Management of Night-Waking in Young Children

Regular waking at night is one of the most common problems encountered by parents of young children. In a family counselling programme in Auckland, a night-waking programme has been used with 208 children referred during a two year period. The programme involved organized bed-time routines, procedures for settling the child and non-reward of crying, calling out and getting out of bed. Programme introduction was followed by daily phone calls to parents in which appropriate parent behaviours were prompted and reinforced. Further face to face sessions were held after one week and then if needed. Parent reports show high rates of parent implementation of procedures and rapid change of child sleep behaviour with improvements being maintained at follow up. In a survey of 48 of the parents, positive changes in the daytime behaviour of children were reported as coinciding with improved sleep habits. Also there was an absence of negative side effects, and generally, parent satisfaction with the programme was high.     

Development of the Stay Safe programme

The development and implementation of the Stay Safe programme is described in this paper. The programme, which was developed in the Republic of Ireland, is a culturally sensitive developmentally staged child abuse prevention. It is a multisystemic programme insofar as it includes modules for teachers, parents and children. It also involves liaison with local child protection and child health professionals as an integral part of implementation. Multimedia‐based instruction is employed to facilitate multimodal leaning. The broad curriculum covers bullying and child abuse as two related forms of victimization. Disclosure training, assertiveness training and coercion management training are included in the curriculum, which also focuses on enhancing self‐esteem and the promotion of peer support. Copyright © 2000 John Wiley & Sons, Ltd.     

Evaluating a community based mental health programme in West Bengal,India: Description of the methodology and lessons learned

Mental disorders impose an enormous burden on society. In developing countries like India, there is a lack of adequate number of trained mental health professionals to provide specialized care and 75–85 % of affected individuals do not have access to appropriate mental health services. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. The Urban Mental Health Programme (UMHP) is a pilot initiative that has attempted the integration of mental health services in primary health care settings in two municipal wards in Kolkata, West Bengal, India. The overarching aim of this paper is to describe the methodology used for the evaluation of the community based mental health programme and to understand the processes of the programme in terms of barriers and facilitators. The current evaluation is based on a concurrent nested design, where qualitative and quantitative data are both collected at the same time but analysed separately and priority was given to qualitative data. This experience will contribute in helping other researchers to make some evaluations more effective, useful and manageable. Ethics approval was obtained from an institutional ethics committee of an organization (Ekjut) based in Ranchi, Jharkhand, India. The evaluation was undertaken by the George Institute for Global Health, New Delhi from February- June 2016.     

Where now for ‘child protection’ in Scotland?

In common with the rest of the UK, child care and protection practice in Scotland has undergone unprecedented change over the last ten years, including a wide‐ranging three‐year Child Protection Reform Programme. In 2006, The University of Dundee's Centre for Child Care and Protection and Barnardo's Scotland Research and Development team were commissioned by the then Scottish Executive to undertake a process review of the Child Protection Reform Programme (Daniel et al., 2007 ). Drawing on findings from the process review, this article considers the impact of the Child Protection Reform Programme. The process review concluded that, in the view of the respondents, the Child Protection Reform Programme made a substantive contribution towards the improvement and delivery of child protection services in Scotland, particularly in terms of raising awareness and increased multi‐agency working. It was beyond the scope of the review to measure outcomes for children as a result of the reforms. Since the completion of the Child Protection Reform Programme, national policy emphasis has broadened from ‘child protection’ towards integrated support for children under the Getting it Right for Every Child reforms of children's services. The paper concludes with a discussion around where ‘child protection’ now fits within this context of universal support for children and argues that there is a need to ensure that the valuable work which was done to improve child protection services in Scotland under the Child Protection Reform Programme is not lost. Copyright © 2010 John Wiley & Sons, Ltd.     

Zimbabwe's AIDS action programme for schools

AIDS education started very early in Zimbabwe and is now compulsory in all schools. This evaluation documents the development of the primary and secondary school AIDS Action Programme from 1991 to 1998. Six programme aspects were evaluated: programme start-up, planning and management, development of syllabi and materials, teacher training, research, monitoring and evaluation, and co-ordination. The Programme drew on resources from within the existing educational system. Due to broad-based consultation and participation, it was supported by Government and partners. Flexible management ensured implementation of mid-course corrections. It was concluded that school AIDS programmes should stress participatory teaching and learning methods and life-skills training. Curriculum writers and teachers needed training and supervision in participatory techniques. Cluster workshops between district and school levels were needed to strengthen the cascade model of teacher training that had been adopted. Systematic research, monitoring and evaluation were essential, including follow-ups to baseline surveys. The Zimbabwean programme was well-designed, relatively inexpensive and replicable.     

