Tesis: "Evaluation of child care services"

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Li, Jun. "The use of child health computing systems in primary preventive care : an evaluation." Thesis, University College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274686.

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Kelleher, Killarney, University of Western Sydney, and Faculty of Health. "Evaluation of the Cottage Community Care Pilot Project." THESIS_FH_XXX_Kelleher_K.xml, 1999. http://handle.uws.edu.au:8081/1959.7/743.

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The outcomes of a child protection/family support programme, the Cottage Community Care Pilot Project, were evaluated in this study. The evaluation employed a non-equivalent comparison group design of 'at risk' consenting first-time mothers in the perinatal period with babies up to 6 weeks of age. Ninety-three families were recruited and 58 of these were matched with a trained volunteer home visitor. Analysis of assessment items and questionnaires, reviews of hospital records and the Department of Community Services Child abuse and neglect notification register and focus groups with mothers and volunteers provided the information used in this study. The CCCP had an impact on particular aspects of family function, certain infant and maternal health indices and the families' use of community services, but its contribution to reducing the incidence of child abuse and neglect is less clear. Client and volunteer feedback indicated support for the programme. While home visitation by trained volunteers is not proposed as the total answer for effective child protection or family support, the findings of this evaluation suggest that there is a place for similar programmes. Master of Science (Hons)

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3

Elliott, Roslyn, University of Western Sydney, of Arts Education and Social Sciences College, and School of Education and Early Childhood Studies. "The book is open but you can't turn the page: parents' perceptions of early childhood service quality." THESIS_CAESS_EEC_Elliot_R.xml, 2003. http://handle.uws.edu.au:8081/1959.7/800.

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This research examines parents’ perceptions of quality on early childhood services as they support families in the care and education of children. Data were collected from parents of under school-aged children using interviews, questionnaires and focus groups. Data analysis has enabled a determination of: the link between parents’ perceptions of quality and early childhood professionals’ views as expressed in the literature; parents’ satisfaction with services and the evaluation processes used by them; opportunities available to parents to engage with service staff to influence the quality of the services provided; and parents’ knowledge and use of the information services provided by the National Childcare Accreditation Council to assist them in their decision making regarding early childhood services. Results showed that communication between parents and staff is problematic. An accretion model of communication is developed to enhance the quality of early childhood services by promoting shared understanding and values between parents and staff, enabling parents to take part in decision making and minimising perceptions of threat to staff’s professional integrity University of Western Sydney

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4

Davis, David C. (David Carlton). "Four Types of Day Care and their Effects on the Well-Being of Children." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279199/.

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Data gathered from Tyler, Texas, the University of North Texas, and the National Survey of Families and Households (NSFH) were used to compare children from commercial, home, church, and university based day care with children not attending day care. The research group, comprised of children attending day care (N=142), were located using non-probability sampling; those not in day care (the control group) came from the NSFH (N=1775). Data from the research group were weighted to match the control group. The independent and control variables included the child's age, length of time in day care, intellectual functioning; the parent's marital status and social class; the day care's staff to child ratio and the staff's training. All data, except that pertaining to the facility itself, were gathered from the children's parents using a self-report questionnaire. The remaining data were gathered through personal interview by the researcher. The dependent variable was an index of emotional and behavioral problems reported for the child. Overall, children who attended day care had only slightly more problems reported than those who did had not attended day care. When each center was examined separately, the children in home centers had the greatest number of problems, followed by the commercial centers and university center, with children from the church centers scoring the lowest. In contrast to earlier research, intellectual functioning was not enhanced by the day care experience. While the staff's training had a statistically significant relationship to the children's well-being, no relationship was found for the staff to child ratio. Further research on the impact of other characteristics of each type of day care is recommended.

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Menzies, Peter, and de Sande Adje van. ""A formative evaluation of the Customary Care Program: Native Child and Family Services of Toronto"." School of Native Human Services, 2003. http://142.51.24.159/dspace/handle/10219/432.

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Across Canada, the percentage of First Nations children in care of child welfare authorities is estimated to be six times that of the general population (Royal Commission on Aboriginal Peoples, Volume 3: Gathering Strength, 1996). Research into the impact of removing children from their homes due to child welfare issues has contributed to our understanding of the significant negative consequences on both the child and family (Bowlby, 1982; Johnson, 1983; Olsen, 1982). Further studies into the impact of government policies on Native people have clearly demonstrated that Native children face additional trauma; not only is the child removed from their home, they are removed from their community and culture (Andres, 1981; Bagley, 1985; Hudson, 1981; Johnston, 1983; Richard, 1989).

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6

Egan, Diana Ray, and Meri Lynn Vandom. "Kin caregivers' perceptions of social worker and agency services and support." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2783.

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Investigates kin caregiver's perceptions about social workers and child welfare agencies they worked with in caring for court dependent relative children who are/were placed in their care. A stratified random sample from 150 interviews of kin caregivers with dependent relative children maintained by San Bernardino and Riverside County Child Protective Services allowed for qualitative analysis of interview responses that related kin caregiver's perceptions of social workers and social service agencies. Results indicate that some relative caregivers were satisfied with the support they received from social workers/agency staff, while others did not feel supported at all.

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Kelleher, Larni. "Evaluation of the Cottage Community Care Pilot Project /." View thesis View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030519.145848/index.html.

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Thesis (M.Sc.) (Honours) -- University of Western Sydney, Macarthur, 1999. A thesis presented to the University of Western Sydney, Macarthur, in partial fulfillment of the requirements for the degree of Master of Science (Honours), March, 1999. Bibliography : leaves 117-125.

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8

Elliott, Roslyn. "The book is open but you can't turn the page: parents' perceptions of early childhood service quality." Thesis, View thesis, 2003. http://handle.uws.edu.au:8081/1959.7/800.

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This research examines parents’ perceptions of quality on early childhood services as they support families in the care and education of children. Data were collected from parents of under school-aged children using interviews, questionnaires and focus groups. Data analysis has enabled a determination of: the link between parents’ perceptions of quality and early childhood professionals’ views as expressed in the literature; parents’ satisfaction with services and the evaluation processes used by them; opportunities available to parents to engage with service staff to influence the quality of the services provided; and parents’ knowledge and use of the information services provided by the National Childcare Accreditation Council to assist them in their decision making regarding early childhood services. Results showed that communication between parents and staff is problematic. An accretion model of communication is developed to enhance the quality of early childhood services by promoting shared understanding and values between parents and staff, enabling parents to take part in decision making and minimising perceptions of threat to staff’s professional integrity

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9

Agere, Leonard Munyaradzi. "An evaluation of the role of child and youth care centres in the implementation of South Africa’s children’s act." Thesis, University of Fort Hare, 2014. http://hdl.handle.net/10353/d1015406.

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The aim of this study was to evaluate the role played by CYCCs to provide support and protection to children who have been found to be in need of care, according to the criteria given in the Children’s Act No. 38/2005 as amended. The study made use of a qualitative approach and the research design was provided by the case study. Data was gathered by means of semi-structured interviews and focus group discussions. The most important findings to emerge from the study were that the factors which affect the operation of CYCCs are either institutional, or else challenges arising from issues pertaining to infrastructure and human resources. However, it was also acknowledged that, despite the challenges which affect their ability to provide their services to young people, the CYCCs had also made progressive steps to halt the suppression of the fundamental rights of children. It has been recommended that the government should apply comprehensive funding to the objectives of the Children’s Act, which would entail increasing the subsidies to CYCCs. It has also been recommended that the Policy on Financial Rewards should call for the same benefits and salary scales to apply for professional staff working in the government and to those working in the CYCCs. The repercussions from failing to adjust to these recommendations will inevitably lead to the employment of a remedial model of care.

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Gurganus, Jill Renee. "An evaluation of educational literature distributed by the Child Health Investment Partnership." Thesis, Virginia Tech, 1993. http://hdl.handle.net/10919/46306.

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Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index. A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail. Master of Science

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Ezechukwu, Rebecca Nneoma. "Negotiating (Un)Heard Voices: Exploring A Fourth Generation Evaluation Approach to Examining the Wraparound Process." Oxford, Ohio : Miami University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1260316500.

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Werner, Jenni. "An evaluative study of a project to integrate children with disabilities into child care services in Western Australia." Thesis, Werner, Jenni (1988) An evaluative study of a project to integrate children with disabilities into child care services in Western Australia. Honours thesis, Murdoch University, 1988. https://researchrepository.murdoch.edu.au/id/eprint/51306/.

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This dissertation is about the implementation of the impact of the Disability Services Act on child care services and families seeking respite care for their children aged from infancy to six years. The legislation attempts to reform existing social patterns and their associated attitudes. Specifically this dissertation documents and analyses changing care methods for children with disability. It is a story of the change from the two earlier practices of isolating them within the confines of institutions or caring for them in the confines of the family home. Whereas the original institutionalising practice isolated the child, the modified practice of caring for them in the home with early intervention programmes in effect isolated the whole family and in particular the mother, thus preventing the parents as well as their children from leading a reasonably integrated normal life. Under these circumstances, many parents lost basic rights, such as the right to work and enjoy leisure. The increasing frequency of family breakdown and necessary institutions, the cost of associated services, particularly respite care, and the loss of opportunities and human dignity, initiated the search for alternative practices. The solution espoused was further integration, particularly through existing schools and child care facilities. Implementation of that change required legislation for the modification of existing attitudes, institutions and practices. It is these processes that are the subject of this dissertation. The dissertation examines the effectiveness of incentive programmes designed to enable the enrolment of more children with disabilities into child care services. Interviews, team teaching and an action research approach helped identify the expectations, changes and support required for the altered role for staff working with all children. A survey of 125 staff working in child care services was conducted to substantiate the case study findings. Overall, child care services are willing to integrate children with disabilities provided that there is additional qualified staff, regular in-service training and access to specialised agency support. The dissertation concludes by identifying some trends which may influence future planning for policy development and integration procedures.

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Schaefer, Jay M. "Is "good" good enough? a small area variation analysis of disparity in expressed rates of access to and satisfaction with child and adolescent healthcare services in east Central Florida." Doctoral diss., University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4603.

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Further research specific to these phenomenon encompassing a clearer understanding of the type of care received and the individual's specific experiences with their healthcare providers was recommended, with ensuing research to better identify commonalities of interactions with specific area providers, local restrictions imposed by area insurance carriers, influences caused by language and/or cultural barriers, and the like as drivers in understanding the individual dynamics of satisfaction.; The purpose of this dissertation research was to explore indications of disparities within the east Central Florida child and adolescent healthcare services market. Structured as a follow-up study to work completed in 2005 under the direction of the Health Council of East Central Florida assessing parental perceptions of community child and adolescent healthcare services, this research extended that evaluation by aggregating participant responses at the county and small area zip code group levels, contextually testing the uniformity of responses in understanding parent perceptions of access to, and satisfaction with, community healthcare service offerings available for children and adolescents. Under a variety of methodologies significance in the responses concerning access to healthcare services were demonstrated between the counties studied. Statistical modeling, however, could not demonstrate the core demographic differences among these data. Data representing perceptions of satisfaction with the services received by children and adolescents were demonstrated at the small area zip code group level within Orange county. Primary effect assessment of the demographic variables representing these respondents yielded findings generally consistent with theoretical expectations of disparity but, notably, the correlation effects between a number of key independent variables demonstrated a mediation of the primary effects on overall perception of satisfaction. Specifically, it was demonstrated that the interaction of white race with possession of private healthcare insurance, and the interaction of greater levels of educational attainment with black race, caused a proportional reduction in the predicted satisfaction score of these survey respondent cohorts. ID: 029050697; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2010.; Includes bibliographical references (p. 117-123). Ph.D. Doctorate Health and Public Affairs Public Affairs

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Aluha, Roselidah Anyango. "Evaluation of the food service for adolescent boys in Mogale Child and Youth Care Centre in Gauteng, South Africa, 2012." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/43670.

