Dissertations / Theses on the topic 'Child care services – Government policy – Canada'

Thesis (DPhil (Social Work))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: The changes in child and youth care policies over the last fifteen years have had profound consequences for the staff at Youth Care and Education Centres (hereafter referred to as YCECs). These changes included systemic changes, philosophical changes, and changes in the way services are rendered to children and youth in their care. It was thus expected of team members to not only change their behaviours but to also make mind shifts. The mandates were that they move from working in silos (educators, residential educators and support team) to working in teams; from rendering generic services to developing individualised plans for children and youth; from following a medical (deficit) approach in service delivery to following a strength based- and developmental approach. Whereas a punitive approach to discipline was followed in the past staff members now have to follow a restorative approach. In addition, the emphasis on children’s rights, in general, and the abolishment of corporal punishment, in particular, brought about changes in the nature of the adultchild relationship. It was required of the team members to learn to use alternatives to this form of punishment. The study explored how the members of the institutional level teams at the four YCECs in the Western Cape were experiencing the implementation of changed child and youth policies. A combined quantitative and qualitative research methodology was followed in obtaining the data from the residential educators, as well as the educators and the support team members comprising of psychologists, school social workers, occupational therapists, and school nurses. The points of departure were the organisational learning model and the phases of team development. Findings derived from the empirical study were that the difference between the way the participants embraced and implemented changed policies and legislation had much to do with the guidance that the principal and senior management provided for them. Where the principal set the tone and conveyed the message that the implementation of the policies were not negotiable and gave staff members the opportunity to thoroughly discuss these changes, they eventually shared the underlying principles of the changed policies. Where the principal provided direction, support and encouragement for the implementation of the changed policies the participants felt secure and empowered. Where this support was not present participants felt uncertain and to some extent let down. When a shared vision was articulated to them the participants were able to align their personal visions thereto, which further led to a greater understanding of their roles within the team. Where participants, however, were not clear on the shared vision they seemed to struggle with role division and status and power issues. When team members were left to their own devices a measure of personal mastery still took place due to the commitment of individuals but team learning was either limited or virtually nonexistent. Systems thinking remained a challenge due to the forming of subgroups within the YCEC and the limited or nonexistent services rendered by external social workers to the families of the children and youth. The most important recommendations resulting from the study indicate that provision must be made for frameworks for the implementation of changes in policy and guidelines for team processes. To ensure that new staff is informed about the policies that guide their services an orientation programme must be in place. Training for principals in effective introduction and implementation of change should also be provided. To ascertain what the staff complement should be to effectively implement changes in the policies, a work-study and a fast track pilot project should be conducted. From this, job descriptions should be developed that make provision for the incumbent’s role within the team. Consideration should also be given to the incentive system that currently only makes provision for individual performance and could hamper teamwork.
AFRIKAANSE OPSOMMING: Die veranderinge in kinder- en jeugsorgbeleide oor die laaste vyftien jaar het diepgaande gevolge ingehou vir personeel by Jeugsorg- en Onderwyssentrums (hierna verwys as JSOS). Hierdie veranderinge het sistemiese en filosofiese veranderings, asook verandering in die wyse waarop dienste gelewer word, aan kinders en jeug in hul sorg, meegebring. Dit word dus van die spanlede verwag om nie net hul gedrag nie, maar ook hul denkwyse te verander. Die mandate vervat in die beleide is dat personeel skuif van werk in silos (opvoeders, residensiële opvoeders en ondersteuningspan) na werk in spanne; van die lewer van generiese dienste tot die ontwikkeling van individuale planne vir kinders en jeug; van die volg van ‘n mediese benadering aangaande dienslewering tot ‘n sterkte-gebaseerde- en ontwikkelingsbenadering. Waar daar in die verlede ‘n strafgerigte benadering gevolg is moet daar nou beweeg word na ‘n helende benadering. Verder het die klem op kinderregte in die algemeen, en die afskaf van lyfstraf in besonder, veranderings meegebring in die aard van die volwasse-kind verhouding. Dit was verwag van die spanlede om te leer om alternatiewes tot die vorm van straf aan te leer. Die studie het ondersoek ingestel na hoe lede van die inrigtingsgebaseerde span by die vier JSOS in die Weskaap die implementering van veranderde kinder- en jeugbeleid ervaar. ‘n Gekombineerde kwantitatiewe en kwalitatiwe navorsing metodologie was gevolg in die insamel van data van die residensiële opvoeders, die opvoeders en die lede van die ondersteuningspan (sielkundiges, skool maatskaplike werkers, arbeidsterapeute en skool verpleegkundiges). Die vertrekpunt was the organisasieleer model en die fases van spanontwikkeling. Bevindings wat gemaak is uit die empiriese studie was dat die verskille tussen die wyse waarop die deelnemers die veranderde beleid aanvaar en implementeer het baie te doen gehad het met die mate van leiding wat die prinsipaal en senior bestuur vir hul gegee het. Waar die prinsipaal die toon aangegee het en die boodskap oorgedra het dat die implementering van die beleide nie onderhandelbaar was nie en personeellede die geleentheid gebied is om die veranderings deeglik te bespreek, het hul geleidelik ingekoop in die veranderde werkswyses. Waar die prinsipaal rigting en ondersteuning vir die implementering van die veranderde beleid gebied het, het die deelnemers veilig en bemagtig gevoel. Waar die ondersteuning egter ontbreek het, het die deelnemers onseker en, tot ’n mate, in die steek gelaat gevoel. Wanneer ‘n gedeelde visie oorgedra is aan hulle was die deelnemers in staat om hul persoonlike visies in lyn te bring daarmee. Dit het verder aanleiding gegee tot beter begrip vir hul rolle binne die span. Waar deelnemers egter nie duidelik was oor die gedeelde visie nie, het dit geblyk dat hulle probleme gehad het met rolverdeling, status en magaangeleenthede in die span. Wanneer spanlede oorgelaat is aan hul eie lot het ‘n mate van persoonlike bemeestering nog plaasgevind as gevolg van die persoonlike toewyding van individue, maar spanleer was óf beperk óf feitlik afwesig. Sisteem denke was steeds ‘n struikelblok as gevolg van die vorming van subgroepe binne die JSOS en die beperkte of afwesige dienslewering deur eksterne maatskaplike wekers aan gesinne van die kinders en jong mense. Die belangrikste aanbevelings, wat voortspruit uit die studie, dui aan dat voorsiening gemaak moet word vir raamwerke vir die implementering van beleidsveranderings en riglyne vir spanprosesse. Om te verseker dat nuwe personeel ingelig is omtrent die beleide wat hul dienslewering rig moet ‘n oriënteringsprogram in plek wees. Opleiding van prinsipale in die effektiewe bekendstelling en implementering van veranderings moet ook voorsien word. Om vas te stel wat die aanvulling vir personeel moet wees om die veranderings in die beleid te implementeer, behoort ‘n werkstudie en ‘n snel loodsprojek onderneem word. Hieruit kan pligstate opgestel word wat voorsiening maak vir die ampsdraer se rol in spanverband. Oorweging moet geskenk word aan die aansporingstelsel wat tans net voorsiening maak vir individuele werksverrigting en wat spanwerk kan strem.

