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Ayar, G., S. Sahin, M. Uysal Yazici, R. Gunduz, H. Yakut, and F. Demirel. "O-199 Evaluation Of Home Health Care Services." Archives of Disease in Childhood 99, Suppl 2 (October 2014): A99.3—A100. http://dx.doi.org/10.1136/archdischild-2014-307384.267.
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Chowdhury, Rakhi, Leena Kumari, and Subhamay Panda. "THE ROLE OF HEALTH INFORMATION SYSTEM IN MATERNAL AND CHILD HEALTHCARE SERVICES." Asian Journal of Pharmaceutical and Clinical Research 10, no. 6 (June 1, 2017): 29. http://dx.doi.org/10.22159/ajpcr.2017.v10i6.15918.
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Health information system deals with any system that helps in capturing, storing, transmitting, and managing health-related information of an individual or to demonstrate the activities or organizations working within health-care sector. In the developing countries, maternal and child health is gaining concern due to increasing cases of morbidity and mortality. The disparities among the maternal, infant, and child health are a growing concern in India and are governed by various determinants such as socioeconomic status, literacy, quality of health care, discrimination, and biological and genetic factors. Accurate and reliable health information and data are the basis for decision-making across the health-care sector and are crucial for the development and implementation of health system policy by the policy-makers. Strict monitoring and evaluation of the present program design and its implementation is required at the microlevel to effectively utilize the resources for the improvement of maternal and child health. Our present article focuses on evaluating the coverage gap at the different levels for the provision of health-care facilities to maternal, neonatal, and child health, immunization, and treatment of poor children. Big data plays a major role in providing sound and reliable health-related information and also help in managing and recording structured and unstructured data. More concrete plans are required further to reduce the inequalities in health-care interventions for providing better maternal and child health-care services in our nation.
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Bond, Sue. "Care Leavers’ and Their Care Workers’ Views of Preparation and Aftercare Services in the Eastern Cape, South Africa." Emerging Adulthood 8, no. 1 (September 24, 2018): 26–34. http://dx.doi.org/10.1177/2167696818801106.
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Emerging adulthood is an exciting time, filled with possibilities while remaining supported. However, care leavers’ journeys into adulthood are compressed and lacking educational, financial, and social support. In South Africa, this is exacerbated by contextual factors and the absence of mandated services for care leavers. A qualitative study was conducted with four Child and Youth Care Centers in a town in the Eastern Cape, South Africa. Focus groups were held with young people in care and their care workers. Discussions focused on preparation for leaving care and aftercare services and the evaluation of these by each group of participants. Care leaving preparation consisted of independent living skills programs. Aftercare services were provided on an ad hoc basis, and there was no policy with respect to services to care leavers. The findings suggest that ongoing experiential learning and implementation of in-house policies may better prepare care leavers for emerging adulthood.
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Danseco, Evangeline, Julia Kurzawa, Purnima Sundar, Jaime Brown, and Christal Huang. "Evaluating the sector-wide implementation of virtual child and youth mental health services in response to the COVID-19 pandemic: Perspectives from service providers, agency leaders and clients." Implementation Research and Practice 2 (January 2021): 263348952110456. http://dx.doi.org/10.1177/26334895211045690.
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Background The COVID-19 pandemic prompted an abrupt shift in the delivery of community-based child and youth mental health services as virtual care was rapidly adopted. The objective of this study was to evaluate the sector-wide transition to virtual care across Ontario, with a focus on implementation facilitators and barriers. Methods We used a multi-level mixed-methods design where agency leaders, service providers, and clients shared their experiences planning, implementing, and accessing virtual care. In total, 97 agency leaders, and 192 youth and family members responded to the surveys; 13 agency leaders, and 11 service providers participated in interviews or focus groups. Results Most agencies undertook a similar journey to implement virtual care. Stakeholders described common facilitators such as staff engagement, leadership support, and training activities. Barriers included internet connection issues, lack of resources, and privacy concerns. Service providers innovated as they implemented by partnering with agencies to meet clients’ needs, using multiple platforms to engage clients, and altering session duration to reduce fatigue. Clients found virtual care easy to use, felt confident using it, and intend to continue accessing virtual care. Conclusion Implementation of virtual care during the pandemic was complex and the evaluation involved obtaining perspectives at multiple levels. This research provides a blueprint for evaluations of the implementation of virtual mental health services, particularly in a child/youth context. Virtual care is a viable way to deliver mental health services, however, equity, accessibility, and appropriateness need to be addressed to ensure services are effective for children, youth, and their families. Plain language abstract Academic literature suggests that using technology to deliver child and youth mental health services is a promising way to enhance access to care and improve engagement for many children and youth. Despite this, the provision of virtual child and youth mental health services in Ontario prior to the COVID-19 pandemic was limited. Efforts that did exist were largely focused on providing care to those in rural and remote areas. The COVID-19 pandemic prompted a rapid shift to virtual care, as most in-person mental health services were suspended. This paper presents new insight into how virtual mental health services were quickly established and used across Ontario from the perspectives of senior leaders, service providers, and clients. Results from this evaluation showed that agencies followed similar steps to prepare to use virtual services. Staff engagement, support from leadership, and opportunities for staff training supported the implementation of virtual care while internet connections issues, lack of resources (like computers or phones), and privacy and safety concerns hindered the implementation. Most youth and family members found virtual services easy to use and intend to continue using them. Most agencies intend to continue to offer virtual services post-pandemic but noted that it was not appropriate or accessible for all clients. This study provides a foundation for additional research to examine situations and conditions that are most conducive to virtual care delivery to address child and youth mental health concerns. These results may encourage agencies to rely more confidently on virtual services as another means to meet clients’ needs and preferences.
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Bezze, Maria, Cinzia Canali, Devis Geron, and Tiziano Vecchiato. "Cash transfer and professional care for tackling child poverty and neglect in Italy." Children Australia 45, no. 4 (October 19, 2020): 229–35. http://dx.doi.org/10.1017/cha.2020.50.
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AbstractThere has been a general increase in poverty over the last decade in Italy, which has mainly affected the younger generations, with children and youth experiencing the worst economic conditions. This is primarily not due to a lack of available economic resources but to the way in which these resources are allocated: mainly in the form of cash transfers rather than services. The provision of adequate services based on professional work needs to be implemented by overcoming two main obstacles which are highlighted by the results of two studies presented here. The first study concerns the quality of professional care and the systematic use of outcome evaluation, the second concerns the vision of professionals and their ability to integrate the provision of services with economic support aimed at improving children’s growth and parenting skills. The two studies were carried out as part of an international debate on how to effectively fight poverty and social exclusion of children which was promoted by the International Association for Outcome-based Evaluation and Research on Family and Children’s Services (iaOBERfcs).
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Araujo, Juliane Pagliari, Cláudia Silveira Viera, Beatriz Rosana Gonçalves de Oliveira Toso, Neusa Collet, and Patrícia Oehlmeyer Nassar. "Assessment of attributes for family and community guidance in the child health." Acta Paulista de Enfermagem 27, no. 5 (October 2014): 440–46. http://dx.doi.org/10.1590/1982-0194201400073.
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Objective To identify the extension in primary health services of attributes for family and community guidance about the health of children health. Methods This was a quantitative, cross-sectional and evaluation study. We administered 548 questionnaires (Brazilian Primary Care Assessment Tool, child version) to families and/or legal guardians of children younger than 12 years of age who were received care in 24 health units. Data were analyzed using SPSS software, version 17.0. Results The basic public health services of the studied municipality were below what is considered ideal for primary health care with regard to the attributes of family and community guidance. Score of these attributes were 4.4 and 5.1, respectively. Scores considered satisfactory were ≥6.6. Conclusion We found that it was difficult for services to integrate families and the community in the care process. This finding reinforces the healing care culture and individual-centered care.
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Oyeniran, Yemisi Adebola, Olajumoke Adeyeye, and Christiana Olanrewaju Sowunmi. "Evaluation of patient satisfaction with the quality of maternal and child services of health facilities in Ile-Ife, Osun State." African Journal of Midwifery and Women's Health 14, no. 3 (July 2, 2020): 1–14. http://dx.doi.org/10.12968/ajmw.2019.0004.