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The study was carried out at the Mogale Child and Youth Care Centre (MCYCC) a privately run institution by Bosasa Operations in partnership with the Gauteng Provincial Departments of Social Development and Health and Social Welfare Department. The facility caters for boys in conflict with law aged 14–18 years, who have been legally placed in the facility as a place of safety by court order. It is expected that the findings and recommendations from this study will be useful in improving the food service standards for such institutions. At the time of this study there were 200 adolescents, 137 were awaiting trial, 55 on the diversion programmes and 8 were serving court sentence at the centre. The cross sectional study evaluated the food service offered at the MCYCC to establish the nutritional adequacy of the food served. Both qualitative and quantitative research methods were used to collect and analyse data. Out of the 200, 144 answered the customer satisfaction questionnaire and 167 took the BMI test. Observations were done in the kitchen to determine the compliance level to the food and safety regulations. The analytical results of the responses from the self-administered questionnaire on the customer service satisfaction generated by the SAS software revealed reliable results. The probability, (p-value) from the Chi-square (χ2) test showed that there was a significant difference in response the parameters tested including the overall satisfaction. Body Mass Index (BMI) calculations established different anthropometric patterns of which 1.3% adolescents were found to be obese, 28.2% were overweight, 57% had normal weight while 13.5% were found to be underweight. The Foodfinder 3 software used to evaluate the nutrient composition in a 2-week cycle menu revealed that in most cases both the macronutrients and micronutrients in the menus exceeded the recommended daily allowance (RDA) for the adolescent boys. Food safety and hygiene standards results showed that the unit is compliant with the required standards as it scored 86%; it was colour coded Silver and rated as very good. All the parameters evaluated scored above average percentage rating the customer satisfaction level for the services offered at the MCYCC are as good. Both underweight and overweight adolescents exist among the adolescents at the centre. The weights from the sample food plates exceeded the RDA of the adolescent boys. The centre’s compliance to health and safety regulations was rated as very good. The authorities in the Gauteng Provincial Departments of Social Development and Health and Social Welfare and Bosasa operation management should make use of this evident information to further improve the food service standards for other such institutions. Dissertation (MSc)--University of Pretoria, 2014. gm2015 School of Health Systems and Public Health (SHSPH) MSc Unrestricted

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Ramonyai, Mothekoa Gratitude. "Evaluating the best interest of a child as a factor influencing the sentencing of the primary caregiver." Thesis, University of Limpopo, 2019. http://hdl.handle.net/10386/3144.

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Thesis (LLM.) -- University of Limpopo, 2019 This mini-dissertation seeks to evaluate the best interests of the child as a separate factor that influences the sentencing of a primary caregiver. When a parent is in conflict with the law, the child stands to be affected sentence that the court may impose on the caregiver. A custodial sentence has the potential of affecting the child’s right to parental care. Therefore, in the event where a custodial sentence is appropriate, alternative care of the child by other persons become a possible option. The author recommends that after applying the principles articulated in S v M and making use of a child impact report; the right of the child to parental care should carry more weight. Thus, courts should duly consider the best interest of the child as an independent factor when negative effects to the child are associated with the sentence. Where appropriate, with either a non-custodial sentence or adequate alternative care (in the case of imprisonment).

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Damasceno, Simone Soares. "Avaliação da orientação à atenção Primária à Saúde da Criança." Universidade Federal da Paraíba, 2014. http://tede.biblioteca.ufpb.br:8080/handle/tede/5146.

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Made available in DSpace on 2015-05-08T14:47:42Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 4451394 bytes, checksum: 931774754daf350a64611d3a30a270e8 (MD5) Previous issue date: 2014-02-28 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES The presence of attributes of the Primary Health Care qualifies the services of basic attention ensuring a higher effectiveness of the developed actions. The general objective was to evaluate the guidance degree related to the child´s Primary Health Care in the Family Health Strategy and the specific ones were to identify the presence and scope of Primary Care attributes concerning the child´s health; to verify the association between the user´s characteristics and the quality of child´s health care in the Family Health Strategy; and to analyze the effectiveness of the child´s health care by means of the association among the Primary Care attributes. It is an evaluative and cross-sectional study of quantitative approach. A total of 344 children´s family members in Family Health Units took part in the research. Data collection occurred from October 2012 to January 2013 by using the Primary Care Evaluation Tool, child´s version, and a tool structured for collecting the families´ socio-demographic data. Data were analyzed in the light of descriptive statistics, distribution of absolute/relative frequencies, calculation of average and construction of scores for the measured attributes, following the guidance contained in the tool´s manual issued by the Health Ministry. In order to analyze the association among the variables, univariate statistical tests and the adaptation of a logistic regression model were used. The study followed the guidelines of the Resolution number 466/12 of the National Council of Health, and obtained favorable opinion of the Research Ethics Committee number 044/2012 and CAAE number 01295412.2.1001.0107. High scores for the access attribute were verified in their procedural component, use and longitudinality which highlight that the service is reference for infantile care and it has been used as regular source of care. Longitudinality is favored by the existence of a suitable information system, procedural component of the coordination. Nevertheless, it was observed commitment of the structural dimension of access accessibility, of the integrality attribute in both evaluated dimensions available and offered services, which consequently resulted in the low family and community guidance. From the user´s characteristics associated to the satisfactory evaluation of the service, the affiliation degree was highlighted which was presented as possibility for a better evaluation of the Family Health Strategy. Probably, the bond is the factor related to the satisfactory evaluation once it provides favorable conditions for the offer of measured attributes. This result emphasizes the importance of the bond for the quality of primary care services in the child´s health. It can be concluded that the Family Health Strategy still is not directed to the child´s Primary Health Care in the investigated context, but it focuses on attaining satisfactory levels for the evaluated attributes, highlighting the need for improving aspects of the service process and structure, especially related to the access accessibility and integrality attributes, in addition to the attributes derived from family and community guidance with the purpose of qualifying the developed actions. A presença dos atributos da Atenção Primária à Saúde qualificam os serviços de atenção básica garantindo maior efetividade das ações desenvolvidas. O objetivo geral foi avaliar o grau de orientação à Atenção Primária à Saúde da criança na Estratégia Saúde da Família e os específicos identificar a presença e a extensão dos atributos da Atenção Primária relacionados à saúde da criança; verificar a associação entre características do usuário e a qualidade da atenção em saúde da criança na Estratégia Saúde da Família; e analisar a efetividade do cuidado à saúde da criança por meio da associação entre os atributos da Atenção Primária. Estudo avaliativo, transversal de abordagem quantitativa. Participaram 344 familiares de crianças em Unidades de Saúde da Família. A coleta de dados ocorreu no período de outubro de 2012 a janeiro de 2013 utilizando-se o Instrumento de Avaliação da Atenção Primária versão criança e um instrumento estruturado para coleta dos dados sociodemográficos das famílias. Os dados foram analisados a luz da estatística descritiva, distribuição de frequências absolutas/relativas, cálculo de médias e construção dos escores para os atributos mensurados, seguindo as orientações contidas no manual do instrumento divulgado pelo Ministério da Saúde. No intuito de analisar a associação entre variáveis foram empregados testes estatísticos univariados e adaptação de um modelo de regressão logística. O estudo seguiu as orientações da Resolução nº 466/12 do Conselho Nacional de Saúde, obteve parecer favorável do Comitê de ética em Pesquisa nº 044/2012 e CAAE nº 01295412.2.1001.0107. Verificou-se escores elevados para os atributos acesso em seu componente processual, utilização e longitudinalidade, os quais evidenciam que o serviço é referência para o atendimento infantil e vem sendo utilizado como fonte regular de atenção. A longitudinalidade é favorecida pela existência de um sistema de informação adequado, componente estrutural da coordenação. No entanto, observou-se comprometimento da dimensão estrutural do acesso-acessibilidade, do atributo integralidade em ambas as dimensões avaliadas - serviços disponíveis e serviços prestados, consequentemente resultaram a baixa orientação familiar e comunitária. Das características do usuário associadas à avaliação satisfatória do serviço sobressaiu-se o grau de afiliação, o qual se apresentou como possibilidade para uma melhor avaliação da Estratégia Saúde da Família. Registra-se que, provavelmente o vínculo é o fator relacionado à avaliação satisfatória, pois fornece condições favoráveis à oferta dos atributos mensurados. Esse resultado reforça a importância do vínculo para qualidade dos serviços de atenção primária na saúde da criança. Conclui-se que a Estratégia Saúde da Família ainda não está orientada à Atenção Primária à Saúde da criança no contexto investigado, mas caminha na direção de alcançar patamares satisfatórios para os atributos avaliados, destacando-se a necessidade de melhorar aspectos de estrutura e processo do serviço, especialmente relacionados aos atributos acesso-acessibilidade e integralidade, além dos atributos derivados orientação familiar e comunitária, no sentido de qualificar as ações desenvolvidas.

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Mokitimi, Stella. "Child and adolescent mental health services in the Western Cape of South Africa: policy evaluation, situational analysis, stakeholder perspectives, and implications for health policy implementation." Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33866.

