A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia

BackgroundThe transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services.AimThis paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations.MethodsData reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis.FindingsThe range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively.ConclusionImproving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change.     

The Saving for Every Child Program in Israel: an overview of a universal asset-building policy

ABSTRACT

In 2017, the Israeli government implemented a universal child development account programme – the Saving for Every Child Program (SECP) – which establishes a personal savings account for every Israeli child and provides monthly deposits until the child turns 18. The SECP has the potential to provide substantial assets when children reach adulthood, but the benefits depend on parents’ investment choices. The unique programme’s nature presents opportunities to learn from its implementation. This paper provides a comprehensive overview of the SECP, its legislative history, early findings from its implementation, and recommendations that may improve programme participation and outcomes across population groups.     

Confidentiality and Media Attention: A Discussion Concerning Denial and Public Education

The article presents the beginning of a discussion on how the doctrine of confidentiality may have been misapplied in the area of children's protective services. It asks the reader to consider who the client is in these cases and, having answered that question, asks what is the professional responsibility? The whole discussion is linked to the difficulties in dealing with media attention in these cases and offers some experience in the form of case examples. Woven in to the matrix of the above discussion is a clinical and public educational discussion. Preserving confidentiality in its traditional sense can contribute to a preservation of the family secret, namely, child abuse. In that way, a child protection agency can actually be contributing to the maintenance of abuse patterns in a family. Also, with no capacity to speak professionally about specific abuse, the public education impact is diminished.     

Movers and Stayers in Care Management in Adult Services

Professional biographies of care managers in the mid-ninetiesand, seven years on, their profiles and career choice are thefocus of this article. The work draws on two linked studiesbased on adult services in two social services departments.The profile of those who stayed in post and those who movedon raises issues for the social work profession, for managersand for policy makers. Those who stayed constitute an experiencedworkforce of middle-aged, predominantly female practitionerswith mixed views about the changing nature of the work. Thosewho moved include a group of females who became managers bydefault. The work raises issues concerning work pressures, genderprofiles within an ageing workforce, and succession planning.The findings link to more extensive workforce studies and contributetowards debates concerning the occupational identity and thefuture of qualified practitioners within a human services landscapewhich is constantly being reshaped within a culture of new managerialism.     

Can the welfare state replace parents? Children's cognition in the United States and Great Britain

We compare family and parental effects on child verbal facility, verbal achievement and mathematics achievement in the United States and Great Britain. We study 3,438 5–13 year-old children from the 1994 NLSY Child-Mother Data Set and 1429 same-aged children from the National Child Development Study, also known as the British Child. Multivariate analyses suggest that the processes through which families invest in child cognition are similar across societies, with factors including low birth weight, child health, maternal cognition, family size and children's home environments being consequential. We conclude that parental investments are equally important across the two societies. The more developed welfare state in Great Britain does not notably compensate for parental investments in that society, although it may play a greater role when parental resources are absent or stretched thin.     

Life-course changes in the mediation of cognitive and non-cognitive skills for parental effects on children’s academic achievement

We assess life-course changes in how cognitive and noncognitive skills mediate the effect of parental SES on children's academic achievement using data from the Early Childhood Longitudinal Study-Kindergarten Cohort. Our results show: (1) the direct effect of parental SES declines while the mediating effect of skills increases over time; (2) cognitive and non-cognitive skills differ in their temporal sensitivities to parental origin; and (3) in contrast to the effect of cognitive skills, the mediating effect of non-cognitive skills increases over time because non-cognitive skills are more sensitive to changes in parental SES. Our results offer insights into the dynamic role skill formation play in status attainment.     

留守儿童的救赎之路——观念与公约的碰撞

留守儿童是当前我国一个庞大而特殊的弱势群体。解决留守儿童问题,有赖于养育儿童观念的改变;遵守联合国《儿童权利公约》,确保不违背儿童父母的意愿使儿童和父母分离;给予农民工国民待遇,取消户籍差别。     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

Child Support: The Limits of Social Policy Based on Assumptions of Knavery Extending the Pillars of Social Policy Financing to Aged Care

Julian Le Grand has argued that a key component of welfare reform involves changes in the assumptions about human behaviour which are embedded in social policies. Policy assumptions have been transformed from espousing a belief that social service providers act as well-intentioned knights and recipients as passive pawns, to a stance in which all participants are regarded as self-seeking knaves. These ideas are particularly pertinent to policy developments concerning financial obligations for children, and this paper examines these issues in relation to child support policy in New Zealand. It highlights the evident and inevitable failure of this policy to meet its primary stated aim of revenue generation. In New Zealand this failure is compounded by the creation of parallel systems for dealing with children and families, one for financial obligations and the other for care and development, which are founded on diametrically opposed assumptions about human behaviour and capabilities. This confusion is symptomatic of a wider failure in government policy towards families in New Zealand.