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Background/Aims An evaluation of patient satisfaction of the quality of healthcare facilities and services provides feedback to enhance improved service delivery. Patient satisfaction with care has been identified as one of the essential elements of quality care, which can be used to determine the quality of care being rendered in health centres. This study aimed to assess patient satisfaction with maternal and child services in health facilities in Ile-Ife, Osun State, Nigeria. Methods A quantitative cross-sectional study was carried out in Ile-Ife, Osun State, in all seven secondary health facilities and 45 selected primary healthcare centres. A total of 330 nursing mothers with babies aged 0–1 years old were selected through simple random sampling. A self-developed, structured, pre-tested satisfaction survey based on Donabedian and Linder-Pelz satisfaction model was used to explore nursing mothers' satisfaction with maternal and child healthcare services and the determinants of satisfaction. Data were analysed using descriptive statistics and t-tests at a significance level of 0.05. Ordered logistic regression was used to establish the significance of association between sociodemographic characteristics and satisfaction. Results The majority of clients were satisfied with maternal and child services in primary (76.7%) and secondary (55.1%) healthcare facilities, respectively. There was a significant difference between satisfaction at primary and secondary healthcare centres (P=0.012). The marital status and number of pregnancies of participants were significant determinants of clients' satisfaction with secondary healthcare facilities (P=0.035 and P=0.013, respectively). Conclusions There is high patient satisfaction with maternal and child healthcare services in both primary and secondary healthcare facilities in Ile-Ife. The majority of the health facilities have inadequate personnel for maternal and child healthcare services, which is one of the major factors contributing to high maternal and infant morbidity and mortality in Nigeria. However, many of the respondents may not have ever experienced high-quality services. Stakeholders in maternal and child services should improve on areas where poor satisfaction was reported.
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Lydon, Anne, Jean Hennings, and Bernadette Ryan Woolley. "Evaluation of a British child bereavement service: The user's perspective." Palliative and Supportive Care 8, no. 3 (September 2010): 297–303. http://dx.doi.org/10.1017/s147895151000009x.
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AbstractObjective:This article summarizes the findings from a 3-year independent evaluation of a regional Child Bereavement Service (CBS). The service was commissioned by a Primary Care Trust in Northern England, and funded by a British cancer charity, Macmillan Cancer Support. The need for a CBS was recognized by members of a Palliative Care Group who identified a gap in local services for bereaved children, who may be susceptible to short/long-term psychiatric/psychological disorders. The service was established to offer support for professionals working with bereaved children and their family.Method:Interventions provided by the service included pre/post bereavement support, individual work with the child and/or family, and group work. An evaluation (2004–2007), was conducted to inform service development utilizing semi-structured interviews with parents/carers of service users (n = 20), and semi-structured interviews with healthcare professionals (n = 8). Interviews were recorded, transcribed verbatim, and analyzed using grounded theory methods.Results:Referrals were higher than expected. Sixty per year were anticipated; however, in the first year alone, there were 255 referrals. Health and social care professionals who attended training courses, provided by the CBS staff, expressed confidence in providing bereavement support themselves, or by making appropriate referrals to the CBS. Parents and carers welcomed a service specifically for their children.Significance of results:The CBS is a viable organization that supports bereaved children as expressed in this article.
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Courtney, Mark. "Standardized outcome evaluation of child welfare services out-of-home care: Problems and possibilities." Children and Youth Services Review 15, no. 5 (January 1993): 349–69. http://dx.doi.org/10.1016/0190-7409(93)90009-x.
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Bradley, E. Jane, and Barbara S. Clark. "Patients’ Characteristics and Consumer Satisfaction on an Inpatient Child Psychiatric Unit." Canadian Journal of Psychiatry 38, no. 3 (April 1993): 175–80. http://dx.doi.org/10.1177/070674379303800304.
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This paper reports the results of a chart review and consumer satisfaction evaluation of referrals to a tertiary care child psychiatric inpatient unit. The evaluation involved an examination of the types of child and family difficulties treated during the period of the study; the nature and extent of assessment, treatment and follow-up; treatment outcome and parental perception of factors related to treatment outcome; and the satisfaction of both the parents and referral sources. Results indicated that children admitted for treatment were a heterogeneous group with severe difficulties from families with a number of problems. Most parents and referring therapists were very satisfied with the treatment, recommendations and follow-up provided. Significant correlations were observed between the parents’ and referring therapist's satisfaction with the service and the extent to which home based problems were addressed during the child's stay in hospital. In addition, some suggestions are given for strategies to improve services. The findings are discussed with special reference to the value of program evaluations for inpatient child psychiatric services.
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Szilagyi, Peter G., Laura Pollard Shone, Jane L. Holl, Lance E. Rodewald, Jacqueline Jennings, Jack Zwanziger, Dana B. Mukamel, et al. "Evaluation of New York State's Child Health Plus: Methods." Pediatrics 105, Supplement_E1 (March 1, 2000): 697–705. http://dx.doi.org/10.1542/peds.105.se1.697.
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Background. The State Children's Health Insurance Program (SCHIP) is the largest public investment in child health care in 30 years, targeting 11 million uninsured children, yet little is known about the impact of health insurance on uninsured children. In 1991 New York State implemented Child Health Plus (CHPlus), a health insurance program that was a prototype for SCHIP. A study was designed to measure the association between CHPlus and access to care, utilization of services, and quality of care. Methods. The setting was a 6-county region in upstate New York (population 1 million) around and including the city of Rochester. A before-and-during design was used to compare children's health care for the year before they enrolled in CHPlus versus the first year during CHPlus, for 1828 children (ages 0–6.99 years at enrollment) who enrolled between November 1, 1991 and August 1, 1993. An additional study involved 187 children 2 to 12.99 years old who had asthma. Parents were interviewed to assess demographic characteristics, sources of health care, experience with CHPlus, and impact of CHPlus on their children's quality of care and health status. Medical charts were reviewed to measure utilization and quality of care, for 1730 children 0 to 6.99 years and 169 children who had asthma. Charts were reviewed at all primary care offices and at the 12 emergency departments and 6 public health department clinics in the region. CHPlus claims files were analyzed to determine costs during CHPlus and to impute costs before CHPlus from utilization data. Analyses. Logistic regression and Poisson regression were used to compare the means of dependent measures with and without CHPlus coverage, while controlling for age, prior insurance type, and gap in insurance coverage before CHPlus. Conclusions. This study developed and implemented methods to evaluate the association between enrollment in a health insurance program and children's health care. These methods may also be useful for evaluations of SCHIP.
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Song, Seung‐Min. "Child Care Service Quality Management Through the Evaluation of Efficiency at Child Care Centers: An Evaluation with Data Envelopment Analysis." Asian Journal on Quality 9, no. 2 (August 21, 2008): 1–9. http://dx.doi.org/10.1108/15982688200800013.
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Morgan, Roger. "Inspection of children’s residential care." Educational and Child Psychology 14, no. 2 (1997): 13–20. http://dx.doi.org/10.53841/bpsecp.1997.14.2.13.
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AbstractChildren’s homes and boarding schools are mainly inspected under the provision of the Children Act, 1989. Monitoring may also include notifications of significant events, management visits and information from complaints and child protection investigations. Inspection comprises gathering, corroborating and evaluating information against declared welfare standards, leading to inspection reports, recommendations and, occasionally, enforcement action. Welfare provision is also significantly influenced by availability of known standards, establishments’ own review in preparation for inspections, cross-fertilization of inspectors’ ideas, and provision of advice by inspection units. Inspection uses a range of inspection methods, which may include the use of questionnaires for comparison with normative data, and assessments by lay persons. Inspections generally progress from general evaluation to consideration of particular emerging issues, balancing factual information and professional judgement, until the level of corroboration balances the amount of new issues in the information being gained. Key issues from inspections include: staff recruitment checks, bullying and its countermeasures, child protection, discipline, who children take personal problems to, and in special settings, restraint and therapeutic provision.Personal social services inspection is currently under national review. An inspection should be regarded as a spot-check, which contributes significantly to child welfare and protection, but cannot in itself ensure sound practice.
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Boro, Mitali, Tikendrajit Sarma, and Pranabjyoti Baishya. "Evaluation of medicinal plants in North-East region relating to maternal and child health care." Journal of Ayurvedic and Herbal Medicine 3, no. 3 (September 30, 2017): 150–58. http://dx.doi.org/10.31254/jahm.2017.3310.
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Maternal and child health care services are composed of specific segment in national health. Many medicinal plants mentioned in Ayurveda for maternal and child health are available in North-East region. In classics these medicinal plants are discussed in various groups like Garbhasthapak, Prajasthapan, Stanyajanan, Stanyasodhan, drugs are also available in the form of monthly regimen during pregnancy, during delivery, certain maternal disorders during pregnancy and after delivery. In context of child health care, foetal abnormality, neonatal care and in specific neonatal disorders drugs are also highlighted. Sushruta, hypothesized these drugs under Prithakparynadi, Pippalyadi gana. Study related to Shatavari reveals growth of mammary glands, alveolar tissue and acini in pregnant rat. Methanolic extract of Bala also exhibit fungal activity. The present study highlights all these drugs and reviewed the in-vitro and in-vivo application carried out previously. Data obtained thus emphasised these herbs propagation in National Health Mission for increasing Maternal and Child health care.