This study of early years services in India explores the take-up of the government ICDS (Integrated Child Development Services Scheme) and RGNCS (Rajiv Gandhi National Crèche Scheme), and the factors affecting their uptake by working mothers in a Delhi slum. Policy cannot assess programme outcomes effectively without understanding how services are implemented. Existing literature indicates that programme impact is related to programme take-up, with non-take-up being a complex phenomenon affected by factors operating at multiple levels of the policy process. The study makes original contributions by examining user perspectives on early childhood education and care (ECEC) in the Indian context; in being the first to research any aspect of the RGNCS; and in utilizing Critical Realism as the underlying philosophical, theoretical and methodological paradigm for studying programme uptake. It poses five research questions that examine mothers' childcare arrangements and needs/expectations from services, their take-up of government programmes and component services, and the combination of factors affecting uptake. Study findings are based on surveys with 200 working mothers and 37 children's centre workers, and interviews with 15 policy experts. Findings reveal childcare arrangements and needs/expectations to vary by family structure, child's age, and mother's age and employment. ICDS uptake is found to be higher (54.3% of all mothers), than RGNCS (18.6%). An explanatory framework for analysing take-up reveals that low take-up results from a combination of multiple factors, most significantly programme characteristics for the ICDS, and participant characteristics for the RGNCS. Two theoretical frameworks frame this analysis - Wolman's (1981) determinants of programme success and failure, and the 'barriers and bridges' to programme uptake. Critical policy analysis further identifies the effects of the policy meaning-making processes, and the role of local 'street-level bureaucrats' in take-up. Both programmes display 'conflicted policy success' vis-à-vis take-up when categorised using McConnell's (2010) criteria for programme 'success' and 'failure'. Policy implications include strategies for increasing programme uptake, and a policy focus upon service users and women in the informal economy, recognition of the dual role of ECEC, and the importance of evidence-creation for interactive governance.

