Barnmisshandel genom sjukvårdsinsatser (BMSI) innebär att ett barn blir utsatt för onödiga sjukvårdskontakter med olika undersökningar och behandlingar. Personen som definieras som förövare är vanligtvis den biologiska modern till barnet, men det kan även vara en annan person i barnets närhet. Studiens syfte var att undersöka socialsekreterares erfarenhet av BMSI samt att undersöka hur samverkan mellan socialtjänst, polis, åklagare, barnläkare och barnpsykiatriker organiseras. Vidare undersöktes om socialsekreterare som jobbat med denna typen av fall kan urskilja specifika framgångsfaktorer i arbetet med BMSI. Frågeställningarna var: Vilka erfarenheter beskriver socialsekreterarna när det gäller BMSI? Hur organiseras samverkan mellan socialtjänst, polis, åklagare, barnläkare och barnpsykiatriker när det föreligger misstanke om BMSI? Vilka framgångsfaktorer anser socialsekreterare är viktiga i ärenden med misstanke om BMSI? För att besvara syfte och frågeställningar genomfördes en kvalitativ intervju och 73 enkäter lämnades ut till en grupp för socionomer. Systemteori användes som teoretiskt perspektiv för analysen eftersom socialarbetare behöver se på barnets situation i och mellan dess omgivning. Resultatet av studien visar att det finns en hög risk för att BMSI inte anmäls till socialtjänsten samt en risk för att ärenden inte utreds som BMSI på grund av kunskapsbrist. Annan vårdnadshavare eller anhöriga var de som i lägst grad anmälde oro för ett utsatt barn trots att det kan antas att de som är närmast bör vara de som slår larm först. Slutsatserna som kunde dras utifrån resultatet var att samverkan och ökad kunskap var två viktiga framgångsfaktorer. / Medical child abuse (MCA) means that a child is exposed to unnecessary health contacts with various examinations and treatments. The person defined as the perpetrator is usually the biological mother of the child, but it may also be another person in the child's vicinity. The aim was to investigate social secretaries’ experience of MCA and to investigate how collaboration between social services, police, prosecutors, pediatricians and pediatric psychiatrists is organized. It was also investigated whether social secretaries who have worked with these types of cases can discern specific success factors in their work with MCA. The questions were: What experiences does the Social Secretaries describe regarding MCA? How is collaboration between social services, police, prosecutors, pediatricians and child psychiatrists organized when there is a suspicion of MCA? What success factors do social secretaries consider important in cases of suspicion of MCA? A qualitative interview was conducted, and 73 questionnaires were handed out to a group for social workers. System theory was used as a theoretical perspective for the analysis as social workers need to see the child's situation in and between its surroundings. The results of the study show that there is a high risk that MCA will not be reported to the social services and a risk that cases will not be investigated as MCA due to a lack of knowledge. Other custodians or relatives were those who reported the least concern for a vulnerable child, although it may be assumed that those closest to them should be the ones who ‘sound the alarm’ first. The conclusions drawn from the results were that collaboration and increased knowledge were two important success factors.

This essay will address the topic of child abuse through healthcare interventions, ormore precisely medical child abuse - which is also called Münchausen syndrome byproxy. A social problem that is quite unusual, and therefore creates complexity. Witha quantitative method, the essay is based on a web-based survey, which social workerson the Swedish social services at the children- and family units in Småland haveresponded to. The questions in the survey processes the social workers' knowledgeand preparedness which will be analyzed by their discretionary space and reasoning.These themes are also linked to Lipsky’s theory of street-level bureaucracy which isused to analyze the empirical data of the study. The results from the essay are analyzedand tested through the statistics program SPSS. The results and analysis show forinstance that the longer the social workers have been working at their units and insocial work in general, the more knowledge they considered themselves to have. Theyalso possessed a higher readiness the longer they worked at the unit. They are morerecon with the term “Münchausen by proxy” than “Medical child abuse”. Regarding guidelines and legislation, they feel uncertain, which we connect to the knowledge-gaps that comes with the social problem. Medical child abuse in the Swedish social services is quite unexplored and with this essay we want to contribute to a betterresearch, to help the children who are victims of medical child abuse.