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Deshpande, Sujata, Pradeep Suryawanshi, Neha Sharma, Rajesh Maheshwari, Rema Nagpal, Nandini Nagar, and Samir Gupta. "Survey of Point-of-Care Ultrasound Uptake in Indian Neonatal Intensive Care Units: Results and Recommendations." Journal of Neonatology 33, no. 1-4 (March 2019): 13–21. http://dx.doi.org/10.1177/0973217919897855.
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Objectives: Point-of-care ultrasonography (POCU) refers to the process of ultrasound performed at the bedside by treating physicians, for the ongoing assessment of disease, evaluation of response to treatment, and assistance in procedures. This study was conducted to assess the current utilization, training, and barriers to the implementation of neonatologist-performed POCU (NP-POCU) in Indian neonatal intensive care units (NICUs). Methods: A survey questionnaire was disseminated to practicing neonatologists in India via an online survey tool from July 2017 to September 2017. The questionnaire addressed the information related to the availability of NP-POCU services, indications for its use, perception among neonatologists about its usefulness, training for NP-POCU, and access to pediatric cardiology and radiology services. Results: The overall response rate was 78%. A total of 72% respondents reported having access to NP-POCU services in their units. Neonatologist-performed POCU (NP-POCU) was used most frequently for cranial ultrasound (97%), functional echocardiography (90%), and evaluating line position (67%). Majority (92%) of the units had no training program for NP-POCU. The most common reasons cited for not having NP-POCU services were non-availability of trained personnel to perform POCU (50%) and strict Pre-conception and Prenatal Diagnostic Techniques (PC-PNDT) Act (50%). Conclusions: Neonatologist-performed point-of-care ultrasonography is being increasingly utilized in Indian NICUs. However, there is a lack of structured training and guidelines for its use. Non-availability of trained personnel and strict PC-PNDT Act are major barriers to its implementation. We recommend that accredited training programs and standardized guidelines be established for the safer use of NP-POCU in India.
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Scheid, Jeanette M., Issidoros Sarinopoulos, Sierra Cameron, and Clare Tanner. "Learning Collaborative Events With Child Welfare and Health Care Providers Improve Systems Knowledge and Intent to Change." Journal of Primary Care & Community Health 12 (January 2021): 215013272110483. http://dx.doi.org/10.1177/21501327211048359.
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Introduction: Children in foster care are at higher risk of health problems. These risks present challenges to achieving permanency, safety, and well-being. Despite efforts to improve the systems serving children in foster care, gaps remain in achieving timely and quality health services. Based on stakeholder reports that health care provider knowledge about child welfare systems is a barrier to care, the Fostering Health Partnerships project conducted 2-session learning collaborative events across Michigan. The project team hypothesized that participants would increase knowledge of child welfare policy and that physician participants would identify and commit to practice change to improve health care services to children in foster care. Methods: Learning collaborative events included an in-person session followed by a live webinar session. Participants included child welfare professionals, physicians, and other health care representatives. Participants completed surveys assessing knowledge about child welfare health policy. Physician participants completed a post-event interview. The investigators used pre- and post-intervention survey design and qualitative evaluation of physician interview data to assess the impact of the learning collaborative events on knowledge and practice. Results: A total of 781 individuals attended the initial session and 383 attended the second session of 36 events for 80 counties in Michigan. 247 individuals completed pre- and post-event surveys and 7 physicians completed interviews after the events. Survey data showed that event participants demonstrated increased knowledge of child welfare policy related to health ( P < .001). Interviewed physicians reported making practice changes to improve health care services and indicated that the events were valuable though time intensive. Conclusion: An abbreviated learning collaborative process is an effective tool to improve knowledge and drive practice change. Future efforts will build on this project to improve access, coordination, and quality health services for children in foster care.
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Montgomery-Taylor, Sarah, Mando Watson, and Robert Klaber. "Child Health General Practice Hubs: a service evaluation." Archives of Disease in Childhood 101, no. 4 (December 23, 2015): 333–37. http://dx.doi.org/10.1136/archdischild-2015-308910.
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ObjectiveTo evaluate the impact of an integrated child health system.DesignMixed methods service evaluation.Setting and patientsChildren, young people and their families registered in Child Health General Practitioner (GP) Hubs where groups of GP practices come together to form ‘hubs’.InterventionsHospital paediatricians and GPs participating in joint clinics and multidisciplinary team (MDT) meetings in GP practices, a component of an ‘Inside-Out’ change known as ‘Connecting Care For Children (CC4C)’.Main outcome measuresCases seen in clinic or discussed at MDT meetings and their follow-up needs. Hospital Episode data: outpatient and inpatient activity and A&E attendance. Patient-reported experience measures and professionals’ feedback.ResultsIn one hub, 39% of new patient hospital appointments were avoided altogether and a further 42% of appointments were shifted from hospital to GP practice. In addition, there was a 19% decrease in sub-specialty referrals, a 17% reduction in admissions and a 22% decrease in A&E attenders. Smaller hubs running at lower capacity in early stages of implementation had less impact on hospital activity. Patients preferred appointments at the GP practice, gained increased confidence in taking their child to the GP and all respondents said they would recommend the service to family and friends. Professionals valued the improvement in knowledge and learning and, most significantly, the development of trust and collaboration.ConclusionsChild Health GP Hubs increase the connections between secondary and primary care, reduce secondary care usage and receive high patient satisfaction ratings while providing learning for professionals.
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Alidina, Shehnaz, and Michele Jordan. "The Challenges of Evaluating Health Systems Networks: Lessons Learned from an Early Evaluation of the Child Health Network for the Greater Toronto Area." Healthcare Management Forum 20, no. 2 (July 2007): 22–27. http://dx.doi.org/10.1016/s0840-4704(10)60511-x.
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This article describes the first system-wide evaluation of the Child Health Network (CHN) for the Greater Toronto Area (GTA), a partnership of 29 community and hospital care providers. The CHN performance evaluation sought to identify the impact of the network on the delivery of maternal, newborn and child health services in the GTA. CHN members identified seven criteria to be evaluated (appropriate care, accessibility, effectiveness, satisfaction, integrated and coordinated care, accountability and affordability) and then collaborated in selecting measurable indicators for each criterion. Data were compiled from administrative data sets, or collected as needed. This undertaking succeeded in providing a comprehensive assessment of the network's performance, identification of strategies to improve outcomes and network sustainability, as well as practical information that will inform the important new field of network evaluation.
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Anderson, Denise. "Use of Mental Health Research in BSW Curriculum: Wraparound Services." Journal of Baccalaureate Social Work 4, no. 1 (October 1, 1998): 143–56. http://dx.doi.org/10.18084/1084-7219.4.1.143.
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This module presents an overview of the Yoe, Santarcangelo, Atkins & Burchard article, “Wraparound care in Vermont: Program development, implementation and evaluation of a statewide system of individualized services,” Journal of Child and Family Studies 5(1), 23–39, and offers teaching strategies to integrate the knowledge into social work practice courses. This article examines the overall programming and effectiveness of the wraparound service system in Vermont.
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Aronson, Susan S. "Role of the Pediatrician in Setting and Using Standards for Child Care." Pediatrics 91, no. 1 (January 1, 1993): 239–43. http://dx.doi.org/10.1542/peds.91.1.239.
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Standards for child care settings define expected performance. Other types of requirements applicable to operation of child care facilities include funding requirements, accreditation criteria, and regulations (legal requirements). During licensing inspections, program monitoring by funding agencies, evaluations by accrediting organizations, and self-evaluations, programs become aware of opportunities for improvement. The process of evaluation alone leads to improved program performance1; the majority of providers want to do a good job. When requirements are used for systematic surveillance, the compliance data generated identify problems to be targeted for quality improvement. Training, technical assistance, linkage to existing resources, and development of new resources are common interventions that lead to improved performance in child care programs. These interventions may be applied at the level of an individual child care facility or at any level involved with child care services. Thus, training and technical assistance may be given to caregivers, to licensors, to policy makers, or to the public. A surveillance system should continuously measure the impact of interventions and focus attention on problems that require further corrective action. When performance data from individual programs are aggregated, they provide powerful tools to assess the need for communitywide interventions. Some changes cannot be accomplished within the limited resources of an individual child care facility. Sometimes program improvement requires one or more types of intervention at the community, regional, state, and/or national level. Updating requirements, conducting surveillance to measure compliance with requirements, and analyzing data to target interventions and measure the impact of actions on program performance are the basic elements of a systems model for improving quality in child care (see Figure).
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Dea, Bruna Di, Fernanda Andrade, and Manoelito Ferreira Silva Junior. "Self-perceived evaluation of prenatal care: a hierarchical analysis by the users of Primary Health Care services in Brazil." Revista Brasileira de Saúde Materno Infantil 21, no. 2 (June 2021): 599–613. http://dx.doi.org/10.1590/1806-93042021000200014.