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In spite of the need for child and adolescent mental health (CAMH) services across the globe, very little has been done to develop and strengthen CAMH in low- and middle-income countries (LMIC). South Africa is an example of an LMIC where CAMH services have been very limited as a result of various potential factors, including the legacy of apartheid, stigma associated with mental health, and lack of priority of CAMH. In this thesis, we set out to generate an evidence-base about CAMH services in one South African province to inform service strengthening across the full healthcare system through policy development and implementation. We proposed that a comprehensive understanding of specific services requires a multilevel exploration of ‘hardware' (structural) and ‘software' (social) elements in the health systems that support these services. We started by reviewing the CAMH policy landscape with an analysis of the current state of policy development and implementation at national and provincial levels in all nine provinces of South Africa. Using the Walt and Gilson policy analysis triangle (1994), we examined the content, context, processes and actors involved in mental health or CAMH-specific policies. We then evaluated the hardware and software elements of CAMHS in the Western Cape Province by performing a situational analysis using the WHO-AIMS version 2.2 of 2005 (Brief version) adapted for the South African context and to CAMHS. We proceeded to seek the perspectives of stakeholders within the province – firstly a SWOT analysis with senior stakeholders, and secondly, qualitative analysis of the perspectives of grassroots service providers, and of parents/caregivers and adolescent service users. We collected information from these stakeholder groups through a stakeholder engagement workshop, focus group discussions and semi-structured individual interviews. Using the World Health Organization (WHO) (2007) and Gilson (2012) health systems frameworks, we reviewed both the hardware and the software elements of CAMH services and concluded with a synthesis of findings to provide a set of recommendations for policy development and service strengthening based on the evidence generated. In terms of service delivery, findings showed that child and adolescent mental health services (CAMHS) in the Western Cape were provided at all levels of care (primary, secondary and tertiary) and, at least at inpatient and outpatient level, based on catchment/geographical service areas. However, CAMHS were still limited and were provided under very resource-constrained conditions by inadequately trained service providers. In terms of the health workforce, CAMHS were provided by a range of professionals including child & adolescent psychiatrists, general psychiatrists, medical officers, clinical psychologists, social workers, mental health nurses, occupational therapists, and speech and language therapists. However, multidisciplinary expertise and psychosocial interventions were only available in specialist CAMHS at tertiary level of care. In addition, the specialist services were all based in the City of Cape Town, with no direct access to specialist CAMHS at secondary levels of care or in any of the rural districts of the province. Health information systems were not fit-for-purposes to generate disaggregated data on under-18-yearolds, thus made it extremely difficult to provide a comprehensive view of CAMHS in the province. In terms of access to essential medicines, basic classes of psychiatric medications were available at all levels of care, but not consistently so. An exploration of financing showed that no ring-fenced or disaggregated budgets were available for CAMHS, thus making it impossible to comment on the appropriateness of funding for the mental health needs of children and adolescents. In terms of leadership and governance, a national CAMH policy existed, but no implementation plans had been developed since the publication of the CAMH policy in 2003. Our findings highlighted a lack of dedicated CAMH leadership and governance in the province. We argued that the absence of a clear CAMH leadership structure also explained why provincial plans and strategies had not been developed and implemented over the last two decades. A very consistent finding from our data was a need for a dedicated provincial lead for CAMH. We concluded the thesis with hardware and software recommendations for policy implementation, service development, training and research.

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Žiaunienė, Elika. "Tėvų, auginančių vaikus su negalia, sveikatos priežiūros įstaigų teikiamų paslaugų vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_142836-85213.

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Magistro darbe pristatomo tyrimo tikslas yra atskleisti, kaip tėvai, auginantys vaikus su negalia, konstruoja sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą. Keliamas mokslinis klausimas: Kaip tėvai, auginantys vaikus su negalia, konstruoja sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą? Tokiam tikslui pasiekti buvo pasirinktas kokybinis tyrimas. Tyrimui duomenys buvo surinkti 2014 metų vasario – kovo mėnesiais vienoje vaikų sveikatos priežiūros įstaigoje giluminio nestruktūruoto interviu metodu. Interviu dalyvavo 8 tyrimo dalyviai, kurie tyrimui buvo pasirinkti pagal kriterinę atranką. Duomenys buvo analizuojami pasitelkiant grindžiamąją teoriją. Teorinė koncepcija - socialinio konstruktyvizmo teorija. Ašinio kodavimo metu sujungiant atviro kodavimo metu išskirtas kategorijas suformuotos dvi didžiosios tyrimo kategorijos – fenomenai: Negalios pasitvirtinimas “Iš pradžių net nepatikėjome“ ir Vaiko su negalia sveikatinimas „Laviruoti tuose (sveikatos paslaugų) labirintuose“. Atrankiniame kodavime buvo pasirinkta ir aprašoma „šerdinė“ kategorija „Mus prisimena ir supranta“. Visos kategorijos vadovaujasi Strauss ir Corbin (1990) paradigminio modelio logika, kuriame išskiriamos fenomeno priežastys, kontekstas, įsiterpiančios sąlygos, veiksmų strategijos bei to pasekmės. Tyrimo rezultatai atskleidė, kad pagrindinės priežastys, kurios konstruoja tėvų, auginančių vaikus su negalia, sveikatos priežiūros įstaigų teikiamų paslaugų vertinimą yra aktualios... [toliau žr. visą tekstą] The objective of research of the master thesis is to reveal how parents, raising children with disabilities, construct evaluation of services of health care institutions. Raised scientific question: How parents, raising children with disabilities, construct evaluation of services provided by health care institutions? Qualitative research was selected for implementation of the objective. Data for the research was collected in February – March 2014 in selected children’s health care institution by the method of in-depthunstructured interviews. Eight research subjects participated in the interviews. They were selected for the interview according to targeted selection. The data was analyzed using grounded theory and based on theoretic concept of social constructivism theory. During axial coding, while connecting categories distinguished during open coding, two main research categories – phenomenon – were identified: Approval of disability “We didn’t even believe in the beginning” and Health rehabilitation of the child with disability “Trimming in these (health care services’) labyrinths”. “Core” category “We are remembered and understood” was selected and described in selective coding. All categories are based on logic of Strauss and Corbin (1990) paradigm model where reasons of the phenomenon, context, interfering conditions, strategies of actions and their consequences are defined. Results of the research reveal that the main reasons that construct evaluation of services... [to full text]

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Oliveira, Vanessa Bertoglio Comassetto Antunes de. "Avaliação da atenção primária à saúde da criança no município de Colombo - Paraná." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-22022013-125217/.

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O presente estudo enquadra-se no campo cuidados em saúde e sua temática refere-se à avaliação do serviço de saúde da criança na rede básica do município de Colombo Paraná. Constitui-se seu objeto o desempenho das Unidades Básicas de Saúde (UBS) e das Unidades de Estratégia Saúde da Família (USF) do município. Os objetivos foram: avaliar a presença e a extensão dos atributos essenciais e derivados relativos à Atenção Primária à Saúde (APS) no cuidado prestado na atenção primária às crianças, sob a ótica das suas famílias, e comparar o desempenho das UBS e USF quanto a esses atributos. Os sujeitos da pesquisa foram responsáveis por crianças de 17 a 22 meses cadastradas e assíduas às atividades das unidades de saúde do município, numa amostra aleatória total de 482 pessoas, sendo 247 das Unidades Básicas e 235 das Unidades de ESF. A coleta de dados foi feita em domicílio e o instrumento utilizado foi o Primary Care Assessment Tool (PCATool) versão criança, já validado em 2008 e utilizado como referência pelo Ministério da Saúde do Brasil. As entrevistas aconteceram entre junho e julho de 2012. As análises, com auxílio do software Statistica 10.1, incluíram o teste t de student para comparação de variáveis quantitativas e o teste qui-quadrado para variáveis qualitativas; para verificação da consistência interna dos itens do instrumento foi obtido o Alfa de Crombach para cada um dos atributos e para o instrumento total. Um estudo piloto foi realizado para garantir a eficácia do instrumento e da entrevista. O estudo seguiu a Resolução 196/96 do Conselho Nacional de Ética em Pesquisa. A pesquisa revelou que as Unidades de ESF obtiveram escores superiores ao mínimo exigido em Afiliação, Coordenação, Integralidade, Orientação Familiar e Acessibilidade, metade dos 10 atributos estudados, indicando que os responsáveis das crianças atendidas nessas unidades referem ter mais frequentemente acesso à utilização dos serviços de saúde, utilizam com mais frequência a unidade de saúde como porta de entrada para o sistema de saúde, estabelecem com maior constância um atendimento integrado entre os serviços e referem reconhecer a valorização dos profissionais quanto ao vínculo com a família. No que tange às UBS, todos os escores ficaram abaixo do ideal para a APS, apontando que essas unidades apresentam maior dificuldade em vincular seus usuários e reconhecê-los como parte de uma comunidade. Observou-se que os trabalhos de avaliação desempenham um papel fundamental no aprimoramento dos eixos de intervenção com o propósito de aderir ao foco do Ministério da Saúde em transformar os serviços de saúde em Atenção Primária. No município em questão, concluiu-se que as unidades de ESF estão mais próximas das diretrizes da APS do que as UBS, entretanto há a necessidade de rever as ações vinculadas à assistência à criança a fim de alcançar consonância com os atributos da APS em ambas as unidades. This study is placed in the health caring field and its thematic refers to the evaluation of childs health care in the city of Colombo Paraná. Its object of study is the performance of Basic Health Units (UBS) and the Strategy Units of Family Health (USF). The study aims: to evaluate both the presence and extention of the essential attributes and derivates relative to the APS regarding the care given at the primary care of the children at their family perspective, and to compare the UBS and USF attributes performance. This research subjects were responsible for 17-22 month-old children, registered and assiduous to the city health units activities, in a random sample of 482 people: 247 from the Basic Units and 235 from the ESF units. Data was collected at their houses and the Primary Care Assessment Tool (PCATool), childrens version, was used. PCATool was validated in 2008 and used by the Brazilian Health Ministry as reference. Interviews were held between June and July 2012. The samples, using the software Statistica 10.1, included the t student test to compare the quantitative variants and the qui-square test, for qualitative variants; Crombachs Alfa was obtained in order to verify the intern consistency of instrument items for each one of the attributes and total instrument. A pilot study has been performed as to guarantee both the instrument and interview efficacy. This study followed Resolution 196-96 from Research Ethics National Council. The research revealed that the ESF units obtained scores higher than the minimum required in Affiliation, Coordination, Integrality, Familiar Orientation and Accessibility, half the studied attributes, indicating that the ones responsible for the children who attend those units refer to having more frequent access to health services, use more often the health unit as an entrance door to the health system, establish more constantly an integrated service and recognize the professional valorization regarding the bond with the family. Regarding the UBS, all the scores were below ideal for the APS, indicating that those units seem to struggle to bond with its users and recognizing them as part of a community. It has been observed that assessment works play a fundamental role in perfecting the intervention axis aiming at joining the Health Ministry focus, which is to transform health services into Primary Care. In that city it has been concluded that the ESF units are closer to APS directress than UBS, however it is necessary to revise the child assistance related actions in order to reach consonance with the APS attributes at both units.

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Sanine, Patricia Rodrigues. "Dos diferentes significados sociais do “ser criança” aos contextos gerenciais na organização da atenção à saúde da criança em serviços de atenção primária." Botucatu, 2018. http://hdl.handle.net/11449/153224.