The government of Malawi established the community based childcare (CBCC) programme with the aim of addressing early childhood problems and achieve national development in the long run. The CBCC programme, as one of the approaches to early childhood development (ECD), is guided by the national early childhood development policy. It promotes some practices that somehow deviate from the traditional childcare ways that communities have always known. Experience has shown that programmes that have elements of conflict with commonly held beliefs are bound to meet with resistance in society. The study employed a mini survey, focus group discussion, observation and document review to understand how the CBCC childcare practices in Malili intersect with commonly held beliefs about childcare as well as how they reflect on the national ECD policy. The study also focused on understanding the perceptions of community members on the CBCC programme. The study revealed that while some aspects of CBCC delivery conform to commonly held beliefs about childcare in the area under study, others diverge from such beliefs. Such convergence and divergence appear to be in line with the propositions of transformalist globalisation theory- one of the perspectives adopted for the study. The study also found that care practices at CBCC are not a true reflection of the national ECD policy as community members’ perceptions, poor community participation, poverty and lack of caregiver training in ECD contribute towards poor quality of care in CBCC, contrary to what is defined in the national ECD policy. The study also found that while both CBCC caregivers and sampled community members perceived the quality of care at the centers as poor, caregivers had a more positive perception towards the CBCC than community members. The study indicated that CBCC are centres of desperation for low economic status communities. Findings from the research have revealed that cultural values and commonly held beliefs, and exposure to new knowledge through globalisation play a role in determining childcare practices as well as perceptions towards them. In this sense the study has indicated that meanings that communities attach to development interventions influence their actions and perceptions towards it.

While this study is partly theoretical it includes an exploratory case study in which theoretical insights are applied. In the theoretical part of this study, criteria for a successful poverty alleviation project were developed, guided by sustainability theory and complexity theory. It was proposed that researchers could assess existing projects according to these criteria to show where they were successful and where they could improve. The second part of this research consists of a case study, where an actual poverty alleviation project (The Nomzamo Special Care Centre, Peddie, Eastern Cape) was assessed according to the criteria developed in the first part. For this exploratory case study a non-random sample of 9 participants was drawn from the Nomzamo Special Care Centre and other stakeholders in the Ngqushwa Local Municipality in the Eastern Cape. Data was collected using questionnaires, observation and interviews. The results obtained from analysis indicate that project members particularly experience challenges pertaining to financial resources, infrastructure and maintenance. It is recommended that project members receive assistance from the government departments in order for the project to remain sustainable.