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Abstract Objective: to analyze the factors associated with positive self-perceived evaluation of prenatal care among users of Primary Health Care (PHC). Methods: the analytical cross-sectional study was carried out with secondary data from the 3rd Module of the 2nd cycle (2013 / 2014) of the External Evaluation of the Improvement of Access and Quality of Primary Care Program (PMAQ-AB – Portuguese acronym), collected from users in the Basic Health Units (BHU) that joined the PMAQ-AB in Brazil. The hierarchical analysis was performed using a theoretical model and logistic regression was performed between the self-perceived evaluation (positive - very good/good or negative - regular/poor/very bad) and the sociodemographic characteristics, prenatal care and health service evaluation (p<0.05). Results: the sample consisted of 9,922 women and 81.7% rated care as very good/good. In the final model, positive evaluation was associated to women with incomplete higher education or over (OR=1.05; CI95%=1.01-1.09; p=0.010), who underwent the VDRL exam (OR=1.07; CI95%=1.01-1.14; p=0.020), consultation with the same professional (OR=1.07; CI95%=1.02-1.12; p=0.010), received guidance on the gynecological preventive exam (OR=1.05; CI95%=1.01-1.08; p=0.007), believed that guidance helped with pregnancy and child care (OR=1.24; CI95%=1.05-1.46; p=0.012), evaluated the BHU structure as very good/good (OR=1.19; CI95%=:1.14-1.24; p<0.001) and would not change BHU or team (OR=1.62; CI95%=1.48-1.68; p<0.001). Conclusion: the positive evaluation of prenatal care was associated with sociodemographic factors, prenatal care and health service evaluation.
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Roby, Jini L., and Stacey A. Shaw. "Evaluation of a Community-Based Orphan Care Program in Uganda." Families in Society: The Journal of Contemporary Social Services 89, no. 1 (January 2008): 119–28. http://dx.doi.org/10.1606/1044-3894.3716.
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In response to the orphan crisis in sub-Saharan Africa, the international child welfare community has agreed on a model that aims to increase the capacity of families and communities. Yet, little is known thus far about the service content and efficacy of programs based on the model. This project examined a community-based program in Uganda that provides support and assistance to families raising orphaned and other vulnerable children. Findings suggest that the households' need in certain categories, such as housing and food security, decreased significantly after services were received. Children's senses of belonging and permanency appeared promising. The program's strengths are discussed with recommended changes, as well as implications for policy, practice, and further research.
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Neufeld, Jerry, Marilyn G. Smith, Harvey Estes, and George C. Hill. "Rural After-School Child Care: A Demonstration Project in a Remote Mining Community." Rural Special Education Quarterly 14, no. 3 (September 1995): 12–16. http://dx.doi.org/10.1177/875687059501400304.
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Residents of rural northeast Nevada lack many of the social services available in the urban parts of Nevada and the nation. One of the services lacking in Battle Mountain, Nevada is quality after-school child care. The University of Nevada Cooperative Extension and the Lander County School District collaborated to develop and administer an after-school program for at-risk elementary students, which addressed this need. The program was designed to provide an educational experience while at the same time providing students with some of the protective factors needed to help them lead more productive lifes. This paper details how the program was carried out and shows the results of the program's evaluation. In lean economic times, a collaborative effort such as this may be one way to address youth needs in rural areas. The result was increased community support for quality after-school child care.
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Subashi, Anisa, and Edit Bregu. "Child Protection Measures as a Legal Instrument for Child Protection at Tirana Municipality." Academic Journal of Interdisciplinary Studies 10, no. 6 (November 5, 2021): 158. http://dx.doi.org/10.36941/ajis-2021-0162.
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For Albanian institutions and society, application of the protection measures comes not only as an innovation in the field of child rights and protection but especially as a legal instrument that for the first time attains to put the highest interest of the child and to guarantee his/her protection in time and according to the simplified legal procedure. This paper presents types of protection measures, child characteristics for which these measures have been in place, analysis of the process starting with the identification and evaluation of the risk till in confirming of the protection measure from the Court as well as all the progress of implementation of the Individual Protection Plan. The paper offers an analysis of the demographic and analytic factors on the motives and cases where protection measures are applied. 74 measures analyzed are 74 children's’ life's where the protection system has intervened to stave off from the risk and offer the services in a safe place. In 36 of them is being realized specialized supervision in family environment where through the Individual Protection Plan, despite family services, specialized support from child protection unit is being more intensive in family. In absence of foster families, the protection measure for child placement in alternative care is applied in residential care institutions or at their relatives. For emergent protection cases, all 23 children are placed in residential care institutions for children; 8 cases taken under immediate protection and other 13 cases taken under protection and placed in alternative care actually are not leaving in street condition but placed in a safe place meanwhile that child protection structure continue with empowering plans for families aiming at returning of child close to biological families.
 
 Received: 31 May 2021 / Accepted: 4 September 2021 / Published: 5 November 2021
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van Dyck, Peter C. "A History of Child Health Equity Legislation in the United States." Pediatrics 112, Supplement_3 (September 1, 2003): 727–30. http://dx.doi.org/10.1542/peds.112.s3.727.
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The Issue. The mission of the Maternal and Child Health Bureau (MCHB) is comprehensive in scope and establishes the capacity, structure, and function for the MCHB to continually improve the health and well-being of pregnant women and children. The MCHB works in partnership with states and has broad authority to improve access to care and ensure the provision of quality preventive and primary care services. Specific provisions of legislation establish the framework for accomplishing this mission. With the increasing recognition of the social, economic, and environmental determinants of child health and the inequities that exist in access and quality of care for children, the Maternal and Child Health Bureau (MCHB) has set the following 3 goals for year 2003: 1) To eliminate disparities in health status outcomes through the removal of economic, social, and cultural barriers to receiving comprehensive, timely, and appropriate health care; 2) To ensure the highest quality of care through the development of practice guidance and data monitoring and evaluation tools; the use of evidence-based research; and the availability of a well-trained, culturally diverse workforce; and 3) To facilitate access to care through the development and improvement of the maternal and child health infrastructure and systems of care to enhance the provision of necessary, coordinated, quality health care. Priority MCHB strategies to accomplish these goals include improving and expanding 1) the cultural competence of providers (in particular to decrease sudden infant death syndrome [SIDS] among minorities), 2) emergency medical services for children, 3) health and safety in child care, 4) quality of primary pediatric care, and 5) the providing of every child with a medical home.
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Spiers, Gemma, Victoria Allgar, Gerry Richardson, Kate Thurland, Sebastian Hinde, Yvonne Birks, Kate Gridley, et al. "Transforming community health services for children and young people who are ill: a quasi-experimental evaluation." Health Services and Delivery Research 4, no. 25 (September 2016): 1–222. http://dx.doi.org/10.3310/hsdr04250.
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BackgroundChildren’s community nursing (CCN) services support children with acute, chronic, complex and end-of-life care needs in the community.ObjectivesThis research examined the impact of introducing and expanding CCN services on quality, acute care and costs.MethodsA longitudinal, mixed-methods, case study design in three parts. The case studies were in five localities introducing or expanding services. Part 1: an interrupted time series (ITS) analysis of Hospital Episode Statistics on acute hospital admission for common childhood illness, and bed-days and length of stay for all conditions, including a subset for complex conditions. The ITS used between 60 and 84 time points (monthly data) depending on the case site. Part 2: a cost–consequence analysis using activity data from CCN services and resource-use data from a subset of families (n = 32). Part 3: in-depth interviews with 31 parents of children with complex conditions using services in the case sites and a process evaluation of service change with 41 NHS commissioners, managers and practitioners, using longitudinal in-depth interviews, focus groups and documentary data.FindingsPart 1: the ITS analysis showed a mixed pattern of impact on acute activity, with the greatest reductions in areas that had rates above the national average before CCN services were introduced and significant reductions in some teams in acute activity for children with complex conditions. Some models of CCN appear to have more potential for impact than others. Part 2: the cost–consequence analysis covered only part of the CCN teams’ activity. It showed some potential savings from reduced admissions and bed-days, but none that was greater than the total cost of the services. Part 3: three localities implemented services as planned, one achieved partial service change and one was not able to achieve any service change. Organisational stability, finance, medical stakeholder support, competition, integration with primary care and visibility influenced the planning and implementation of new and expanded CCN services. Feeling supported to manage their ill child at home was a key outcome of using services for parents. Various service features contributed to this and were important in different ways at different times. Other outcomes included being able to avoid hospital care, enabling the child to stay in school, and getting respite. Although parents judged that care was of high quality when teams enabled them to feel supported, reassured and secure in managing their ill child at home, this did not depend on a constant level of contact from teams.LimitationsDelays in service reconfigurations required adaptation of research activity across sites. Use of administrative data, such as Hospital Episode Statistics, for research purposes is technically difficult and imposed some limitations on both the ITS and the cost–consequence analyses.ConclusionsLarge, generic CCN teams that integrate acute admission avoidance for all children with support for children with complex conditions and highly targeted teams for children with complex conditions offer the possibility of supporting children more appropriately at home while also making some difference to acute activity. This possibility remains to be tested further.Future workFurther work should refine the evidence on outcomes of services by looking at outcomes in promising models, value for money and measuring quality-based outcomes.FundingThe National Institute for Health Research Health Services and Delivery Research Programme.