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Orientador: Elen Rose Lodeiro Castanheira Resumo: A atenção à saúde da criança está entre as ações mais tradicionais e bem estruturadas na Atenção Primária à Saúde (APS) no Brasil, entretanto deve-se reconhecer que as relações entre as necessidades sociais de saúde desse grupo e as práticas a ele dirigidas foram construídas de diferentes maneiras ao longo da história. O reconhecimento desse processo mostra-se importante para identificar quais necessidades sociais de saúde estão sendo respondidas pelas práticas atuais. Apesar dos grandes avanços alcançados, como a redução das taxas de mortalidade infantil, indicadores de atenção à saúde da criança apontam a necessidade de melhorias, como nas taxas de internações por causas evitáveis pela APS, no crescente número de afecções originadas no período perinatal e na atenção ao parto. Avaliar a qualidade da organização da atenção, a partir do projeto contemporâneo para a saúde desse segmento, permite julgar a base material do projeto social em execução pelas práticas. O presente trabalho tem por objetivos: reconhecer a construção histórica do significado social de “ser criança” no Brasil e avaliar a capacidade de resposta dos serviços de APS às necessidades sociais de saúde das crianças. Os estudos foram apresentados na forma de 3 artigos. Parte de um ensaio alicerçado em revisão bibliográfica e na análise de sua correlação com as práticas de saúde pública voltadas à criança, privilegiando-se as ações desenvolvidas na APS (Artigo 1). A avaliação da organização das ações de atenção à... (Resumo completo, clicar acesso eletrônico abaixo) Abstract: The child health care in Brazil is among the most traditional and well-structured actions in Primary Health Care (PHC). However, it must be acknowledged that the child's health needs and practices directed at children have been constructed differently. Recognition of this construction process is important in identifying what needs are being replicated by current practices. Indicators of child care show poor performance, as in the rates of hospitalizations for sensitive conditions by PHC and the increasing number of conditions originating in the perinatal period. Evaluating the quality of the organization of child health care today allows us to judge the material basis of the social project being implemented by the practices. The objective of the study is: to recognize the historical construction of the social meaning of being a child in Brazil; and to assess the responsiveness of PHC services to the health needs of children. Three articles were presented. The first is an essay based on a bibliographical review and the analysis of its correlation with the health practices/public of the child, with a focus on PHC actions (Article 1). Then, an evaluation of the organization of actions of children's health care in PHC services in the interior of the State of São Paulo/Brazil was carried out, using two cross-sectional evaluative surveys. The first one sought to identify changes in child health care in the years 2007/2010/2014. It evaluated 86 services from 32 municipalities that r... (Complete abstract click electronic access below) Doutor

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Meira, Denise Sayuri Maruo. "Analise das praticas de humanização do SUS = acompanhamento multidisciplinar em ambulatorio de follow up de bebes de risco - CRDI Fenix." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311692.

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Orientador: Regina Yu Shon Chun Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Made available in DSpace on 2018-08-15T06:43:28Z (GMT). No. of bitstreams: 1 Meira_DeniseSayuriMaruo_M.pdf: 2428503 bytes, checksum: 25cfeeea5c3265a70b9872f56f4588d4 (MD5) Previous issue date: 2010 Resumo: Introdução: O predomínio do componente neonatal sobre o pós-natal na mortalidade infantil, nas décadas de 1980 e 90 no Brasil, trouxe em evidência a elevada proporção de óbitos evitáveis e a importância da qualidade assistencial mãe-bebê. A especialização, o desenvolvimento de tecnologias, a valorização e capacitação de recursos humanos além do estabelecimento de políticas públicas de saúde voltadas à Atenção Materno-Infantil contribuíram para maior sobrevida de bebês com graves intercorrências perinatais. Tais fatos contribuíram para a criação de Ambulatórios de Follow Up, proporcionado por programas longitudinais como o Centro de Referência em Desenvolvimento Infantil Fênix - CRDI (Campinas, SP, Brasil). O serviço segue as diretrizes da Política Nacional de Humanização, buscando superar a fragmentação da rede e do processo de trabalho e recebeu reconhecimento do Ministério da Saúde em 2006, tendo sido inserido no Banco de Projetos do Humanizasus. O Programa Nacional Avaliação de Serviços de Saúde alerta sobre a importância de mecanismos de avaliação e de controle da qualidade assistencial bem como da opinião daqueles aos quais os serviços se destinam. Assim, este estudo volta-se à avaliação desse Programa por meio da análise de indicadores de avaliação do serviço e da perspectiva do cuidador. Objetivo: Avaliar a assistência do CRDI-FÊNIX por meio de (i) indicadores de oferta (capacidade de oferta do serviço), da demanda de encaminhamento e de chegada, de cobertura (proporção da população-alvo atingida pelo programa/intervenção), e de utilização (proporção de uso do serviço da população alvo) e (ii) entrada, acompanhamento multidisciplinar, qualidade e resolutividade da assistência e vínculo entre usuário/cuidador/equipe na opinião do cuidador. Sujeitos e métodos: Trata-se de pesquisa retrospectiva aprovada pelo Comitê de Ética e Pesquisa. Foi feito levantamento dos sujeitos que receberam alta de junho de 2005 a julho de 2006 para constituição do corpus e caracterização do perfil da população atendida. Resultados: Os prontuários caracterizaram os bebês quanto a: local de moradia, tempo médio de seguimento e profissionais envolvidos na assistência. A adesão foi de 53% dos sujeitos e demanda de encaminhamento da maternidade de referência de 28,77%. A demanda de chegada ao serviço foi de 83,22% e a capacidade de oferta estimada em 140 bebês/ano. Verifica-se que do total de nascimentos, 10,74% dos bebês foram encaminhados para cuidados intensivos e intermediários, sendo que 6,09% pertenciam ao Sistema Único de Saúde. Desses, chegaram ao serviço 1,60% por apresentarem risco para alteração no desenvolvimento neuropsicomotor. A utilização integral do serviço foi de 52,78% e a parcial, 47,22%. Os cuidadores indicam satisfação quanto a qualidade, resolutividade da assistência e a importância do acompanhamento multidisciplinar. Conclusão: Os achados mostram a eficácia dos indicadores estudados e reiteram a importância da escuta e do acolhimento ao usuário em uma perspectiva humanizada e integral, mostrando-se como ferramentas fundamentais para conhecimento e avaliação do serviço. A responsabilização dos diferentes sujeitos implicados no processo dessa rede de cuidados contribui para desburocratização da assistência e para maior autonomia dos atores envolvidos, exercendo-se a humanização, como proposta pelas políticas vigentes Abstract: Introduction: The prevalence of the neonatal component over the post-neonatal in infant mortality, in the decades of 1980 and 1990 in Brazil, showed the high proportion of avoidable deaths and the importance of the care quality mother-baby. The specialization, the development of technologies, the valuing and capacity of human resources in addition to the establishment of public health policies aiming the Mother-Child attention, contributed for a highest survival of babies with severe perinatal interferences. These facts contributed to the creation of High-risk Infant Follow-up Program , provided by longitudinal programs such as the Fenix Reference Center in Children Development - CRDI (Campinas, SP, Brazil). The service follows the guidelines from the National Policy of Humanization, aiming to overcome the system and work process fragmentation and was recognized by the Ministry of Health in 2006, being inserted in Humanizasus projects database. The National Program of Health Services Assessment warns about the importance of assessment tools and of assistential quality control such as the opinion of those at whom the service is aimed. Therefore, this study aims to evaluate this program through the analysis of the service assessment indicators and the caregiver perspective. Objective: To evaluate the assistance of CRDI-FENIX through (i) provision indicators (capacity of service provision), incoming and referral demand, coverage (proportion of target population that is assisted by the program/intervention) and use (proportion of the service use by target population) and (ii) incoming, multidisciplinary assistance, quality assistence, solving assistance and attachment between the user/caregiver/staff according to the caregiver opinion. Subjects and methods: This is a retrospective research approved by Research Ethics Committee. A survey was done on subjects that received medical discharge during the period of June 2005 to July 2006, composing the corpus and the population characterization. For the analysis of the target population that was assisted by the program, it were used data from July 2007 to June 2008, since the reference maternity did not have the data from 2005 and 2006. Results: The subject records categorized the babies according to: the place of their residences, average period of assistance, and professional involved in assistance. The adherence was of 53% and referral demand from the reference maternity was 28.77%. The incoming demand to the service was 83.22% and the offer capacity estimated of 140 babies per year. The results showed that from the total of the new bourns, 10,74% need intensive care, from that 6,09% are dependent from the Brazilian Unified Health System (SUS) and 1.6% arrived at the service. The integral use of the service was 52.78% and parcial 47.22%. The caregivers showed satisfaction regarding the quality and solving of the assistance, and the importance of the multidisciplinary assistance. Conclusion: The findings revealed the efficiency of the indicators studied and reiterate the importance of the user's listening and embracement according to a humanized and integral perspective, considered as important tools to know and evaluate the service. The responsibility of the different subjects involved in the process of this care network contributes for the disbureaucracy of the assistance and for a greater independence of the people involved, considering the humanization as a proposal from the current politics Mestrado Saude, Interdisciplinaridade e Reabilitação Mestre em Saúde, Interdisciplinaridade e Reabilitação

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Loveday, Marian Patricia. "An evaluation of the SACLA Rehabilitation Worker project in Cape Town, South Africa, 1992-1993." Master's thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/27156.

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This dissertation reports on an evaluation of the home visiting programme of the SACLA Rehabilitation Worker project against the background of the socio-economic context of the community and the history of the project. The evaluation had two aims. Firstly, it aimed to highlight the programme's strengths and weaknesses so that the work could become both more efficient and more effective. Secondly, it aimed to establish whether the SACLA rehabilitation project is an effective model of a community based rehabilitation project on which other local projects could be based. Quantitative data was collected by interviewing the caregivers of disabled children who were involved in the project. In-depth interviews with the rehabilitation workers provided qualitative data which was used to confirm the validity of some of the quantitative data. The foremost findings were that the mothers were very positive about the support received from the RWs. The majority of the caregivers remembered the activities that they had been taught by the RWs and performed them well. Poor communication with the caregivers and a lack of skills on the part of the RWs gave rise to a number of problems. A number of changes highlighted by the evaluation were suggested. In conclusion, the project was found to be an effective model of local community based rehabilitation on which other projects could be based.

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Aguilar, Myriam Renee, and Amanda Nicole Robles. "Cultural competence needs of non-Latino foster parents: A study of transcultural foster care with Latino children." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2728.

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Souza, Sineide Santos de. "Avaliação dos atributos essenciais da Atenção Básica em Saúde da Criança: estudo de caso no Distrito de Saúde Norte da cidade de Manaus/AM." Universidade Federal do Amazonas - Fundação Oswaldo Cruz, 2016. http://tede.ufam.edu.br/handle/tede/5573.

