by means of self-administered questionnaires. It was found that mothers know the available services and that a number of factors have an impact on the utilisation of health care services. These relate amongst others to educational level, finances and cultural beliefs. / Health Studies / M.A. (Public Health)

The study sought to determine the meaning and interpretation by facility managers and nurses on utilisation of expanded programme on immunisation and integrated management of childhood illnesses (EPI and IMCI) programmes for follow-up and antibody testing of HIV-exposed infants (HEI) at 18 months. Also to understand the factors within the health systems that influence the follow-up and antibody testing. The study setting selected was six facilities in Steve Tshwete subdistrict in Nkangala district of Mpumalanga province in South Africa. The study used a hermeneutic phenomenology using in-depth interviews for collecting data from 4 facility managers and 12 nurses. The major themes that emerged from the interviews were referral, defaulting, integration, stigma, and off-site ART initiation within the health system. These were found to influence the utilisation of HEI and IMCI services for follow-up and management of HEI. It was also found that the importance of integrating the management of HEI into the EPI and IMCI cannot be overemphasised. It was concluded that the Health Department needs to be vigilant and use all available resources to manage HEI to meet the MDG 4 of prevention of infant mortality / Health Studies / M.A. (Nursing Science)

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges for their health and the health of their infants. Current health care services face many constraints and are not able to meet all the needs of pregnant mothers. Home-visiting programmes implemented by community health workers can alleviate these constraints. The current RCT assessed the effectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal and child nutrition and mental health. The effectiveness of the intervention was assessed by measuring infant social withdrawal behaviour using the modified Alarm Distress Baby Scale (m- ADBB). A total of 681 cases were randomised into control (N=330) and intervention groups (N=351) and assessed using the m-ADBB. A cut-off score of two and above was used to determined significant social withdrawal behaviour. Data was analysed using descriptive statistics and cross-tabulation initially, followed by analysis of variance and multilevel modelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, no significant differences between groups were found. The current prevalence was substantially higher in comparison to the only other published study using the m-ADBB. Furthermore, the prevalence rate was also significantly higher compared to the majority of other studies using the original Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawal behaviour found in this study indicates an increased risk for suboptimal infant development. Further research regarding social withdrawal behaviour and the casual mechanisms associated with the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed. / AFRIKAANSE OPSOMMING: Swanger vroue wat in Suid-Afrikaanse buitestedelike nedersettings woon staar baie uitdagings in die gesig met betrekking tot hul gesondheid en die gesondheid van hul babas. Huidige gesondheidsdienste is baie beperk en is nie in staat om in al die behoeftes van swanger moeders te voorsien nie. Huis-besoek programme wat deur gemeenskaplike gesondheidswerkers geïmplementeer word, kan hierdie beperkings verlig. Die huidige RCT het die effektiwiteit van die Philani Plus Intervensie Program wat MIV, alkohol, voeding en geestelike gesondheid aanspreek, geassesseer. Die effektiwiteit van die intervensie is geassesseer deur sosiale onttrekkingsgedrag met behulp van die gewysigde Alarm Nood Baba Skaal (m-ADBB) te meet. ‘n Totaal van 681 gevalle is lukraak in kontrole (N = 330) en intervensie groepe (N = 351) verdeel en geëvalueer volgens die m-ADBB. 'n Afsnypunt van twee en hoër is gebruik om beduidende sosiale onttrekkingsgedrag te bepaal. Data is aanvanklik ontleed met behulp van beskrywende statistiek en kruis-tabulering, gevolg deur analise van variansie en multi-modelle. Resultate toon 'n 46,7%-voorkoms van sosiale onttrekkingsgedrag, maar het egter geen beduidende verskille tussen groepe getoon nie. Die huidige voorkoms was aansienlik hoër in vergelyking met die enigste ander gepubliseerde studie wat gebruik gemaak het van die m- ADBB. Verder was die voorkomssyfer ook aansienlik hoër in vergelyking met die meerderheid van die ander studies wat gebruik gemaak het van die oorspronklike Alarm Nood Baba Skaal (ADBB). Die hoë voorkoms van sosiale onttrekkingsgedrag dui op 'n verhoogde risiko vir suboptimale baba ontwikkeling. Verdere navorsing oor sosiale onttrekkingsgedrag en die meganismes wat verband hou met die ontwikkeling van sulke gedrag, is nodig. Verder word die bekragtiging van die m-ADBB in verskillende instellings benodig.

The existing District Health Information System in South Africa can be described as a facility based Information System, focusing on the clinics and hospitals and not on the community. Consequently, only those who access health services through these facilities are included in the system. Many children do not have access to basic health and social services and consequently, are denied their right to good health. Additionally, they are excluded from the routine Health Information System. Policy and resource decisions made by the District Managers, based on the current health facility information, reinforces the exclusion of these already marginalised children. The premise behind this research is that vulnerability of children can be tackled using two interconnected strategies. The first is through the creation of awareness of the situation of children and the second through mobilising the commitment and action of government and society to address this situation. These strategies can be supported by designing an Information System for action / an Information System that can be used to advocate and influence decisions and policies for the rights of these children / an Information System that includes all children. An interpretive participatory action research approach, using a case study in a rural municipality in South Africa, was adopted for the study of a child-health Community-Based Information System. The context in which the community is placed, as well as the structures which are embedded in it, was examined using Structuration Theory. This theory also influenced the design of the Information System. As the aim of the research is to change the Information System to include vulnerable children, a Critical Social Theoretical and longitudinal perspective was adopted. In particular, concepts from Habermas, such as the creation of a public sphere and the &rsquo / Ideal Speech Situation&rsquo / , informed the methodology chosen and were used to analyse the research undertaken. <br /> <br /> Based on the research conducted in this municipality, four main changes to the Health Information System were made. These were: &bull / determination of the community&rsquo / s own indicators / &bull / changes in data collection forms / &bull / creation of forums for analysis and reflection, and / &bull / changes in the information flows for improved feedback. Other practical contributions of the research are the development of local capacities in data collection and analysis, the development of practical guidelines on the design of a child-health Community-Based Information System, and the development of strategies for enabling participation and communication. In line with the action research approach adopted, and the desire to link theory and practice, the research also contributed on a theoretical level. These contributions include extending the use of Structuration Theory, in conjunction with Habermas&rsquo / Critical Social Theory, to the empirical context of South Africa / addressing the gap of Community-Based Information Systems in Information System design / extending the debate on participation and communication in Information Systems to &rsquo / developing&rsquo / countries, and developing generalisations from a qualitative case study.