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Tomas, Maria Anita. "Evaluation of the Effectiveness of Community Involvement Program of Education and Nursing Students." JPAIR Institutional Research 18, no. 1 (June 15, 2022): 63–83. http://dx.doi.org/10.7719/irj.v18i1.828.
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The college department conducted this research study to evaluate the effectiveness of the community involvement program (CIP) in terms of health, literacy, and numeracy services rendered by nursing and education students in Matangtubig from 2015-2020.The study utilized participatory research. It involves stakeholders in Barangay Matangtubig in community projects, evaluating, collecting, and analyzing data. The information taken will be utilized to adjust and improve the project. The study explored the experience of Barangay Matangtubig residents in terms of health care and tutorial services rendered by the college students at a private school, specifically the Bachelor of Science in Nursing (BSN) and Education. It investigated the participants’ experience with the health care services delivered regarding maternal and child health care, health education, nutrition, environmental sanitation of the community, and education regarding reading, writing, and numeracy services. The results of the study provided baseline information for policymakers in designing programs, setting standards, and taking necessary actions. The study revealed that people in the community must assume personal responsibility to become self-reliant. The presence of the nursing and education students was meant only to facilitate and help the residents.
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Allen, Davina, David Cohen, Kerry Hood, Mike Robling, Christine Atwell, Claire Lane, Lesley Lowes, et al. "Continuity of care in the transition from child to adult diabetes services: A realistic evaluation study." Journal of Health Services Research & Policy 17, no. 3 (July 2012): 140–48. http://dx.doi.org/10.1258/jhsrp.2011.011044.
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Hazell, Juliana, Richard L. Henry, and J. Lynn Francis. "Improvement in asthma management practices in child care services: an evaluation of a staff education program." Health Promotion Journal of Australia 17, no. 1 (2006): 21–26. http://dx.doi.org/10.1071/he06021.
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Szilagyi, Peter G., Jane L. Holl, Lance E. Rodewald, Laura Pollard Shone, Jack Zwanziger, Dana B. Mukamel, Sarah Trafton, Andrew W. Dick, and Richard F. Raubertas. "Evaluation of Children's Health Insurance: From New York State's Child Health Plus to SCHIP." Pediatrics 105, Supplement_E1 (March 1, 2000): 687–91. http://dx.doi.org/10.1542/peds.105.se1.687.
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Background. The legislation and funding of the State Children's Health Insurance Program (SCHIP) in 1997 resulted in the largest public investment in child health care in 30 years. The program was designed to provide health insurance for the estimated 11 million uninsured children in the United States. In 1991 New York State implemented a state-funded program—Child Health Plus (CHPlus)—intended to provide health insurance for uninsured children who were ineligible for Medicaid. The program became one of the prototypes for SCHIP. This study was designed to measure the association between CHPlus and access to care, utilization of care, quality of care, and health care costs to understand the potential impact of one type of prototype SCHIP program. Methods. The study took place in the 6-county region of upstate New York around and including the city of Rochester. A before-and-during design was used to compare children's health care for the year before they enrolled in CHPlus versus the first year during enrollment in CHPlus. The study included 1828 children (ages 0–6.99 years at enrollment) who enrolled between November 1, 1991 and August 1, 1993. A substudy involved 187 children 2 to 12.99 years old who had asthma. Data collection involved: 1) interviews of parents to obtain information about demographics, sources of health care, experience and satisfaction with CHPlus, and perceived impact of CHPlus; 2) medical chart reviews at all primary care offices, emergency departments, and health department clinics in the 6-county region to measure utilization of health services; 3) claims analysis to assess costs of care during CHPlus and to impute costs before CHPlus; and 4) analyses of existing datasets including the Current Population Survey, National Health Interview Survey, and statewide hospitalization datasets to anchor the study in relation to the statewide CHPlus population and to assess secular trends in child health care. Logistic regression and Poisson regression were used to compare the means of dependent measures with and without CHPlus coverage, while controlling for age, prior insurance type, and gap in insurance coverage before CHPlus. Results. Enrollment: Only one third of CHPlus-eligible children throughout New York State had enrolled in the program by 1993. Lower enrollment rates occurred among Hispanic and black children than among white children, and among children from lowest income levels. Profile of CHPlus Enrollees: Most enrollees were either previously uninsured, had Medicaid but were no longer eligible, or had parents who either lost a job and related private insurance coverage or could no longer afford commercial or private insurance. Most families heard about CHPlus from a friend, physician, or insurer. Television, radio, and newspaper advertisements were not major sources of information. Nearly all families had at least 1 employed parent. Two thirds of the children resided in 2-parent households. Parents reported that most children were in excellent or good health and only a few were in poor health. The enrolled population was thus a relatively low-risk, generally healthy group of children in low-income, working families. Access and Utilization of Health Care: Utilization of primary care increased dramatically after enrollment in CHPlus, compared with before CHPlus. Visits to primary care medical homes for preventive, acute, and chronic care increased markedly. Visits to medical homes also increased for children with asthma. There was, however, no significant association between enrollment in CHPlus and changes in utilization of emergency departments, specialty services, or inpatient care. Quality of Care: CHPlus was associated with improvements in many measures involving quality of primary care, including preventive visits, immunization rates, use of the medical home for health care, compliance with preventive guidelines, and parent-reported health status of the child. For children with asthma, CHPlus was associated with improvements in several indicators of quality of care such as asthma tune-up visits, parental perception of asthma severity, and parent-reported quality of asthma care. Health Care Costs: Enrollment in CHPlus was associated with modest additional health care expenditures in the short term—$71.85 per child per year—primarily for preventive and acute care services delivered in primary care settings. Conclusions. Overall, children benefited substantially from enrollment in CHPlus. For a modest short-term cost, children experienced improved access to primary care, which translated into improved utilization of primary care and use of medical homes. Children also received higher quality of health care, and parents perceived these improvements to be very important. Nevertheless, CHPlus was not associated with ideal quality of care, as evidenced by suboptimal immunization rates and receipt of preventive or asthma care even during CHPlus coverage. Thus, interventions beyond health insurance are needed to achieve optimal quality of health care. This study implemented methods to evaluate the association between enrollment in a health insurance program and children's health care. These methods may be useful for additional evaluations of SCHIP. Implications: Based on this study of the CHPlus experience, it appears that millions of uninsured children in the United States will benefit substantially from SCHIP programs.
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BAYRAK, Nurten Gülsüm, and Dilek EKİCİ. "ÇOCUK İSTİSMARINDA AİLE DİNAMİKLERİNE YÖNELİK RİSK FAKTÖRLERİ VE KORUYUCU- ÖNLEYİCİ MÜDAHALELER." EJONS INTERNATIONAL JOURNAL ON MATHEMATICS, ENGINEERING & NATURAL SCIENCES 18, no. 5 (June 20, 2021): 436–49. http://dx.doi.org/10.38063/ejons.436.
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The main purpose of the study is to discuss the risk factors associated with family dynamics, protective and preventive approaches in child abuse. In its simplest definition, child abuse, is physical, sexual, and/or psychological maltreatment or neglect of a child or children. Child abuse has been increasing in our country and in the world in recent years. Child abuse, which negatively affects the development of the child in all aspects, also constitutes an important obstacle to raising healthy societies. Many factors such as parents' attitudes and behaviors, personality traits, health conditions, levels of knowledge and skills in raising children, socio-economic status, and education level sare important components of the child'sex posure to abuse in terms of family dynamics. Primary health care services, schools, and Child Advocacy Centers are very important in determining family-based risk factors, evaluating them in a holistic manner and monitoring them, as well as protective and preventive studies of child abuse. Within the scope of the study, national and international studies on child abuse were scrutinized, protective and preventive interventions, family dynamics of children who were victims of abuse were evaluated. In this context, evaluation of family-based risk factors in primary health care services, assessment of parents by counseling teachers in schools, Child Advocacy Centers are the most important steps in determining the risks. It is thought that; categorizing at-risk groups and making the necessary interventions and guidance according to risk priority, increasing the awareness of parents, implementing protective and preventive interventions with a multidisciplinary team understanding within a comprehensive and standardized program and evaluating the effectiveness of interventions through academic studies will be a guide in determining familyrelated risk factors and combating the serisks in child abuse.