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No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação - Sineide S. Souza.pdf: 3041205 bytes, checksum: 3c989c8f882d3d4d3b91e6f57cd8594d (MD5) Previous issue date: 2016-09-16 The Primary Health Care (APS) has been strengthened after the International Conference of Alma-Ata. Brazil has chosen the Family Health Strategy (FHS) to operationalize the PHC, as ordering the care model based on the principles of the Unified Health System (UHS). The APS has attributes which, being applied, favoring the quality of care, especially for children. This study aimed to evaluate the essential attributes of APS in health care for children offered by the FHS teams in the north of Manaus and identify the factors associated with essential score through the PCATool. This is an evaluative study and we used two instruments for data collection: a questionnaire on socioeconomic characteristics and the Primary Care Assessment Tool (PCATool) Brazil Child version. The study included 320 mothers of children under two years living and registered in the areas of coverage of the FHS teams. The analysis followed the recommendations of PCATool-Brazil Guide. As for the essential attributes of APS, showed satisfactory scores (≤ 6.6) only attributes Access - Use (6.7) and Coordination - Information System (8.7); the other attributes presented low scores: Access - Accessibility (5.0), Longitudinality (6.5), Coordination - Integration of Care (6.5), Comprehensiveness - Services Available (5.5) and Services (6.1). The Essential attribute score of APS was unsatisfactory (6.5) and shows that APS must move towards providing effective access and comprehensive care for children. The component degree of affiliation showed an average 6.7. Statistically significant between Essential score of APS and socioeconomic associations were identified, meaning that the outcome of Essential score can be attributed only to the health service offered. The α Cronbach presented value >0.75, reinforcing the validity of the instrument. The study revealed that the health care of children under two years in the FHS is not guided by APS and presents less effective, with problems related to access, difficulties in creating bond with the child/family, persistent fragmentation of care and coordination of care deficient. There is need for reorientation of health actions, in order to modify and improve the quality of care provided to the child population, which because of their vulnerability, makes up one of the priority areas in the country. A Atenção Primária à Saúde (APS) vem sendo fortalecida após a Conferência Internacional de Alma-Ata. O Brasil escolheu a Estratégia Saúde da Família (ESF) para operacionalizar a APS, como ordenadora do modelo assistencial, baseada nos princípios do Sistema Único de Saúde (SUS). A APS possui atributos, os quais, sendo aplicados, favorecem a qualidade da atenção, especialmente para crianças. Este estudo objetivou avaliar os atributos essenciais da APS na assistência à saúde da criança ofertada pelas equipes da ESF na zona Norte de Manaus e identificar os fatores associados ao escore essencial, por meio do PCATool. Trata-se de uma pesquisa avaliativa com a utilização de dois instrumentos para coleta de dados: um questionário características socioeconômicas e o Instrumento de Avaliação da Atenção Primária – PCATool Brasil versão Criança. Participaram do estudo 320 mães de crianças menores de dois anos residentes e cadastradas nas áreas de abrangência das equipes da ESF. A analise obedeceu às recomendações do Manual PCATool-Brasil. Quanto aos atributos essenciais da APS, apresentaram escores satisfatórios (≤ 6,6) apenas os atributos Acesso – Utilização (6,7) e Coordenação – Sistema de Informação (8,7); os demais atributos apresentaram baixos escores: Acesso – Acessibilidade (5,0), Longitudinalidade (6,5), Coordenação – Integração de Cuidados (6,5), Integralidade – Serviços Disponíveis (5,5) e Serviços Prestados (6,1). O escore do atributo Essencial da APS foi insatisfatório (6,5), o que evidencia que a APS precisa avançar no sentido de oferecer acesso efetivo e cuidado integral à criança. O componente grau de afiliação apresentou média 6,7. Não foram identificadas associações estatisticamente significativas entre escore Essencial da APS e condições socioeconômicas, significando que o resultado do escore Essencial pode ser atribuído somente ao serviço de saúde oferecido. O α de Cronbach apresentou valor > 0,75 e comprovou a validade do instrumento. O estudo revelou que a assistência à saúde da criança menor de dois anos na ESF não está orientada pela APS e se apresenta pouco efetiva, com problemas relacionados ao acesso, dificuldades na criação de vínculo com a criança/família, persistência da fragmentação do cuidado e coordenação da atenção deficiente. Há necessidade de reorientação das ações de saúde, com vista a modificar e melhorar a qualidade da atenção oferecida à população infantil, que devido à sua vulnerabilidade, compõe uma das áreas prioritárias no país.

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Lebihan, Laëtitia. "Trois essais économétriques sur le développement et le bien-être des enfants canadiens." Thesis, La Réunion, 2014. http://www.theses.fr/2014LARE0010/document.

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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)

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Linder, Laura A. Butterfield. "The ideology of care explaining the politics of child care in the United States, France, and Israel /." Click here for download, 2008. http://proquest.umi.com/pqdweb?did=1633770391&sid=1&Fmt=2&clientId=3260&RQT=309&VName=PQD.

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McKee, Julie. "Corporate initiatives in providing child care services." Virtual Press, 1985. http://liblink.bsu.edu/uhtbin/catkey/421945.

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This thesis explores the initiatives possible for corporations interested in providing child care services to their employees. It also attempts to explain why corporations are becoming increasingly interested in providing this benefit to employees.A needs assessment survey was designed to discover the child care related needs of employees and to determine how child care responsibilities impact the work environment. An exploratory study was conducted of a sample of employees (N=127) at General Telephone in Fort Wayne, Indiana.Most employees, parents and non-parents, in this sample believed that child care responsibilities adversely affected productivity within their company. They also felt that company-sponsored child care assistance could improve productivity. Using the chi-square test of significance, child care responsibilities were significantly related to increased rates of absenteeism, work interruptions and turnover. There was substantial interest among employees in a corporate sponsored child care center and/or financial assistance to reduce the cost of child care expenses.

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Coonce, Donna J. "Empowering parents in their child care decisions /." View online, 1997. http://repository.eiu.edu/theses/docs/32211998827285.pdf.

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Al-Ali, Ibrahim Jassim. "Child care policy and fostering in Kuwait." Thesis, Cardiff University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.238135.

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Martinelli, Katrini Guidolini. "Avaliação da assistência pré-natal na microrregião de São Mateus-ES." Universidade Federal do Espírito Santo, 2013. http://repositorio.ufes.br/handle/10/5683.

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Made available in DSpace on 2016-12-23T13:46:58Z (GMT). No. of bitstreams: 1 Katrini Guidolini Martinelli.pdf: 2375909 bytes, checksum: 291c73d644bca5e04e659c2dab99219b (MD5) Previous issue date: 2013-07-10 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior O pré-natal é um dos fatores que contribui para a persistência de desfechos perinatais negativos e morte materna em níveis elevados. Sendo assim, a avaliação do acesso e do processo da assistência pré-natal é de suma importância na detecção dos nós que persistem no serviço oferecido. Os objetivos deste estudo são os de avaliar a adequação do processo da assistência pré-natal segundo os parâmetros do Programa de Humanização do Pré-natal e Nascimento acrescido dos procedimentos previstos pela Rede Cegonha, bem como o acesso à assistência pré-natal, segundo as dimensões de disponibilidade, capacidade de pagamento e aceitabilidade, no SUS da microrregião de São Mateus - ES. Trata-se de um estudo seccional que selecionou 742 puérperas em sete maternidades da região escolhida para a pesquisa. Os dados foram coletados por meio de entrevistas e análise do cartão da gestante e prontuário do recém-nascido. Posteriormente, esses dados foram processados e submetidos ao teste Qui-quadrado, ao teste exato de Fisher e ao teste não paramétrico de Spearman com p-valor menor que 5%. Apesar de o SUS garantir constitucionalmente o acesso universal ao sistema de saúde, nota-se que ainda existem iniquidades entre as puérperas no acesso aos serviços de saúde. Apenas 7,4% e 0,4% das puérperas receberam pré-natal adequado segundo os parâmetros do PHPN e Rede Cegonha, respectivamente. Recomenda-se que a localização das unidades de saúde, os recursos de transporte e o financiamento dos serviços de saúde sejam reorganizados, do mesmo modo o atendimento pré-natal precisa ser sistematizado, mais humano e focalizado na atenção as mulheres mais vulneráveis Prenatal care is one of the factors that contributes to the persistence of adverse perinatal outcomes and maternal death at high levels. Thus, the evaluation of access and the process of prenatal care is of high importance in the detection of the issues who remain in the offered service. The objectives of this study are to evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal and Birth plus procedures provided by Stork Network , as well as access to prenatal care, according to the dimensions of availability, acceptability and ability to pay, on the SUS of the region of São Mateus - ES. It is a cross-sectional study that selected 742 postpartum women in seven hospitals in the region chosen for the research. Data were collected through interviews and analysis of records from prenatal care and newborn records. Subsequently, these data were processed and subjected to chi-square test, the Fisher exact test and the nonparametric Spearman with p-value less than 5%. Although the SUS constitutionally guarantee universal access to health care, it is noted that there are still inequalities between pregnant women in accessing health services. Only 7.4% and 0.4% of the mothers received adequate prenatal care according to the parameters PHPN and Stork Network , respectively. It is recommended that the location of health facilities, transport resources and financing of health services are reorganized, the same way the prenatal care needs to be systematized, more humane and focused on attention to the most vulnerable women

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Salina, Alessandra. "O abrigo como fator de risco e proteção: indicadores e avaliação institucional." Universidade Federal de São Carlos, 2007. https://repositorio.ufscar.br/handle/ufscar/2964.

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Made available in DSpace on 2016-06-02T19:45:57Z (GMT). No. of bitstreams: 1 DissAS.pdf: 873261 bytes, checksum: 9886f0f3c41c4d04cfaf6a4ff398724f (MD5) Previous issue date: 2007-02-09 Universidade Federal de Sao Carlos Research indicates how foster care institutions problems may harm the development of children and adolescents in need for protection. Thus, a more efficient practice by professionals who work in these entities could contribute with the prevention of deficiencies, which institutionalized children may present. The present work focuses on the role of child protection services and has as general objective to investigate the strategies employed by such professionals, when evaluating foster care institutions, as well as under which quality indicators their assessment behavior is under control. Two studies were carried through in two interior cities of São Paulo estate, Brazil. Four child protection agents, a member of the Municipal Council for the Rights of the Children and the Adolescents, a member of the Social Assistance City Council, the Judiciary power s Social Worker, the town´s Judge, and the Coordinator of the town s single foster care institution participated of Study 1. Study 2 participants were: nine professionals responsible for the foster care evaluation (five Child Protection Agents, one member of the Municipal Council for the Rights of the Children and the Adolescents, the Youth and Child Judge and the city s Prosecutor; as well as five foster care institutions Coordinators). The data was collected by means of interviews, questionnaires and document analysis. Results indicated that the professionals who monitor foster care institutions, in both studies, use, predominantly, local visits to the entity as an evaluation strategy. However, these visits vary in frequency and format (some talk every two to six months with employees and children; while others only observe the functioning of the entity). Quality indicators described as guidelines for the assessment are also varied. The low frequency of reports regarding training aspects of foster care staff and the entity s concern for maintenance of the familiar bonds are of notice. Pesquisas indicam como as dificuldades de instituições do tipo abrigo podem prejudicar o desenvolvimento de crianças e adolescentes que estão sob essa medida de proteção. Nesse sentido, uma prática mais eficiente dos profissionais que atuam nessas entidades, poderia contribuir com a prevenção de deficiências às quais os abrigados estão sujeitos. O presente trabalho foca o papel da rede de proteção à criança e ao adolescente e tem o objetivo geral de investigar as estratégias utilizadas por esses profissionais ao avaliarem os abrigos, bem como sob quais indicadores de qualidade o comportamento de avaliar dos mesmos está sob controle. Foram realizados dois estudos em duas cidades do centro-oeste do estado de São Paulo. Participaram do Estudo 1 quatro conselheiros tutelares, uma representante do Conselho Municipal dos Direitos das Crianças e dos Adolescentes, uma integrante do Conselho de Assistência Social do Município, a Assistente Social do poder judiciário, o juiz da cidade e a coordenadora do único abrigo do município. Os participantes do Estudo 2 foram nove profissionais responsáveis pela avaliação dos abrigos, sendo eles: os cinco Conselheiros Tutelares do Município, uma das integrantes do Conselho Municipal dos Direitos da Criança e do Adolescente, o Juiz da Vara da Infância e da Juventude e o promotor da cidade; e cinco coordenadores de abrigos. A coleta de dados foi realizada por meio de entrevistas, questionários e análise documental. Os resultados indicam que os profissionais que monitoram os abrigos, em ambos os estudos, utilizam predominantemente a visita à entidade como estratégia de avaliação. No entanto a mesma é conduzida de forma e freqüência variada (alguns conversam, bimestralmente ou semestralmente, com funcionários e abrigados; outros apenas observam o funcionamento da entidade). Os indicadores de qualidade descritos como orientadores da tarefa de avaliar, também são variados. Ressalta-se a baixa freqüência de citação de aspectos relacionados às práticas educativas dos monitores dos abrigos e cuidados da entidade para manutenção dos vínculos familiares.