Prevention of child sexual abuse: implications of programme evaluation research

Thirty child abuse prevention programme evaluation studies were selected according to a set of methodological criteria following an extensive manual and computer literature search. Targets for intervention in 17 studies were children; in three parents; in four teachers; and in six studies multisystemic programmes were evaluated where some combination of children, parents and teachers was targeted for intervention. From a review of the 30 studies, it was concluded that child abuse prevention programmes can lead to significant gains in children's, parents' and teachers' safety knowledge and skills. Best practice guidelines arising from the review include the use of multisystemic programmes; child‐focused curricula which cover a wide range of safety skills and concepts; and the use of didactic instruction and discussion, video modelling and active behavioural skills training techniques in programme delivery. The curricula for parents' and teachers' programmes should cover child protection issues and local child protection procedures along with an overview of the children's programme lesson plans. Longer programmes conducted by trained staff are preferable and such staff may include teachers, parents, mental health professionals and law enforcement officers. Copyright © 2000 John Wiley & Sons, Ltd.     

Transforming a municipal school sports programme through a critical communicative methodology: The role of the of advisory committee

This research applies a communicative methodology (CM) to the transformation and improvement of the Municipal Comprehensive School Sports Programme in Segovia, Spain (MCSSP), using egalitarian dialogue, based on validity rather than power claims to achieve intersubjectivity and arrive at consensus between all of the Programme’s stakeholders through the intervention of an advisory committee (AC). The AC is a body comprising representatives of all stakeholder groups involved in the programme. During the 2013–2014 academic year the programme’s AC met four times, operating as a communicative focus group (CFG). The meetings focused on: (1) excluding dimensions (barriers preventing transformation) and transforming dimensions (ways of overcoming barriers), (2) the programme’s strengths, (3) the programme’s weaknesses and specific actions to remedy them, and (4) the resulting conclusions which were then incorporated into the subsequent programme contract signed between the University and the Segovia Local Authority for 2014–2018. The key conclusions were: (1) the recommendations of the AC widen the range of perspectives and help the research team to make key decisions and (2) the use of CM to fully evaluate the programme and to reach a consensus on how to improve it proved very valuable.     

Developing a framework for monitoring child poverty: results from a study in Uganda

In 2002 Save the Children UK carried out a study of child poverty in Uganda, as part of the on‐going Uganda Participatory Poverty Assessment Programme. Using participants from all regions of the country, the researchers asked children about their perceptions of poverty and anti‐poverty strategies, as well as questioning adult key informants about trends in child poverty, vulnerable groups and the effectiveness of government policies in tackling child poverty. This article reports on one aspect of the study, looking at the different indicators that children use to assess poverty, and comparing these with official poverty monitoring indicators. It finds that while some areas—notably, health, education and water and sanitation—are well documented, others, which may be as, or more significant to children's welfare, such as child abuse or quality of parental care, are almost totally neglected. A more holistic framework for assessing child poverty is proposed.     

Lessons from introducing a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camps in Kenya

Evidence shows that displacement, family separation and economic status are risk factors for child protection concerns and children's mental health, and that violence and economic status are risk factors for children's physical, emotional and social development. Family based care, community social support and economic strengthening have been shown to moderate such risk factors. This article explores the introduction of a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camp complex in Kenya, with the primary objective of strengthening the household economy of foster families and improving the care of the fostered children. In this article the authors reflect on the programme's work in recognising and building on existing traditional clan-based family tracing and care mechanisms for unaccompanied and separated children, as well as the importance of understanding the particular needs of specific groups of children such as those without appropriate care. They discuss issues of insecurity and lack of funding affecting programme quality and programme monitoring, and discus challenges of project design. Consideration of how such challenges can impact on existing traditional care mechanisms is shared. The authors argue for greater acknowledgement and efforts to build on traditional child protection mechanisms within wider debates on child protection systems; greater understanding and consideration of the needs of unaccompanied children in particular contexts; better monitoring of the outcomes of child protection programmes on the children they serve; and adequate and sustained funding for child protection in emergencies.     

How Do Social Workers Respond to Potential Child Neglect?