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Abrahams, Sharon, and Orlee Udwin. "An Evaluation of a Primary Care-Based Child Clinical Psychology Service." Child and Adolescent Mental Health 7, no. 3 (September 2002): 107–13. http://dx.doi.org/10.1111/1475-3588.00020.
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Alonso Díaz, R., E. Cortázar Alonso, H. Guillén Rodrigo, R. Remesal Cobreros, and S. Fuentes Márquez. "Mental health care to children and adolescents." European Psychiatry 33, S1 (March 2016): S343. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1208.
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Unit Mental Health Day Hospital Child and youthful, is a device of tertiary health care, integrated into the UGC Mental Health, led to intensive treatment of children and young people in the province of Huelva, with severe mental illness and who need specialized medical care.To first access to this unit, the person should be referred for specialized Pediatrics; by your psychiatrist or psychologist benchmark for mental health teams; or from the Hospitalization Unit, as it is a third-level device.When a patient was diagnosed with eating behavior disorder (TCA) is derived, an initial consultation with the child and parents, a first psychiatric evaluation, also by nutritional and Endocrinology Nursing is performed. After evaluation of these professionals, you can take the decision to begin an intensive outpatient treatment in which the patient would have frequent consultations with the psychiatrist, the nurse and endocrine.They may also decide inpatient hospitalization and this could be partial, to be held in the Day Hospital; or all, if the patient is under 14 years and hospitalization for psychiatric criteria indicated; the patient would enter Pediatrics. If he is over 14 years old, would join Hospitalization Unit.In Child and Adolescent Hospitalization Unit of Huelva patient it is included in a specific program for TCA where a psychiatric, endocrine, educational approach in the classroom is done. Coordination meetings with education, social services and early care centers that are also in contact with that child are also conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Borghini, Alice, Ilaria Corazza, and Sabina Nuti. "Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway." International Journal of Environmental Research and Public Health 18, no. 4 (February 4, 2021): 1481. http://dx.doi.org/10.3390/ijerph18041481.
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The ability to deal with adversity and the resilience of people and groups are shown to depend positively on the tendency to nurture positivity. Therefore, the aim of this study is to evaluate whether Learning from Excellence (LfE) can be an effective method to manage systematic health systems, when transparent disclosure and benchmarking of data are adopted in performance evaluation. This study consists of a quantitative and a qualitative phase. In the former, maternal care is investigated at the regional level, starting from performance data and indicators of the maternity pathway referred to 98 healthcare providers in 10 Italian regions, that share the same evaluation system. The second phase investigates qualitatively the organizational determinants and the experience of professionals involved in the pathway, through the organization of on-site workshops. We identified the seven best practices among the 42 units of analysis. Communication, trust and shared goals among health professionals involved in the pathway emerged as core themes from the qualitative analysis. This study confirms that LfE under the conditions of benchmarking assessment and transparent disclosure of data can be implemented systematically in management practice, in order to boost health personnel’s resilience and, in general, the organizational climate in the working environment.
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Birleson, Peter, and Peter Brann. "Reviewing the learning organisation model in a child and adolescent mental health service." Australian Health Review 30, no. 2 (2006): 181. http://dx.doi.org/10.1071/ah060181.
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From 1995 onwards, a child and adolescent mental health service (CAMHS) applied Senge?s learning organisation model. This review compared service performance with that of peer services 5 years later and explored whether any differences were associated with the application of this model. The comparison methodology used quantitative analysis of external data from the Department of Human Services, together with qualitative analysis of material including interviews with CAMHS directors and service managers. Results showed high evaluation activity and high quality, efficiency and efficacy of care compared with other services. Several restraints to the optimal application of the model were identified, including inadequate training of new managers, service overload, major external organisational change and limited investment in information systems. Other outcomes are discussed.
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Araujo, Juliane Pagliari, Cláudia Silveira Viera, Beatriz Rosana Gonçalves de Oliveira, Maria Aparecida Gaiva, and Rosa Maria Rodrigues. "Assessment of the essential attributes of Primary Health Care for children." Revista Brasileira de Enfermagem 71, suppl 3 (2018): 1366–72. http://dx.doi.org/10.1590/0034-7167-2017-0569.
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ABSTRACT Objective: To identify the presence and extent of essential attributes in primary health care services for children, focusing on the evaluation of structure and process. Method: Evaluative, quantitative study carried out in 23 traditional basic health units in a city in Parana State, with 548 caregivers of children under 12 years old, using the Primary Care Assessment Instrument (PCATool Brazil), child version. Essential and general scores of the primary care were calculated according to the methodology proposed, with a cut-off score ≥6.6. Results: The scores of the essential attributes in relation to structure are: Accessibility (5.5), Kinship (6.9), Integrality of care - Services Available (6.0) and Coordination - System information (7.4). As for the Process, the following results were obtained: First visit - Use (8.6), Longitudinally (6.1), Integrality - Services Provided (6.1) and Coordination - Integration of Care (6.9). Conclusion: The essential score was 6.6 and the general score was 6.3, showing weak focus on primary health care.
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Kleinsorge, Christy A., Michael C. Roberts, Kimberlee M. Roy, and Michael A. Rapoff. "The Program Evaluation of Services in a Primary Care Clinic: Attaining a Medical Home." Clinical Pediatrics 49, no. 6 (February 4, 2010): 548–59. http://dx.doi.org/10.1177/0009922809358615.
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Vosler, Nancy R., and John G. Robertson. "Nonmarital Co-parenting: Knowledge Building for Practice." Families in Society: The Journal of Contemporary Social Services 79, no. 2 (April 1998): 149–59. http://dx.doi.org/10.1606/1044-3894.1812.
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The number of children born in the U.S. to nonmarried parents is increasing, and these children are at risk of deleterious outcomes. However, little is known about relationships between unmarried fathers and mothers. Based on a review of extant empirical research and on a multilevel social systems theoretical framework, a practice model is proposed that identifies 12 key factors for further knowledge-development: child well-being, mother's well-being, father's well-being, mother–child relationship, father–child relationship, mother–father relationship, maternal extended family relationships, paternal extended family relationships, neighborhood characteristics, mother's family background, father's family background, and public services and institutional structures. Implications for multilevel approaches to social work practice include needed interventions at both macro and micro levels that address poverty, housing and neighborhood stabilization, employment, child care, human capital development, health and mental health services, family and individual counseling, and parenting skills. Further research must focus on this specific population of “fragile families,” including development and evaluation of effective policies, programs, and services.
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Rodrigo, María José, Ana Delia Correa, María Luisa Máiquez, Juan Carlos Martín, and Guacimara Rodríguez. "Family Preservation Services on the Canary Islands." European Psychologist 11, no. 1 (January 2006): 57–70. http://dx.doi.org/10.1027/1016-9040.11.1.57.
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This article describes the results of a parenting program “Apoyo Personal y Familiar,” (APF; Personal and Family Support program) targeted at parents of families at high psychosocial risk. APF aims at preventing unnecessary placement of children from vulnerable families into foster-care by increasing parental competence in order to improve their autonomous functioning. The program is implemented through group meetings in community centers. The method involves exposing the parents to parental views and practices in specific child-rearing episodes and encouraging them to reflect on their own views and the consequences on child development. In the Intervention group 144 mothers completed the pretest and posttest measures and 155 mothers were in a waiting-list comparison group. Self-report measures on parental implicit theories, child-rearing practices, and personal agency were used to perform the evaluation. Group discourse and the monitor's behavior observed during the sessions were used as predictors of the program's efficacy. Compared to control mothers, program mothers endorsed less simple views on child development, reported positive changes in their child-rearing practices, and had more confidence in their personal resources and a more accurate view of their parental role. Group effect sizes on the outcome measures were predicted by the type of group discourse and the type of group management observed during the sessions. The use of a perspectivist discourse was positive for promoting complex ideas and actions, whereas a self-centered discourse was positive for improving personal agency and for reporting less use of permissive practices. The role of the monitor was particularly relevant for reinforcing the mothers' sense of confidence in their own resources and for facilitating changes in child-rearing tactics.
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Hodgins, Michael, Katarina Ostojic, Nan Hu, K. D. Lawson, Nora Samir, Amanda Webster, Helen Rogers, et al. "Study protocol for a real-world evaluation of an integrated child and family health hub for migrant and refugee women." BMJ Open 12, no. 8 (August 2022): e061002. http://dx.doi.org/10.1136/bmjopen-2022-061002.