Cette thèse propose trois essais économétriques ayant trait au capital humain et au bien-être de l'enfant. Chacun des essais présente une méthodologie distincte afin de répondre à l'objectif concerné. Dans le premier chapitre, nous évaluons les effets à long terme d'une politique de services de garde universels au Canada sur le bien-être de l'enfant (santé, comportement, développement moteur et social). Nous montrons que la réforme a un effet négatif sur le bien-être des enfants d'âge préscolaire, mais ces effets tendent à disparaître lorsque l'enfant devient plus âgé. Nous trouvons que cette tendance persiste même dix ans après la mise en place de la réforme. Le second chapitre s'intéresse à l'effet de l'intensité des services de garde sur le développement cognitif des enfants d'âge préscolaire. Nous utilisons la méthode d'appariement à traitements multiples pour répondre à cet objectif. Nous montrons que les effets des services de garde sont grandement hétérogènes. Leurs effets varient selon le statut socioéconomique des familles, la scolarité ou non de l'enfant, le niveau d'intensité des services de garde ainsi que le mode de garde utilisé. Le troisième chapitre porte sur la modélisation des trajectoires des performances mathématiques des enfants canadiens de 7 à 15 ans ainsi que sur l'identification des facteurs de risque durant la petite enfance susceptibles d'influencer l'appartenance à ces trajectoires. La méthode utilisée est celle du Group-Based Trajectory Modeling de Nagin (2005)
This thesis contains three econometric essays on child human capital and well-being. Each essay has a distinct methodology to meet the purpose. In the first chapter, we evaluate the long-term effects of a reform of universal child care in Canada on children's health, motor and social development, and behaviour. We show that the policy had negative effects on preschool children's well-being, but these effects tend to disappear as the child gets older. We find that this pattern persist even ten years after the implementation of the reform. The second chapter focuses on the effect of the intensity of child care on preschool children's cognitive development using propensity score matching with multivalued treatments. We show that the effects of child care are significantly heterogeneous and vary by family socioeconomic status, schooling or not of the child, the intensity of child care and the type of child care arrangement. The third chapter models mathematics trajectories of Canadian children aged 7 to 15 years and identifies risk factors during early childhood on the membership of these trajectories using Group-Based Trajectory Modeling (Nagin, 2005)

“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice. I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services. Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship.

Today in Canada, child care is not perceived by the government, nor its citizenry, as a public good. Despite numerous reports from economic, health, social and psychological experts, Canadians remain complacent about the inadequate child care provisions in our country. As a society, we do not demand, or even anticipate, the public provision of universal, affordable, accessible child care. Instead, Canadians consider the care of children to be a predominantly private issue; unworthy of significant government intervention or assistance. Consequently, parents and children must improvise within a privatized, ad hoc, market-oriented patchwork of individualized child care arrangements. While it is true that certain "special" cases are acknowledged to deserve the government's support, - for example Aboriginal children and children with special needs, as well as the children of "welfare moms" - their exceptional status serves to reinforce the notion that the care of children is primarily a private parental responsibility. The purpose of this paper is to analyze and critique the current child care system (or lack thereof) in Canada. In addition, I intend to show that existing child care arrangements are unsatisfactory not only because of the immediate consequences for parents, children, and child care workers, but because of the way in which the privatized purchasing of child care reinforces other systemic shortcomings in our patriarchal, racialized, capitalist society. I will argue that current attitudes toward child care in Canada, as part of a patriarchal capitalist and racialized paradigm, rely on and perpetuate detrimental notions of class, gender and race, to the disadvantage of all citizens. Finally, I will discuss the possibilities for meaningful reform of the Canadian approach to child care.

This dissertation explores historical processes and daily practices of indigenization within the context of British Columbia's model for delegating Aboriginal agencies for child and family services. This research draws from historical data, examining the ways in which contemporary indigenization within Aboriginal child welfare is shaped by Canada's colonial past- most notably, the historical relationship between the Indian Residential School System and Aboriginal child welfare in Canada. Grounded in indigenous methodologies, research practice, and critical theory, this dissertation queries indigenization within the Pacific Aboriginal Child Welfare Association (PACWA). This dissertation explores the complexity of the urban setting in which PACWA operates, providing case studies of daily practices of indigenization within the association, considering the roles of Aboriginal Elders and Knowledge Keepers throughout this process, and arguing for the need to reframe urban Aboriginal child welfare in Canada. This dissertation asserts that Indigenization at PACWA is making significant differences in the lives of children and families involved in Aboriginal child welfare and that Aboriginal families continue to have their children removed at alarming rates most often because they are living in the aftermath of colonization, amidst contemporary conditions that continue to marginalize Aboriginal peoples. Indigenization is a process that can and is being achieved within the context of child welfare in British Columbia today. It is a process connected to Aboriginal sovereignty, self-government, identity and mainstream-Aboriginal relations. It is also a process that is making significant impacts in the lives of those connected to Aboriginal child welfare (Aboriginal and otherwise), while simultaneously being challenged by the structural inequalities and political eddies that continue to marginalize urban Aboriginal peoples. This research demonstrates that successful indigenization practice, at the level of large organizations such as PACWA, requires that various levels of Canadian government view them as true partners in a project of decolonization and indigenization. This requires a recognition and honouring of history and diversity of Aboriginal peoples in Canada, validated by means of mutual respect and sharing power.