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Tase, Terezinha Hideco. "Segurança do paciente em maternidade: avaliação do protocolo de identificação do binômio mãe-filho em um hospital universitário." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-27052015-155602/.

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Introdução: A identificação inequívoca do paciente é um componente essencial na atenção à saúde e determinante para garantir uma assistência segura e de qualidade. Objetivo geral: Avaliar o protocolo de identificação por meio das pulseiras das mulheres admitidas na Clínica Obstétrica e dos neonatos no Centro Obstétrico em um hospital universitário do Município de São Paulo. Método: Estudo quantitativo, exploratório, descritivo e prospectivo, realizado na Clínica Obstétrica e no Centro Obstétrico, em um hospital universitário de atenção terciária. A casuística correspondeu a 800 oportunidades de observação, selecionadas por amostragem probabilística aleatória simples. A coleta de dados ocorreu entre setembro de 2013 e março de 2014, conforme um formulário, contendo os itens das três etapas do protocolo de identificação: presença e quantitativo de pulseiras, componentes de identificação e condições da pulseira. A análise foi baseada na estatística descritiva e inferencial, com significância de 5%. Resultados: A conformidade geral do protocolo na Clínica Obstétrica correspondeu a 58,5% e no Centro Obstétrico a 22,3%. Quanto às três etapas, na Clínica Obstétrica, a maior conformidade foi nos componentes de identificação (93,4%) e a menor, condições da pulseira (70%). No Centro Obstétrico, a maior conformidade também foi nos componentes de identificação (69%), e a menor, condições da pulseira (44,5%), com diferença estatística significante p<0,001. Quanto aos itens avaliados na Clínica Obstétrica, nas três etapas, os melhores foram: a presença do registro hospitalar (99,5%) e o número sequencial do parto (98,3%); no Centro Obstétrico, a presença das pulseiras plásticas, do código de barras (100%) e do nome e sobrenome maternos (99%). Os piores índices de conformidade na Clínica Obstétrica corresponderam à legibilidade (76,1%) e às condições de uso da pulseira (80,3%); no Centro Obstétrico, foram as condições de uso (46,3%) e pulseiras no membro preconizado (55,2%). Na comparação entre as duas unidades, quanto à conformidade geral, houve diferença estatisticamente significante, p<0,001. Conclusão: Os achados possibilitaram retratar que há necessidade de elevar os índices de conformidade na Clínica Obstétrica na primeira e terceira etapas e nas três etapas do Centro Obstétrico. Outrossim, ratificam a relevância do monitoramento sistemático dos protocolos institucionais, possibilitando a implementação de medidas corretivas e preventivas no processo de identificação, visando a estabelecer metas assistenciais e gerenciais para a melhoria contínua da qualidade e segurança do binômio mãe-filho, dos profissionais de saúde e da instituição Introduction: The unequivocal identification of the patient is an essential component in health care and crucial to ensure safe and quality care. General Objective: To assess the identification protocol by means of bracelets for women admitted to the Obstetric Clinic and for newborns at the obstetric center in a university hospital in the city of São Paulo. Methodology: Study quantitative, exploratory-descriptive and prospective study conducted in the Obstetric Clinic and Obstetric Center, in a university hospital of tertiary care. The sample corresponded to 800 opportunities of observation, selected by simpler random probability sampling. Data collection occurred between September 2013 and March 2014, according to a form containing the items of the three stages of the identification protocol: presence and quantity of bracelets, identification components and bracelet conditions. The analysis was based on descriptive and inferential statistics, with 5% significance. Results: The overall compliance to the protocol was as follows: Obstetric Clinic accounted for 58.5% and 22.3% for Obstetric Center. Regarding the three stages, in Obstetric Clinic, the major compliance was assigned to the identification components (93.4%) and the minor to bracelet conditions (70.0%). In Obstetric Center, the main conformity was related to identification components (69.0%) and the minor regarding to bracelet conditions (44.5%), showing a statistically significant difference p<0.001. Regarding the items in the three stages of the Obstetric Clinic, the best was the presence of hospital records (99.5%) and the sequential number regarding child birth (98.3%); in the Obstetric Center, the presence of plastic bracelets, bar code (100.0%), maternal name and surname (99.0%). The worst compliance rates in Obstetric Clinic corresponded to legibility (76.1%) and the bracelet conditions of use (80.3%) and in the Obstetric Center, conditions of use (46.3%) and bracelets in the recommended member (55.2%). Comparing the two units, on the topic of the overall compliance, a statistically significant difference, p <0.001 was observed. Conclusion: The findings allowed verifying the need to improve compliance rates in Obstetric Clinic in the first and third stages and in the three steps of the Obstetric Center. Also, showed the relevance of systematic monitoring of institutional protocols, enabling the implementation of corrective and preventive measures in the identification process aiming to establish care and management goals for the continuous improvement of quality and safety of mother and child, health professionals and the institution

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Ma, Kwong-cho. "Unattended child : an area of neglect in Hong Kong /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22054467.

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Newell, Amy Noël Abell Ellen Elizabeth. "Quality in family child care the voice of the family child care provider /." Auburn, Ala, 2009. http://hdl.handle.net/10415/1632.

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Waters, Elizabeth. "Measuring child health and wellbeing." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270153.

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Dahlström, Margareta. "Service production uneven development and local solutions in Swedish child care /." Uppsala : Distribution, Kulturgeografiska institutionen, Uppsala universitet, 1993. http://catalog.hathitrust.org/api/volumes/oclc/30694948.html.

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Stewart, Latonia A. "An exploration of characteristics, child development knowledge, sources of information, and training needs of family home providers /." View online, 1993. http://repository.eiu.edu/theses/docs/32211131396959.pdf.

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Jones, Cathy R. "Developing a West Virginia child care director's credential identifying the knowledge, skills, and issues /." Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1399.

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Thesis (Ed. D.)--West Virginia University, 2000. Title from document title page. Document formatted into pages; contains ix, 165 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 143-149).

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Santos, Nathanielly Cristina Carvalho de Brito. "Modelos de atenção primária à saúde da criança: análise comparada." Universidade Federal da Paraíba, 2016. http://tede.biblioteca.ufpb.br:8080/handle/tede/8705.

