Magistro darbe yra nagrinėta Kūdikių namų veiklos krypčių kaitos tendencijos problemos, išanalizuoti palyginti ir apibendrinti įvairių Lietuvos ir užsienio autorių vadybinės, socialinės, pedagoginės, istorinės, psichologinės, medicininės literatūra, pasirinktos temos aspektu, teoriniai mokslo darbai. Išsamiai analizuojami Kūdikių namų prioritetai, užtikrinantys visavertį vaiko, augančio vaiko ne šeimoje, raidą, kokia turėtų būti Kūdikių namų veiklos krypčių kaita, kaip sukurti visaverčius Kūdikių namuose augančių vaikų ir jo šeimų santykius. Išnagrinėti Lietuvos Respublikos įstatymai, nutarimai, Civilinis kodeksas, Kūdikių namų nuostatai, Europos ir pasaulio šalių gera patirtis, kuriant paslaugų sistemą ankstyvojo amžiaus vaikams ir jų šeimoms. Patvirtinta suformuota mokslinio tyrimo hipotezė, kad Šiaulių apskrities sutrikusio vystymosi Kūdikių namų veiklos krypčių pagrindinės kaitos tendencijos yra šios: Kūdikių namai iš sveikatos priežiūros įstaigos turėtų keistis į globos įstaigą, orientuotą į šeimos išsaugojimą, socioedukacinę ir vadybinę veiklą; dėl objektyvios institucinės aplinkos vaiko raidos kokybė neatitinka biologinių, psichologinių, edukologinių, socialinių ir ekonominių vaiko amžiaus charakteristikų; esant šeimyninei krizei, Kūdikių namų paslaugos galėtų keistis iš paslaugų teikimo ne tik vaikui, bet ir jo šeimai; Kūdikių namai nepakankamai dėmesio skiria socioedukaciniam darbui su tėvais, neauginančiais savo vaiko. / In the research work for Master of Arts the problems of the tendency of the change in the directions of the activity of Infant Home have been analyzed; the literature and theoretical scientific works in management, social sciences, education, history, psychology, and medicine of various Lithuanian and foreign authors in the aspect of the chosen topic have been analyzed, compared and generalized. The priorities of Infant Home that ensure full development of a child who does not grow up in a family, the questions what change the directions of the activity of Infant Home should undergo and how to create full relations between children who grow up in Infant Home and their families have been thoroughly analyzed. The analysis of the laws and resolutions of the Republic of Lithuania, the Civil Code, the rules of Infant Home, the good experience of the European and world countries in the process of the creation of the service system for young children and their families has been performed. The formulated hypothesis of the scientific research has been proved: the main tendencies of the change in the directions of the activity of Infant Home are focused on the preservation of the relationship between a child and his/her family, the solution of emerging social problems and they allow identifying the optimal possibilities of the interaction between a child and his/her family.

Background The Parent-Infant Home Visiting Programme (PIVHP) is a home-based parenting programme targeted at new and expectant mothers, characterised as vulnerable. Participants are recruited from low-income communities situated on the Cape Flats, in Cape Town, South Africa. The programme consists of antenatal and postnatal sessions, facilitated by trained Parent Infant Attachment Counsellors (PIACs) recruited from target communities. There are two programme cycles per year: one from January to June, and a second one from July to December. The overarching goal of PIHVP is to contribute towards the prevention of child abuse, abandonment and neglect; and to promote positive infant growth and development. The programme has to date not been guided by an explicit theory of change (TOC). There was no Monitoring and Evaluation (M&E) system in place, at the time of the evaluation, either. The programme engages in extensive data collection for administrative purposes. This data, however, is not captured nor analysed systematically to monitor progress or measure impact. This formative evaluation aims to capitalise on the existing data. Evaluation Focus This evaluation focused on the first 2019 programme cycle. The main objective of this evaluation was to determine the extent to which the PIHVP had been implemented with fidelity. As such, a process evaluation was conducted to address the following evaluation questions: 1. Did the PIHVP beneficiaries recruited for the first 2019 programme cycle meet the eligibility criteria specified by programme? 2. What proportion of participants completed and dropped out of the PIHVP during the first programme cycle of 2019? What are the reasons provided for programme dropout? questions: 3. To what extent did the PIHVP meet its targeted number of participants? What are the reasons for over/under coverage? 4. Did the participants receive the home-visiting sessions at the duration and frequency prescribed by the programme model? 5. Did PIACs complete and conduct all programme activities, developmental screenings and demonstrations as intended? 6. How did participants perceive PIACs in terms of the support they provided and their preparation level, knowledge, and reliability? 7. To what extent do PIACs implement the skills acquired through their training into their sessions? 8. Are the participants satisfied with the service they received? What are the strengths and limitations they identified? 9. To what extent did participants engage with the PIACs (around the content) during home-visit sessions? Methodology The evaluator first extracted and refined the programme's TOC through structured consultations with the programme manager. The plausibility of the PIHVP's programme theory was then assessed through an extensive literature review. The evaluator then proceeded with the process evaluation. A mixed methods approach was used, as combination of both primary and secondary data sources, and quantitative and qualitative data analysis were used to systematically answer the evaluation questions.

This thesis analyses the reforms of health and social care in the Czech Republic, focusing on the impacts of the reform measures on providers and consumers of health care. Health reforms are currently very up to date, but have not yet been adequately processed and published. Health care of the modern state which Czech republic undoubtedly is must provide affordable and quality health care to all children and people of the society. There is however a necessary role of the state as the representative of the entire health system and relevant legislation. In this thesis we studied the prepared government reforms. The aim of this work was to understand this difficult area and bring this issue further primarily to medical professionals. The results of the research can serve professionals in health social area and be published in scientific journals. The thesis contains a theoretical and empirical part. In the theoretical part we focused on health care systems after 1989, the need for a new reform, the economic development, the health legislation and we also mentioned problems of the current health care system in the Czech Republic. In more detail, we focused on the amended laws related to the new changes in the healthcare system of the Czech Republic. Regarding the reform measures of the Ministry of Labour and Social Affairs, we focused on the change in the institutional child care and thus a possible replacement of nurseries foster care. For the empirical part research was chosen qualitative method of semi-structured interview with nurses. The research sample consisted of 20 university educated nurses who work mainly on children's wards in hospitals in Czech Budejovice, Tabor, Czech Krumlov and General University Hospital in Prague. In the thesis we stated six goals and six research questions. First, we wanted to determine nurses opinions on the big planned new health and social reform. Furthermore, we were interested in awareness nurses would planned changes in the health and social sphere with other goals we wanted to see what would nurses would like to change in the health system of the Czech Republic, how well informed Theky are about the changes in health care since 1989, what they know about the problems of institutional care and what their opinion on the possible cancelation of nurseries and they replace ment of institutional care by foster care is. From the research it was shown that the specifics of the health reform were seen by the respondents from different point of views. During the qualitative investigation it was found that the knowledge of university educated nurses regarding the planned health reforms was not fully sufficient. With the year of 2014 crucial changes occurred in the Czech health system. In particular, we do not pay medical fees for inpatient stay (1st. January 2014). By the media discussed many medical fees majority of the respondents was aware of but they didnt know the other reforms. In this thesis we focused on the lack of (un) awareness of nurses of planned the health reforms. Our hope is to convince the wider professional public that basic knowledge of politics in the Czech Republic is a very important issue.