Although neglect is a common form of child maltreatment, it can be difficult to detect within a clinical interview between a social work clinician and client for the purpose of assessment and intervention, leading to a failure to act and secure a child's safety. This Canadian study utilized the objective structured clinical exam (OSCE) to assess social work clinicians' ability to recognize and respond to a case of suspected child neglect. Twenty-three participants (social work students, recent graduates of a Masters in Social Work programme, and experienced social workers) conducted a 15-minute interview with a standardized client followed by a structured reflective dialogue focusing on case conceptualization and emotional awareness. Qualitative analysis of the reflective dialogues revealed participants' difficulty in detecting child neglect as opposed to focusing on a client's negative self-beliefs or mental health issues. Implications for social work education and practice are suggested.     

Double trouble: maternal depression and alcohol dependence as combined factors in child and family social work

This study, part of a large programme of research incorporating four child and family care teams, focuses on the combined effects of alcohol dependence alongside clinical depression in mothers. A comparison is made between women who were clinically depressed and women who were both clinically depressed and alcohol dependent. The latter group had significantly higher levels of difficulty in social relationship, health, child, and particularly parenting problems. When considered alongside the intensity, duration and range of intervention required, the results indicated that there is considerable concern about the ‘dangerousness’ of this particular group with major implications for policy and practice. Copyright © 2002 John Wiley & Sons, Ltd.     

Developing an early intervention programme to prevent child maltreatment

This paper describes the development and implementation of a programme to prevent child maltreatment in a multicultural, inner city community setting with very high rates of physical abuse and neglect. The rationale and philosophy underpinning the prevention programme is outlined. It has a unique approach, combining several features present to varying degrees in other home visiting programmes within a well‐structured framework. This includes the identification of vulnerable parents during the antenatal period, the use of generic health professionals (health visitors) in identification and intervention with families, an ‘active engagement’ strategy, the development of specialist non‐stigmatizing clinics for parents and the creation of a consultation service for generic workers. A variety of interventions are briefly described which are used to support vulnerable families. These include antenatal parenting workshops; baby massage; dedicated crying, sleeping and feeding clinics; and clinics to help parents manage toddler behaviour.Evaluation over the first 5 years of these clinics shows almost 75% of cases have successful outcomes. Copyright © 2001 John Wiley & Sons, Ltd.     

Understanding the concept of food sovereignty using the Ghana School Feeding Programme (GSFP)

This article deepens the understanding of the emerging food sovereignty concept using a case study of a home-grown school feeding programme that promotes local food demand – supply linkages. A school feeding programme in four selected districts in Ghana is analysed with respect to community involvement in programme implementation and management as well as its socio-economic impacts. A combination of quantitative and qualitative methodological approaches was used in data collection and analysis. Results showed a significant improvement in household food access and months of adequate household food provisioning, which were used as measurement proxies for food sovereignty, as a result of access to local market created by the Ghana School Feeding Programme. However, the study recommends more empirical evidence from research to support the claim that using locally produced food for school feeding actually reduces poverty and malnutrition in rural farming communities.     

Bridging the qualitative–quantitative divide: Experiences from conducting a mixed methods evaluation in the RUCAS programme

Quantitative and qualitative approaches to planning and evaluation in education for sustainable development have often been treated by practitioners from a single research paradigm. This paper discusses the utility of mixed method evaluation designs which integrate qualitative and quantitative data through a sequential transformative process. Sequential mixed method data collection strategies involve collecting data in an iterative process whereby data collected in one phase contribute to data collected in the next. This is done through examples from a programme addressing the ‘Reorientation of University Curricula to Address Sustainability (RUCAS): A European Commission Tempus-funded Programme’. It is argued that the two approaches are complementary and that there are significant gains from combining both. Using methods from both research paradigms does not, however, mean that the inherent differences among epistemologies and methodologies should be neglected. Based on this experience, it is recommended that using a sequential transformative mixed method evaluation can produce more robust results than could be accomplished using a single approach in programme planning and evaluation focussed on education for sustainable development.     

Extinguishing the social?: state sponsored self‐care policy and the Chronic Disease Self‐management Programme

The Chronic Disease Self-management Programme (CDSMP) is a psycho-educational programme designed to increase the capacity of people with chronic conditions to self-manage. This initiative forms an integral part of the 'Expert Patient Programme' in the UK and the 'Sharing Health Care' programme in Australia. The aim of this paper is to critically appraise the principles of the CDSMP as a national self-care policy initiative in the context of existing formations and ideological approaches to self-care. Although the CDSMP appears to promote a 'social model' of disability, particularly in its generic manifestation, the use of the notion of self-efficacy as a primary marker of change means that it ultimately falls back onto an individualistic approach. The latter ignores pre-existing traditions of self-help embedded within advanced welfare societies.. We argue that state sponsored polices about self-management would benefit from greater recognition of existing social knowledge and theories about how people respond to being diagnosed with a long-term condition.     