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Submitted by Maike Costa (maiksebas@gmail.com) on 2016-12-01T11:59:45Z No. of bitstreams: 1 arquivo total.pdf: 4992182 bytes, checksum: 52ed8734ff1b5b63c713939ee7da097a (MD5) Made available in DSpace on 2016-12-01T11:59:45Z (GMT). No. of bitstreams: 1 arquivo total.pdf: 4992182 bytes, checksum: 52ed8734ff1b5b63c713939ee7da097a (MD5) Previous issue date: 2016-08-19 Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq In the world, a significant number of children still die, before celebrating the fifth birthday, from preventable causes in qualified primary care. Therefore, health care models should be oriented to Primary Health Care and / or structured in accordance with its ordering attributes. Objective: To compare the degree of orientation to the child´s primary health care in basic care units which operate with different models of care. Method: It is a cross-sectional, quantitative and evaluative research in which a total of 1,484 family members and / or caregivers of children under ten years took part. These children were seen in health units which work with different models of care. Data collection was carried out from October 2012 to February 2013 by using the instruments: Primary Care Assessment Tool, Brazil, child version, to evaluate the Primary Care; and the other one covering the families´ socio-demographic and economic data. The analysis was made by means of descriptive statistics with simple frequencies and construction of scores of evaluated attributes, according to the Ministry of Health Manual. To evaluate the most oriented model to Primary Health Care and compare the attributes among the different models, the parametric analysis of variance - associated with Tukey´s multiple comparison test -, and Kruskal-Wallis test - associated with Dunnett´s multiple comparison test - were applied, respectively, both with a 5% significance level. Results: By comparing the models, statistically significant difference was verified in favor of the mixed Basic Health Unit model (p<0,05) to the overall score and superiority to the essential score, even without significant difference. As to the attributes, only the first contact access - use - was satisfactory and did not show any difference between the models. However, among the attributes that showed differences, this was favorable to the mixed model for degree of affiliation, coordination - integration of care, comprehensiveness – available services and provided services, and to the traditional Basic Health Unit model for the dimensions: information system and accessibility. Although the derived attributes have not reached the cut-off point, the models that work with the Family Health Strategy had a favorable difference for family and community orientation. Conclusion: The mixed Basic Health Unit was revealed as the most oriented model to the child´s primary care. This is possibly due to the sum of potentialities of the traditional and the Family Health Strategy models, once even with limitations, they showed overall scores close to ideal. Thus, when integrated into a single structure, they can contribute to improving the work process of the teams towards the reorientation of the child´s primary care. Por falta de una atención primaria de buena calidad, muchos niños todavía mueren antes de cumplir cinco años en todo el mundo. Para una mejor atención primaria, los modelos de atención a la salud deben estar orientados para la Atención Primaria a la Salud y/o estructurados según sus atributos reguladores. Objetivo: Comparar el grado de orientación a la atención primaria a la salud al niño en las unidades de atención básica que actúan con diferentes modelos de atención. Método: Es una investigación transversal, cuantitativa/evaluativa, realizada con 1.484 familiares y/o cuidadores de niños menores de diez años, atendidas en unidades de salud actuantes en diferentes modelos de atención. Recogemos los datos de octubre de 2012 a febrero de 2013 utilizando los instrumentos Primary Care Assessment Tool, Brasil, versión niño, para evaluar la Atención Primaria y otro observando datos sociodemográficos /económicos de las familias. El análisis fue estadístico descriptivo con frecuencias sencillas y construcción de los escores de los atributos evaluados según el manual del Ministerio de la Salud. Para evaluar el modelo más orientado a la Atención Primaria a la Salud y comparar los atributos entre los diferentes modelos, empleamos el análisis de variancia paramétrica integrado al test de comparaciones múltiples de Tukey y el test de Kruskal-Wallis, asociado al de comparaciones múltiples de Dunnett, ambos con nivel de significancia de 5%. Resultados: Verificamos diferencia estadísticamente significativa en favor del modelo de Unidad Básica de Salud mista (p< 0,05) para el escore general y superioridad para el escore esencial, no obstante, sin diferencia significativa. Sobre los atributos, solo el acceso del primer contacto - utilización - fue satisfactorio y no presentó diferencia entre los modelos pero entre los atributos que presentaron diferencia, fue favorable al modelo misto para grado de afiliación, coordinación - integración de cuidados, integralidad - servicios disponibles y servicios prestados incluso al modelo tradicional para las dimensiones sistema de información y accesibilidad. Aunque los atributos derivados no hayan alcanzado el punto de corte, los modelos que actúan con la Estrategia Salud de la Familia, presentaron diferencia favorable para orientación familiar y comunitaria. Conclusión: La Unidad Básica de Salud mista reveló ser el modelo más orientado a la atención primaria en el cuidado al niño. A lo mejor, ese resultado se debe a la suma de potencialidades de los modelos tradicionales y Estrategia Salud de la Familia, pues aunque limitado, presentaron escores generales próximos al ideal. Así, cuando integrados en una misma estructura, pueden contribuir para la mejoría del proceso de trabajo de los equipos hacia la reorientación de la atención primaria en el cuidado al niño. No mundo um expressivo número de crianças ainda morre antes de comemorar o quinto aniversário, por causas evitáveis diante de uma atenção primária de boa qualidade. Por essa razão, os modelos de atenção à saúde devem estar orientados para a Atenção Primária à Saúde e/ou estruturados em conformidade com seus atributos ordenadores. Objetivo: Comparar o grau de orientação à atenção primária em saúde da criança nas unidades de atenção básica que operam com diferentes modelos de atenção. Método: Trata-se de pesquisa transversal, quantitativa e avaliativa, da qual participaram 1.484 familiares e/ou cuidadores de crianças menores de dez anos, atendidas em unidades de saúde que atuam com diferentes modelos de atenção. Os dados foram coletados de outubro de 2012 a fevereiro de 2013, utilizando-se os instrumentos: Primary Care Assessment Tool, Brasil, versão criança para avaliar a Atenção Primária, e outro que contemplou dados sociodemográficos e econômicos das famílias. A análise foi feita por meio de estatística descritiva, com frequências simples e construção dos escores dos atributos avaliados, de acordo com o Manual do Ministério da Saúde. Para avaliar o modelo mais orientado para a Atenção Primária à Saúde e comparar os atributos entre os diferentes modelos, foram aplicados, respectivamente, a análise de variância paramétrica, associada ao teste de comparações múltiplas de Tukey, e o teste de Kruskal- Wallis, associado ao de comparações múltiplas de Dunnett, ambos com nível de significância de 5%. Resultados: Ao comparar os modelos, verificou-se diferença estatisticamente significativa em favor do modelo de Unidade Básica de Saúde mista para o escore geral (p<0,05) e superioridade para escore essencial, mesmo sem diferença significativa. Quanto aos atributos, somente o acesso de primeiro contato - utilização - foi satisfatório e não apresentou diferença entre os modelos. No entanto, entre os atributos que apresentaram diferença, foi favorável ao modelo misto para grau de afiliação, coordenação - integração de cuidados, integralidade - serviços disponíveis e serviços prestados, e ao modelo de Unidade Básica de Saúde tradicional para as dimensões sistema de informação e acessibilidade. Apesar de os atributos derivados não terem alcançado o ponto de corte, os modelos que operam com a Estratégia Saúde da Família apresentaram diferença favorável para orientação familiar e orientação comunitária. Conclusão: A Unidade Básica de Saúde mista revelou ser o modelo mais orientado para a atenção primária no cuidado voltado para a criança. Isso se deve, possivelmente, à soma de potencialidades dos modelos tradicional e Estratégia Saúde da Família, pois, mesmo com limitações, apresentaram escores gerais próximos ao ideal. Assim, quando integrados em uma mesma estrutura, podem contribuir para melhorar o processo de trabalho das equipes em direção a reorientar a atenção primária no cuidado à criança.

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Vaughan-Thomas, Non. "The child, first and always? Aspects of children's health care interests." Thesis, University of Cambridge, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240053.

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Smith, Jennifer Ann. "An explorative study of child and youth care workers experiences of "lifespace therapeutic care"." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=init_4931_1178701317.

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The goal of this research was to explore and describe child and youth care workers lived experiences of life space therapeutic care in a residential setting. Life space refers to the daily living environment, context and situation of children.

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42

Brookes, Sheila J. "An examination of child care subsidies and their impact on families with infants and toddlers /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3074380.

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Witt, Kendra Elizabeth Marie. "Evaluation of a nutrition program targeting child care centers." To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2008. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.

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44

Kansteiner, Suzanne. "A parent handbook for family childcare programs." [Denver, Colo.] : Regis University, 2007. http://165.236.235.140/lib/SKansteiner2007.pdf.

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45

NEVES, TICIANA MASCARENHAS GALEAO. "MAIN MARKET DETERMINANTS OF CHILD CARE SERVICES IN RIO DE JANEIRO." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2009. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=14175@1.

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A primeira infância é fundamental para o desenvolvimento físico e psíquico dos seres humanos, influenciando-os pelo resto da vida. Assim sendo, a oferta de serviços de creche adequados, calcados no correto mapeamento dos desejos e necessidades dos consumidores, é de extrema importância. Partindo desta motivação, este trabalho objetiva analisar as características relevantes para os pais no processo de seleção de creches. A dissertação é baseada na metodologia da análise conjunta e seu desenvolvimento é composto de duas etapas: i. Revisão da literatura, entrevistas em profundidade, grupo de foco e definição dos estímulos a serem avaliados pelos respondentes; ii. Coleta de dados, cálculo das importâncias relativas dos atributos, cálculo das utilidades dos níveis propostos e análise dos resultados. A análise dos resultados é feita considerando-se não somente o total da amostra como também segmentos definidos a priori de acordo com dados sócio-econômicos levantados na coleta de dados. O resultado da análise conjunta para o total da amostra revela os atributos localização, projeto pedagógico e grau de capacitação dos profissionais como sendo os de maior importância relativa. Este resultado evidencia que, muito além da praticidade de creches que sejam guardiãs de seus filhos, os pais buscam também uma instituição que propicie o aprendizado e a socialização. Na segmentação, os resultados por região de residência, faixa etária das crianças e faixa de renda familiar possibilitaram a definição de estratégias específicas para cada segmento. The first childhood is fundamental for the physical and psychological development of human beings, influencing them for the rest of their lives. In this way, offering adequate child care services, based in a correct mapping of customers’ necessities is extremely important. Derived from this motivation, this work aims to analyze the relevant characteristics for parents in the child care services selection process. The dissertation is based on conjoint analysis methodology and is developed in two parts: i. Literature revision, interviews, focus groups and definition of the stimulus to be evaluated by the respondents; ii. Data collection, calculation of the relative importance of the attributes, calculation of the utilities of each suggested level and analyses of the results. The analysis is done considering not only the total sample but also segments defined according to socio-economical data gathered as part of the data collection process. The result of the conjoint analysis for the overall sample reveals that location, teaching methodology and professional knowledge and skills received the greatest relative importance. It shows that, far beyond a practical child care service that can look after their children, parents are aiming for an institution that leverages development, socialization and learning. When segmenting the data, analyses by neighborhood, children’s age and familiar income enabled the definition of strategies for each specific segment.

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46

Berthelsen, Donna. "An ecology of centre-based child care." Thesis, Queensland University of Technology, 1997. https://eprints.qut.edu.au/36555/6/36555_Digitised%20Thesis.pdf.

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The studies in the thesis were derived from a program of research focused on centre-based child care in Australia. The studies constituted an ecological analysis as they examined proximal and distal factors which have the potential to affect children's developmental opportunities (Bronfenbrenner, 1979). The project was conducted in thirty-two child care centres located in south-east Queensland. Participants in the research included staff members at the centres, families using the centres and their children. The first study described the personal and professional characteristics of one hundred and forty-four child care workers, as well as their job satisfaction and job commitment. Factors impinging on the stability of care afforded to children were examined, specifically child care workers' intentions to leave their current position and actual staff turnover at a twelve month follow-up. This is an ecosystem analysis (Bronfenbrenner & Crouter, 1983), as it examined the world of work for carers; a setting not directly involving the developing child, but which has implications for children's experiences. Staff job satisfaction was focused on working with children and other adults, including parents and colleagues. Involvement with children was reported as being the most rewarding aspect of the work. This intrinsic satisfaction was enough to sustain caregivers' efforts to maintain their employment in child care programs. It was found that, while improving working conditions may help to reduce turnover, it is likely that moderate turnover rates will remain as child care staff work in relatively small centres and they leave in order to improve career prospects. Departure from a child care job appeared to be as much about improving career opportunities or changing personal circumstances, as it was about poor wages and working conditions. In the second study, factors that influence maternal satisfaction with child care arrangements were examined. The focus included examination of the nature and qualities of parental interaction with staff. This was a mesosystem analysis (Bronfenbrenner & Crouter, 1983), as it considered the links between family and child care settings. Two hundred and twenty-two questionnaires were returned from mothers whose children were enrolled in the participating centres. It was found that maternal satisfaction with child care encompassed the domains of child-centred and parent-centred satisfaction. The nature and range of responses in the quantitative and qualitative data indicated that these parents were genuinely satisfied with their children's care. In the prediction of maternal satisfaction with child care, single parents, mothers with high role satisfaction, and mothers who were satisfied with the frequency of staff contact and degree of supportive communication had higher levels of satisfaction with their child care arrangements. The third study described the structural and process variations within child care programs and examined program differences for compliance with regulations and differences by profit status of the centre, as a microsystem analysis (Bronfenbrenner, 1979). Observations were made in eighty-three programs which served children from two to five years. The results of the study affirmed beliefs that nonprofit centres are superior in the quality of care provided, although this was not to a level which meant that the care in for-profit centres was inadequate. Regulation of structural features of child care programs, per se, did not guarantee higher quality child care as measured by global or process indicators. The final study represented an integration of a range of influences in child care and family settings which may impact on development. Features of child care programs which predict children's social and cognitive development, while taking into account child and family characteristics, were identified. Results were consistent with other research findings which show that child and family characteristics and child care quality predict children's development. Child care quality was more important to the prediction of social development, while family factors appeared to be more predictive of cognitive/language development. An influential variable predictive of development was the period of time which the child had been in the centre. This highlighted the importance of the stability of child care arrangements. Child care quality features which had most influence were global ratings of the qualities of the program environment. However, results need to be interpreted cautiously as the explained variance in the predictive models developed was low. The results of these studies are discussed in terms of the implications for practice and future research. Considerations for an expanded view of ecological approaches to child care research are outlined. Issues discussed include the need to generate child care research which is relevant to social policy development, the implications of market driven policies for child care services, professionalism and professionalisation of child care work, and the need to reconceptualise child care research when the goal is to develop greater theoretical understanding about child care environments and developmental processes.

