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Supporting the health of families who are marginalised: A public health nursing perspective
The welfare of children is of paramount importance” Children First 2011
Public Health Nursing
Public Health Nursing integrates with primary care to provide a service to people in the community
The focus of Public Health Nursing is to promote Health and Wellbeing and to provide quality clinical care.
The PHN
PHN: Caseload holder in a primary care setting
Child Health
Older Person
Disability
Clinical activity
PHN Services Specific to Child and Family
Child Health and Well Being
Children with Life Limiting Conditions
Complex Care Needs
Early Learning Support
Child Protection and Welfare
Child Health and Well Being
Parent craft/ Antenatal Classes
Postnatal Pilates and Baby Massage (Physio Team)
Birth Notification within 48-72 hours
Neonatal Screening 72hrs post delivery
Nurse led Developmental Assessments
Breast feeding support
Infant feeding/ nutrition/ weaning programme
Child Protection and Welfare (CF 2011)
Child Health Well Being continue
Child Safety Awareness Programme
Follow up Infant Immunisation Programme
Child and Family Health Needs Assessment (Development /Parenting/ Environment)
Parenting Programmes
Community Mothers Programme
Postnatal Depression Screening (PAC 2005)
Primary/ Post Primary Immunisation/ School Screening Programme
Area Profile West Tallaght
Population 47,540 ( CSO 2011)
2 of the 4 disadvantaged communities; highest areas of deprivation in the country (Kelly & Tekjeur 2013)
One of the electoral areas; highest growth in population 22% increase (CSO 2011)
Profile continued; the context
2700 Births annual ( DSW/ HSE 2014)
1200 are in West Tallaght
600 families are from African, Asian and Eastern European countries (PHN records 2014)
54 births born to Traveller mothers in DSW 38 in West Tallaght (PHN Records 2014)
400 of 652 referred to Tusla were from West Tallaght (first 4 months of 2015 Tusla DSW)
Families: an every day encounter
Families from other countries
Traveller families
Drug and Alcohol use
Domestic violence
Mental Health issues
Families; continued
Disabilities; intellectual disabilities/ autism/ behavioural issues
Physical Disabilities
Children with life limiting conditions
Poverty>> homelessness and risk of homelessness/ relocation >> >>>>>>
Isolation and Stress
Traveller Women; a snap shot
Traveller females, life expectancy 70.1 2008
General Female , life expectancy 80 2008
Infant mortality rate (12 per 1000) 4 times general population
129 Female prisoners 21 were Travellers
(Traveller women 22 times more at risk of prison)
(AITHS 2010)
Roma families
The Case of Child A removed form his family home in Athlone 2013
The Case of Child T removed from her family home in Tallaght 2013
Significance of the information recorded by the PHN in both cases
The Emily Logan Report (2014)
Adverse Childhood Experiences ACE
ACE: Largest study of its kind examines the health and social effects of adverse childhood experiences over a lifespan (The Centres for Disease Control and Prevention 2014)
Adverse childhood experiences are the most basic cause of health risk behaviours, morbidity, disease, mortality disability, and health care costs ((Fellitti & Anda 2010 )
Professor Trevor Spratt TCD Director of the Children’s Research Centre
Interagency
No one professional has all the skills, knowledge, or resources necessary to comprehensively meet all the requirements of an individual case. It is essential therefore that a coordinated response is made by all professionals involved with a child and his carer/s (Children First 2011).
Interagency ProjectsMcUlliam Project: Barnardos and PHN: A Parent Toddler & Child Health Project (Barnardos/ HSE 2014)
Set up in 2012 in response to a recent closure of a preschool facility
PHN finding it difficult to access families and young children
Mother and Toddler Group and Child Health Clinic/ (Developmental/ Parenting/ Environment)
Antenatal to Three Initiative ATTI
Government’s Area Based Childhood Programme ABC
Improve health, education and social outcomes for children who live in poverty and social exclusion
Improve the effectiveness of existing services 0 to 3
Consultation Finding: Up to 50 services working across the spectrum, Interagency tends to be reactive/ Need for a coordination approach (CDI 2015)
To Date: Speed Network/ Interagency Approach: Maternal Mental Health / Infant Mental Health (Attachment)
Report available from CDI Tallaght West (Haran 2015)