A complex solution to a complicated problem? Early messages from the national evaluation of the Children's Fund Prevention Programme

This paper is concerned with exploring the research and policy base that underpinned the development of the Children's Fund Prevention Programme. It discusses how the initiative developed, how it is being evaluated and how it is now contributing to the new policy agenda around prevention services. Early findings are discussed highlighting some of the challenges local projects have to manage around partnership working, participation of children and young people in the programme, and the embedding of prevention strategies in local practice. Finally the conclusion sets the Children's Fund in forthcoming central government policy activity and examines how the evaluation can best inform the development of collaborative preventative services to children and their families.     

The Community Mothers Programme—Empowerment of parents by parents

SUMMARY: An innovative directed support intervention programme using lay people aimed at improving the quality of parenting during the first year of life was introduced on a pilot basis in Dublin in 1983 for parents of children living in working class communities. It involved experienced mothers who delivered a programme focusing on healthcare, nutritional improvement and overall child development to new parents. Support, encouragement and guidance were used rather than advice. The programme was evaluated in 1989 using a randomised controlled approach and was found to be effective in terms of health, nutrition and developmental stimulation. It has since expanded to incorporate breastfeeding support, mother and toddler groups and attention to the special needs of travellers, and the potential for applying this approach to other areas of healthcare and social development is large.     

MAKING AND MANAGING ELECTRONIC CHILDREN: E-assessment in child welfare

'Every Child Matters' (ECM) is a government response to longstanding concerns about child welfare and protection. A key feature is the use of information and communication technologies (ICTs) to improve information sharing and inter-professional communication. One of the proposals requires the establishment of an index, ContactPoint, which is a database containing information on all children in their area, to be used by child welfare professionals to indicate their involvement with a child and, where there is 'cause for concern', to facilitate joint action. Whilst these proposals for harnessing ICTs within child welfare are a central part of the government's modernization strategy, plans for the Index have been heavily criticized for its panoptic potential to invade privacy and override professional discretion and judgement. This paper reports findings from an ethnographic study funded by the ESRC e-Society Programme. Drawing on data collected in one 'Trailblazer' local authority area during the pilot phase, it describes the introduction of a local child index and the ways in which professionals and the technologies are drawn together within the local child welfare network. For the Index to achieve its original purpose of improving information sharing and inter-professional communication it must be 'used' by child welfare practitioners. But establishing the Index as a friend to the child welfare professional is not a straightforward process. The research suggests this is dependent on a set of relations that are being constantly negotiated and accomplished in everyday practice. It is clear the deployment of ICTs in professional practice is highly contingent upon local policy implementation, the local arrangement of services and the everyday practices of busy and sceptical practitioners.     

Traditional birth attendant training and local birthing practices in India

Training birth attendants (TBAs) provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training programmes redirected funds to providing skilled attendants during delivery. This study aimed to assess the ways in which a TBA training programme in India has been successful in disseminating evidence-based knowledge on birthing practices. TBAs practicing within 16 villages targeted by training programme initiatives were administered with structured questionnaires. The post training birthing practices of trained (24) and untrained (14) TBAs was compared and birthing practices adopted by women assisted by trained (16) and untrained (9) TBAs was analysed. Positive post training practices were hand washing, use of a clean blade for cutting the cord, immediate breastfeeding and weighing of babies. Nevertheless, the training could be further improved with up to date and evidence-based information and more comprehensive instructions. The findings suggest an integration of local and evidence-based knowledge is needed to improve the training. Raising community awareness of public health measures related to maternal and child health is also recommended.     

Developing Differences: Gender,Childhood and Economic Development

SUMMARY: Western images of the child in modern thought set up an opposition between innocence and experience which is supplemented by discourses of child care and child protection, and reflected in international policies and legislation for children. This article traces idealised conceptions of children of the North and South and unravels dichotomies between work and play as they map onto gendered and cultural spaces. These issues are linked to an analysis of assumptions underlying both international policies for child development and models of economic development, focusing in particular on the Human Development Index put forward in the 1992 United Nations Development Programme. In order to counter the naturalisation and abstraction of development in both, which reflects and contributes to the cultural and economic domination of the Northern hemisphere over the South, the article ends with a call to attend to both the specificity and diversity of children's developments.