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47

Anderson-Michael, Julie L. "A study of the first four fiscal years of Eastern Illinois University School of Family & Consumer Sciences Child Care Resource & Referral /." View online, 1996. http://repository.eiu.edu/theses/docs/32211998764272.pdf.

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48

Nupponen, Hannele. "Leadership and Management in Child Care Services: Contextual Factors and Their Impact on Practice." Thesis, Queensland University of Technology, 2005. https://eprints.qut.edu.au/16094/1/Hannele_Nupponen_Thesis.pdf.

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There has been minimal Australian research focussed on the management and leadership aspects of directors' work in centre-based child care to date. In Australia, practices in early education have been largely drawn from studies in other cultural contexts, particularly research undertaken in the United States. It is timely that Australian research should inform its social policy about quality child care programs. The focus of this research was on the nature and characteristics of effective management and leadership practices in centre-based child care. Research (Jorde Bloom, 1992b; Morgan, 2000; Poster & Neugebauer, 2000; Rodd, 1994) indicates that quality of child care programs is influenced mostly by the leadership that the centre director can provide to staff within the centre. The conceptual framework adopted in this study views leadership from a Social Systems framework. Central to a Social Systems framework is the notion that organisations do not exist in isolation rather, leadership and management in these settings are embedded in a broader social context. A Social Systems Model has received little attention in contemporary research on child care in Australia, and this study aims to build a framework for future studies in this area. The aim was to investigate leadership and management in child care in social, legislative and economic context. The findings seek to inform researchers, policy makers and practitioners. Eight directors were purposively selected from community-based and privately based centres in urban and rural areas, and from accredited centres in South East Queensland. The selection of varying locations allowed the researcher to gain a broader perspective of the directors' daily lives, as different contextual and environmental conditions were anticipated to influence management and leadership within the child care centres. Within this study, case studies of directors of child care centres were developed through interviews with the directors. The interview methodology focussed on exploratory semi-structured, open-ended questions in relation to management and leadership in centre-based child care. Directors were interviewed on two occasions within a three month period. In the current context of the delivery of child care services in a market driven climate, the language of business and organisational theory has entered the lexicon of the early childhood field (Press, 1999). The findings indicate that the director of a child care centre needs to have training and experience in business management and leadership to enhance their competencies for management of centres in today's competitive environment. Growth in child care franchises is significantly changing and truly developing a "child care industry" (Murdoch, 2004). Also, consideration needs to be given to increasing accountability in child care service delivery, and how to better support directors in their role as advocates in the broader early childhood field. Further, families in specific communities have varying needs and early childhood programs should reflect the needs of the local community. Leadership models within child care centres should encompass the micro and macro influences on the operation of centres. Literature suggests that early childhood centres provide an opportune place to support families in a variety of ways through integrating support services to address the underlying social and policy factors that affect young children and their families (Commonwealth of Australia, 2003; Corter, 2001).

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49

Nupponen, Hannele. "Leadership and Management in Child Care Services: Contextual Factors and Their Impact on Practice." Queensland University of Technology, 2005. http://eprints.qut.edu.au/16094/.

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There has been minimal Australian research focussed on the management and leadership aspects of directors' work in centre-based child care to date. In Australia, practices in early education have been largely drawn from studies in other cultural contexts, particularly research undertaken in the United States. It is timely that Australian research should inform its social policy about quality child care programs. The focus of this research was on the nature and characteristics of effective management and leadership practices in centre-based child care. Research (Jorde Bloom, 1992b; Morgan, 2000; Poster & Neugebauer, 2000; Rodd, 1994) indicates that quality of child care programs is influenced mostly by the leadership that the centre director can provide to staff within the centre. The conceptual framework adopted in this study views leadership from a Social Systems framework. Central to a Social Systems framework is the notion that organisations do not exist in isolation rather, leadership and management in these settings are embedded in a broader social context. A Social Systems Model has received little attention in contemporary research on child care in Australia, and this study aims to build a framework for future studies in this area. The aim was to investigate leadership and management in child care in social, legislative and economic context. The findings seek to inform researchers, policy makers and practitioners. Eight directors were purposively selected from community-based and privately based centres in urban and rural areas, and from accredited centres in South East Queensland. The selection of varying locations allowed the researcher to gain a broader perspective of the directors' daily lives, as different contextual and environmental conditions were anticipated to influence management and leadership within the child care centres. Within this study, case studies of directors of child care centres were developed through interviews with the directors. The interview methodology focussed on exploratory semi-structured, open-ended questions in relation to management and leadership in centre-based child care. Directors were interviewed on two occasions within a three month period. In the current context of the delivery of child care services in a market driven climate, the language of business and organisational theory has entered the lexicon of the early childhood field (Press, 1999). The findings indicate that the director of a child care centre needs to have training and experience in business management and leadership to enhance their competencies for management of centres in today's competitive environment. Growth in child care franchises is significantly changing and truly developing a "child care industry" (Murdoch, 2004). Also, consideration needs to be given to increasing accountability in child care service delivery, and how to better support directors in their role as advocates in the broader early childhood field. Further, families in specific communities have varying needs and early childhood programs should reflect the needs of the local community. Leadership models within child care centres should encompass the micro and macro influences on the operation of centres. Literature suggests that early childhood centres provide an opportune place to support families in a variety of ways through integrating support services to address the underlying social and policy factors that affect young children and their families (Commonwealth of Australia, 2003; Corter, 2001).

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50

Kearney, Lauren Naomi. "Open Access community child health services: A three-phase evaluation." Thesis, Australian Catholic University, 2010. https://acuresearchbank.acu.edu.au/download/72ba800703df2602e5bbb1296d3eed793f534b7d7413d033db2d02bd6fd46c07/4262683/64944_downloaded_stream_169.pdf.

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Despite significant evidence of the importance of the early years of life, to date limited research has evaluated how health services best support and assist families during this crucial time. One important service through which infant and children's health are promoted and monitored in Australia are the government-based community child health nursing services (CCHNS). Traditionally, child health surveillance and health promotion are provided through CCHNS via individual appointment-based clinics. In recent years, resource allocation and workload within CCHNS has changed, requiring the development of contemporary approaches to service delivery. One novel approach, which was examined in this study, was an Open Access Clinic (OAC), which provided a group-based, appointment-free clinic where parents could attend with their infant for child health nurse support and health care, based on parental needs and convenience. The objective of this research study was to investigate the efficacy, quality and perceived value of the OAC approach to universal child health surveillance in one urban community child health service. A three-phase study, using method triangulation was conducted. It comprised a retrospective documentary analysis of pre- and post-OAC healthcare outcomes; a phenomenological inquiry into the lived experience of those directly involved with the OAC; and an 18-month prospective cohort study, tracking health care-seeking behaviours and child care practices of families who accessed the OAC.;There was also a statistically significant increase in families receiving unemployment benefits (thus were from a relatively low socio-economic demographic) in the OAC cohort, when compared with the individual appointment approach. However, a statistically significant decrease was noted in the developmental assessment documentation in the OAC cohort when compared with the individual appointment cohort, which was further investigated in the prospective cohort study (phase three). The second phase of the overall study was a phenomenological inquiry into the everyday experience of the OAC. The purpose of phase two was to understand what the OAC meant to those involved with it, and to gain insight into the everyday experience of the OAC. The methodology used for this phase was a North American phenomenological inquiry approach, which sought to describe and interpret the everyday experience of multiple participants' lived experiences of the phenomenon - the OAC. New knowledge and understanding has been generated through this inquiry. According to the participants the OAC represented a place where support and reassurance could be accessed flexibly and provided in a non-judgemental manner. The emerging themes described a busy and bustling clinic. It was a place where parents felt safe and supported. They enjoyed the flexibility, the appointment-free structure and valued the accessible location of the both the urban clinics, where shops were close by and public transport available. However, for working parents, services offered in extended hours would be of benefit. The service had a clear role definition and according to the participants achieved this purpose through the working of the OAC, in conjunction with other support services (such as the breastfeeding clinic and the early intervention specialists). Furthermore, parents often shared experiences of feeling lonely and socially isolated.;They valued the consistency of seeing the same child health nurse within the OAC, and the child health nurses valued this for reasons of continuity. The parents reported the benefits of the group approach, and overall preferred it to individual appointments. The mothers identified their use of other service providers, for example their general practitioner if sensitive or confidential issues required attention. The information discussed during the clinics was offered in a non-judgemental way, however the findings indicate that it is essential that the child health nurse's advice and practice is consistent with the latest evidence-based guidelines. The child health nurses sometimes found the clinic stressful and busy, without enough time to perform thorough family assessments.;More specifically, clear trends of usage, such as increased visit frequency and use of breastfeeding clinics in the early weeks, provided helpful evidence to assist in service planning. Through understanding where parents access information, such as family and friends, health services may target these sources with health promotion activities. 'The real challenge lies in ensuring sustained policy effort to achieve long-term measurable change in outcomes for children - to improve their health and well being, to modify the effects of social determinants, and to minimise the inequalities already apparent in early childhood' (Goldfeld & Oberklaid, 2005, p. 209). This final phase affirmed that parents have varied patterns of attendance within the OAC, based on their immediate needs, and that these change with the age of the infant. Important data was also found detailing patterns of usage for other child health service providers, such as access of general practitioners and child health nurses for routine well-baby assessments. Potentially, parents could be provided with clearer service pathways prior to discharge from maternity units, informing them regarding which services are helpful for specific infant health issues. There is also potential for increased collaboration between Queensland Health and general practitioners and practice nurses, to ensure that services are streamlined and thus reduce unnecessary burden on the health care system. This may also be helpful in ensuring consistency of health care information provided to parents between different providers. Whilst this phase was limited by the small sample size, and a context specific group of families, it does provide new information in key areas, such as why parents introduce solids early, when they consider prevention for childhood obesity, where they are attending for their infants' developmental assessments, and health care needs at different stages between 0-eighteen months.;These findings will provide Child Health Services, with valuable information to more efficiently and effectively plan services to meet parental and infant health needs. Overall, the key findings from the combined phases found the OAC compared favourably to the traditional individual-appointment method of child health surveillance in the areas of parent and health care professional satisfaction, infant growth and nutrition, immunisation status and key health promotion areas such as Sudden Infant Death Syndrome prevention. However, areas for quality improvement were also found, specifically in the areas of consistent evidence-based information, documentation in areas such as developmental assessment attendance, health care provider duplication and collaboration and timely discussion of parent-infant attachment. This study has generated new knowledge and understanding regarding the effectiveness and quality of an OAC approach to community child health nursing services, specifically in the delivery of group-based, appointment-free universal child health surveillance services.

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