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IntroductionContinuity of child and family healthcare is vital for optimal child health and development for developmentally vulnerable children. Migrant and refugee communities are often at-risk of poor health outcomes, facing barriers to health service attendance including cultural, language, limited health literacy, discrimination and unmet psychosocial needs. ‘Integrated health-social care hubs’ are physical hubs where health and social services are co-located, with shared referral pathways and care navigation.AimOur study will evaluate the impact, implementation and cost-benefit of the First 2000 Days Care Connect (FDCC) integrated hub model for pregnant migrant and refugee women and their infants.Materials and methodsThis study has three components. Component 1 is a non-randomised controlled trial to compare the FDCC model of care with usual care. This trial will allocate eligible women to intervention and control groups based on their proximity to the Hub sites. Outcome measures include: the proportion of children attending child and family health (CFH) nurse services and completing their CFH checks to 12 months of age; improved surveillance of growth and development in children up to 12 months, post partum; improved breastfeeding rates; reduced emergency department presentations; and improved maternal well-being. These will be measured using linked medical record data and surveys. Component 2 will involve a mixed-method implementation evaluation to clarify how and why FDCC was implemented within the sites to inform future roll-out. Component 3 is a within-trial economic evaluation from a healthcare perspective to assess the cost-effectiveness of the Hubs relative to usual care and the implementation costs if Hubs were scaled and replicated.Ethics and disseminationEthical approval was granted by the South Eastern Sydney Local Health District Human Research Ethics Committee in July 2021 (Project ID: 020/ETH03295). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences.Trial registration numberACTRN12621001088831.
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Nabudere, Harriet, Delius Asiimwe, and Rhona Mijumbi. "Task shifting in maternal and child health care: An evidence brief for Uganda." International Journal of Technology Assessment in Health Care 27, no. 2 (March 30, 2011): 173–79. http://dx.doi.org/10.1017/s0266462311000055.
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The Problem: There is a shortage and maldistribution of medically trained health professionals to deliver cost-effective maternal and child health (MCH) services. Hence, cost-effective MCH services are not available to over half the population of Uganda and progress toward the Millennium Development Goals for MCH is slow. Optimizing the roles of less specialized health workers (“task shifting”) is one strategy to address the shortage and maldistribution of more specialized health professionals.Policy Options: (i) Lay health workers (community health workers) may reduce morbidity and mortality in children under five and neonates; and training for traditional birth attendants may improve perinatal outcomes and appropriate referrals. (ii) Nursing assistants in facilities might increase the time available from nurses, midwives, and doctors to provide care that requires more training. (iii) Nurses and midwives to deliver cost-effective MCH interventions in areas where there is a shortage of doctors. (iv) Drug dispensers to promote and deliver cost-effective MCH interventions and improve the quality of the services they provide. The costs and cost-effectiveness of all four options are uncertain. Given the limitations of the currently available evidence, rigorous evaluation and monitoring of resource use and activities is warranted for all four options.Implementation Strategies: A clear policy on optimizing health worker roles. Community mobilization and reduction of out-of-pocket costs to improve mothers’ knowledge and care-seeking behaviors, continuing education, and incentives to ensure health workers are competent and motivated, and community referral and transport schemes for MCH care are needed.
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Holl, Jane L., Peter G. Szilagyi, Lance E. Rodewald, Laura Pollard Shone, Jack Zwanziger, Dana B. Mukamel, Sarah Trafton, Andrew W. Dick, Richard Barth, and Richard F. Raubertas. "Evaluation of New York State's Child Health Plus: Access, Utilization, Quality of Health Care, and Health Status." Pediatrics 105, Supplement_E1 (March 1, 2000): 711–18. http://dx.doi.org/10.1542/peds.105.se1.711.
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Background. The recently enacted State Children's Health Insurance Program (SCHIP) is modeled after New York State's Child Health Plus (CHPlus) program. Since 1991, CHPlus has provided health insurance to children 0 to 13 years old whose annual family income was below 222% of the federal poverty level and who were ineligible for Medicaid or did not have equivalent health insurance coverage. CHPlus covered the costs for ambulatory, emergency, and specialty care, and prescriptions, but not inpatient services. Objectives. To assess the change associated with CHPlus regarding 1) access to health care; 2) utilization of ambulatory, inpatient, and emergency services; 3) quality of health care; and 4) health status. Setting. Six western New York State counties (including the city of Rochester). Subjects. Children (0–6.99 years old) enrolled for at least 9 consecutive months in CHPlus. Methods. The design was a before-and-after study, comparing individual-level outcomes for the 12 months immediately before CHPlus enrollment and the 12 months immediately after enrollment in CHPlus. Parent telephone interviews and medical chart reviews conducted 12 months after enrollment to gather information. Subjects' primary care charts were located by using interview information; emergency department (ED) charts were identified by searching patient records at all 12 EDs serving children in the study; and health department charts were identified by searching patient records at the 6 county health department clinics. Logistic regression and Poisson regression were used to compare the means of dependent measures with and without CHPlus coverage, while controlling for age, prior insurance type, and gap in insurance coverage before CHPlus. Results. Complete data were obtained for 1730 children. Coverage by CHPlus was associated with a significant improvement in access to care as measured by the proportion of children reported as having a usual source of care (preventive care: +1.9% improvement during CHPlus and sick care: +2.7%). CHPlus was associated, among children 1 to 5 years old, with a significant increase in utilization of preventive care (+.23 visits/child/year) and sick care (+.91 visits/child/year) but no measurable change in utilization of specialty, emergency, or inpatient care. CHPlus was also associated, among children 1 to 5 years old, with significantly higher immunization rates (up-to-date for immunizations: 76% vs 71%), and screening rates for anemia (+11% increased proportion screened/year), lead (+9%), vision (+11%), and hearing (+7%). For 25% of the children, a parent reported that their child's health was improved as a result of having CHPlus. Conclusion. After enrollment in CHPlus, access to and utilization of primary care increased, continuity of care improved, and many quality of care measures were improved while utilization of emergency and specialty care did not change. Many parents reported improved health status of their child as a result of enrollment in CHPlus. Implication. This evaluation suggests that SCHIP programs are likely to improve access to, quality of, and participation in primary care significantly and may not be associated with significant changes in specialty or emergency care.
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NEUSPIEL, DANIEL R. "Neonatal Intensive Care: Cost-Benefit Analysis." Pediatrics 75, no. 4 (April 1, 1985): 798. http://dx.doi.org/10.1542/peds.75.4.798.
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To the Editor.— Walker et al1 have contributed to the recent plethora of studies applying cost-benefit analysis to the provision of health care. In using this dangerous method to determine the value of neonatal intensive care, they legitimize the acceptance of cost criteria for the rationing of health services. This approach reduces the measurement of human life to economic productivity and accepts the unproven contention of dwindling societal resources available for health care. Walker et al divided their subjejcts according to their neurodevelopmental evaluation into four categories: normal, (midly imapired, moderately impaired, or severely handicapped).
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Yuliyatni, Putu Cintya Denny, Wayan Pujana, and Citra Indriani. "Evaluation of HIV screening at antenatal care settings in Denpasar City." Public Health and Preventive Medicine Archive 5, no. 1 (July 1, 2017): 33. http://dx.doi.org/10.15562/phpma.v5i1.39.
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Background and purpose: National strategy to increase the coverage of prevention of mother to child transmission (PMTCT) program in Indonesia is integrating the service into public health centres (puskesmas). In Bali, the integration has been started since 2014. After one year of program implementation, an evaluation was conducted in order to provide input and feedback for program improvement.Methods: Secondary data analysis and indepth interview with 13 key informants in Denpasar City were conducted to assess input, process and output of the integration implementation. Results: Of the 11,719 pregnant women targeted within the program, 43% were offered to undergo HIV testing and 98% of these agreed to have HIV test with 17 were found HIV positive. Interviews with key informants found that there were adequate resources both in terms of manpower, funds and equipment. Obstacles found in the implementation include different site of ANC and HIV testing facility. The other barrier was high number of pregnant mother who conducted ANC at private obstetrician which not yet included in the program.Conclusions: Integration of PMTCT into ANC services at public health centre (PHC) is an effective way to improve the uptake of HIV screening among pregnant women. However, there is a need of effective of referral systems from private midwives and PHC satellite services. The expansion of networks into private midwives and obstetrician will be instrumental in improving performance outcomes.
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Wesenberg, Sandra, Christina Frank, Marilena de Andrade, Miriam Weber, Claus-Peter Rosemeier, Bert Krause-Lanius, and Silke B. Gahleitner. "Results of an Evaluation of Therapeutic Residential Groups for Adolescents in Berlin." Research on Social Work Practice 30, no. 5 (February 12, 2020): 524–38. http://dx.doi.org/10.1177/1049731520901600.