Ethiopia has two stories to tell: a fast progress and unfair distribution of the gains in child health care. Despite Ethiopia’s achievement in meeting MDG4, wealth-related mortality inequality increased by 1.5 for every 1,000 live births between 2000 and 2011. Two major dividing lines contribute to child health inequality in Ethiopia: place of residence and wealth status. Lack of proper studies on health inequality policy making is affecting the comprehensiveness and quality of inequality reduction in Ethiopia. This study wished to assess child health inequality and policy factors that affect progress in inequality reduction. Accordingly, the study explored policy-makers’ attitude and interest; policy contents, and institutions to make recommendations that promote child health equity in Ethiopia. The research is mainly a qualitative policy research. Conducted between 2013 and 2017, it was design based on health policy researching and health inequality theories. The researcher conducted semi-structured interviews among health policy makers; policy analysis; and a review of the literature. Twenty policy-makers, 15 policy documents, over 350 literatures were selected through purposing and theoretical open sampling methods. Data was synthesised and analysed with ATLAS.ti 7.1.4 through applying the tools of critical interpretive synthesis and ground theory. The study found that Ethiopia is in an early state of recognizing and intervening against health inequalities. The quality and level of knowledge is mixed and gets reduced as one goes far from the centre. Consensus is still growing on the major underlying causes of child health inequalities in Ethiopia. Most of the policy makers focus on down-stream factors than broader determinants of health. Wealth inequality is less discussed and intervened than geographical inequalities. The production of a new Plan of Action can helped to resolve the challenges of lack of detailed approaches that can help reduce the gap in Ethiopia. However, the content of the health policy documents is not comprehensive and based on global lessons. Policy makers from the central government in Ethiopia tend to reject the use of redistribute justice intervention as policy options. There were multiple reasons including: fear of sustainability, ethics and effectiveness were used to reject these interventions. However, leaders from DRS and DPs broadly support the proper adaption of these interventions. The recent surge of interest to address health inequalities is mainly led by small groups from the top leaders. The engagement of the middle level leaders, Developing Regional States (DRSs), civil society and development partners has been limited. The relation between different institutes is very important in the Ethiopian federal state to reduce inequality. Without an improved level of awareness; change in attitude; broader engagement of citizens; use of independent data source and review of resource distribution Ethiopia’s progress towards Universal Health Coverage in 2030 could get delayed. Finally, this research provided a list of recommend interventions that Ethiopia might take in its plan, to narrow down health inequalities among children by 2030.
Health Studies
D. Litt. et Phil. (Health Studies)

Text in English
South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care.
Sociology
M.A. (Sociology)

Text in English
South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care.
Sociology
M.A. (Sociology)

In the wake of the HIV/AIDS pandemic, welfare organisations in Vryheid situated in northern KwaZulu-Natal have noted dramatic increases in requests for foster care placements for orphaned children. In many instances, orphans have lived by private arrangement with extended families for several years. However, families are increasingly overwhelmed with the burden of overextending scarce resources, forcing them to seek welfare assistance. Community-based responses to the crisis are regarded as top priority. This study examines literature regarding child care alternatives for orphans, focussing on foster care as the primary option. A study was conducted which explored community perceptions towards the local orphan crisis and foster care in particular. Findings revealed that although the adage 'Blood is thicker than water' still applies, foster care cannot stand alone. Alternate forms of care-giving need to be found to avoid plunging orphan care into further crisis.
Social work
M.A.(Social Science (Mental Health))

The focus of this dissertation is on exploring the needs of and services provided to orphaned and vulnerable children (OVCs) in Richmond, KwaZulu-Natal. This research is based on the findings from in-depth face-to-face interviews, and the focus group discussion conducted with key informants and primary caregivers of OVCs, respectively. The findings underline that although the needs of OVCs are similar to those of all other children, OVCs face unique challenges. It further shows that the government of South Africa has been responsive in developing relevant legislation, policies, and programmes that attempt to address the needs of OVCs. The findings also revealed that the services provided are coordinated, to a limited extent, through the Flagship Project led by the office of the Premier and. that coordination and integration of activities rendered by various stakeholders is crucial to a positive impact, and in increasing the accessibility of these services.
Social Work
M.A. (Social Behaviour Studies in HIV/AIDS)