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In the last few years, a large amount of research have been done in the field of youth care services. However, there is still a substantial need for empirical findings, especially on institutions with specific missions such as therapeutic residential groups for young people. This article grew out of cooperation between practitioners and researchers and presents the results of a German study entitled “Process Evaluation of Therapeutic Residential Groups for Young People” (TRGs). The main research question of the evaluation study was whether the treatment in the TRGs is specifically stabilizing, protective, and, above all, effective in dealing with young people with severe problems. The study employs multiple methodologies (qualitative and quantitative procedures) to obtain a satisfactorily comprehensive analysis of both outcome and process quality. The article presents selected results from the quantitative part of the study and the qualitative interview study and discusses them considering recent research in the field of child and adolescent care services.
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Lee, Chuan Mei, Jessica Lutz, Allyson Khau, Brendon Lin, Nathan Phillip, Sara Ackerman, Petra Steinbuchel, and Christina Mangurian. "Pediatric Primary Care Perspectives of Mental Health Services Delivery during the COVID-19 Pandemic." Children 9, no. 8 (August 3, 2022): 1167. http://dx.doi.org/10.3390/children9081167.
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Due to a national shortage of child and adolescent psychiatrists, pediatric primary care providers (PCPs) are often responsible for the screening, evaluation, and treatment of mental health disorders. COVID-19 pandemic stay-at-home orders decreased access to mental health care and increased behavioral and emotional difficulties in children and adolescents. Despite increased demand upon clinicians, little is known about mental health care delivery in the pediatric primary care setting during the pandemic. This focus group study explored the experiences of pediatric PCPs and clinical staff delivering mental health care during the pandemic. Transcripts from nine focus groups with San Francisco Bay Area primary care practices between April and August 2020 were analyzed using a thematic analysis approach. Providers expressed challenges at the patient-, provider-, and system-levels. Many providers reported increased patient mental health symptomatology during the pandemic, which was often intertwined with patients’ social determinants of health. Clinicians discussed the burden of the pandemic their own wellness, and how the rapid shift to telehealth primary care and mental health services seemed to hinder the availability and effectiveness of many resources. The findings from this study can inform the creation of new supports for PCPs and clinical staff providing mental health care.
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Lee, Han-Cheol, Se-Young Jun, Heon-Ho Ha, Ju-Seok Song, Young-Ju Lee, and Jung-Beom Kim. "Evaluation of Microbiological Safety of Food Service Environment in Child Care Centers." Journal of Food Hygiene and Safety 35, no. 2 (April 30, 2020): 146–51. http://dx.doi.org/10.13103/jfhs.2020.35.2.146.
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Santhanam, Radhika, Ernest Hunter, Yvonne Wilkinson, Harvey Whiteford, and Alexandra McEwan. "Care, Community Capacity: Rethinking Mental Health Services in Remote Indigenous Settings." Australian Journal of Primary Health 12, no. 2 (2006): 51. http://dx.doi.org/10.1071/py06022.
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In 2002 a project was initiated to evaluate and restructure the Child and Youth Mental Health (CYMH) services in three health Service Districts: Cape York, the Torres Strait and Northern Peninsula Area and remote Cairns. The objective was to develop, establish and evaluate models of best practice for remote area CYMH services for Indigenous families living in far north Queensland. For the purposes of the project, an action research framework was adopted to guide the project design, methodology, implementation and evaluation. The first phase involved mapping of needs, the second phase focused on service restructure and outcomes were measured in the third phase. The planning/implementation/planning cycle was an ongoing part of the project and raised five significant themes: service equity, service quality, service sufficiency, Indigenous workforce, and service structure/ infrastructure. The principal project outcome was the establishment of a defined model of service delivery that incorporates the identified themes and sits within a community development framework. Other significant outcomes include the implementation of regular supervision and professional development activities and improvements in service data collection. This paper is a descriptive account of the process of service restructure and discusses the key project outcomes.
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Werling, Anna Maria, Susanne Walitza, Stephan Eliez, and Renate Drechsler. "The Impact of the COVID-19 Pandemic on Mental Health Care of Children and Adolescents in Switzerland: Results of a Survey among Mental Health Care Professionals after One Year of COVID-19." International Journal of Environmental Research and Public Health 19, no. 6 (March 10, 2022): 3252. http://dx.doi.org/10.3390/ijerph19063252.
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Background: To assess the impact of the COVID-19 pandemic on treatment demand and supply in children and adolescents with mental disorders during the first year of the pandemic from the perspective of child and adolescent psychiatrists and psychologists in Switzerland. Methods: The survey was conducted anonymously, in German or French and online in April/May 2021. Mental health professionals working in child and adolescent psychiatry, psychotherapy services or independent practices were contacted by email. Results: N = 454 professionals completed the survey (176 child and adolescent psychiatrists and 276 psychologists). After an initial period of decreased demand during the lockdown in spring 2020, requests for treatment increased, considerably exceeding the demand pre-pandemic and reaching a peak in January/February/March 2021. The vast majority of professionals (78.2%) estimated that there was currently too little supply during the pandemic, which differed from the evaluation of the pre-pandemic situation (37%). A total of 65% of participants indicated that waiting time until the initiation of treatment increased during the pandemic, 41% reported their current workload to be somewhat higher and 44.5% much higher. Conclusions: For the first pandemic year, youth mental health professionals reported a large increase in the treatment demand and waiting time and a worrisome overload of treatment services.
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Serohina, T. V. "The system of protection of the rights of children as a object of government policy." Public administration aspects 6, no. 11-12 (February 20, 2019): 64–71. http://dx.doi.org/10.15421/151875.
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There is no doubt that the evaluation system should be an integral part of the management of any sphere. However, in the context of this study, the actuality is exacerbated by the fact that children are one of the most vulnerable strata of Ukrainian society. Insufficient attention to problematic issues in this area entails consequences for each child as well as for society as a whole. evidence of the priority of this direction of state policy is the participation of the state in a number of international documents in this area, which include the UN Convention on the Rights of the Child, the agreements within the framework of the Council of Europe and the Hague Conference on Private International Law, the Convention on Civil Aspects of International Child Abduction, European Convention on the Exercise of Children’s Rights, Convention on contact with children, etc. Despite the declared principles and high level of financing, there are no noticeable changes. Consequently, it is considered necessary to introduce into the management the evaluation system, which will answer a number of questions: Have the planned results been achieved? How positive were the assumptions about the results of the policy / program / project? How effective, productive and sustainable are the changes? Evaluating the results of the policy / program / project gives feedback on the achievement of the policy / program / project objectives and objectives. In the context of the research it is impossible not to take into account the features of the service sphere, which include the following: the object of evaluation is the activities of the organization providing the service; the complexity of the numerical expression of the quality of services; the consumer of the service itself acts as a participant in the process of rendering the service; therefore, the quality must meet its expectations; services are not stored, they are realized in the process of contact with the consumer.On the other hand, the peculiarities of the sphere of children’s rights protection should also be taken into account, as it is impossible to assess the degree of satisfaction of needs, which is one of the important indicators in assessing the effectiveness of public services. This is due to the fact that children do not represent real consumers, that is, those who decide for themselves, need help or not, should be arranged in the residential institution or not, what requirements for the services provided to them and t. The National Strategy for the Reform of the Institutional Care and the Rearing of Children for 2017-2026 is intended to promote the development of a system for protecting children’s rights under the new principles. Among other things, the document provides the basis for applying evaluation as one of the key points in achieving the goals set in the Strategy. First, the Strategy contains elements of the preliminary assessment, which is carried out before the implementation of the program documents, and creates the preconditions for conducting qualitative evaluation at subsequent stages. In particular, the document discloses existing problems, describes the institutional structure, identifies the indicators, including the number of children in institutions of institutional care and upbringing of children, the percentage of children who have orphan status or a child deprived of parental care, the number of children, who have a disability, etc.Secondly, the Strategy contains a basis for evaluating the effectiveness. In particular, the Action Plan for the implementation of Stage I of the Strategy defines the measures responsible for implementation, terms of implementation and indicators. Indicators include: the number of children covered by inclusive education; the number of orphans provided with housing, children deprived of parental care; the number of children who are raised in institutions of institutional care and upbringing of children, etc.Thirdly, the Strategy contains data on the expected results, which include: the suspension of placement by the year 2020 of children up to three years of age prior to institutional care and upbringing; the termination by 2026 of activity of all types of institutional care institutions and the upbringing of children in which more than 15 pupils live; providing children and families with children with access to services according to their needs in each territorial community, etc.To date, the establishment of a regional Register of children of institutional care and education institutions (electronic database) has been started, which will provide an opportunity to receive updated data on the number of pupils in institutions and their needs in terms of settlements and to plan content and volume support services for children returning from institutional institutions to the community and their families.