20th March 2014
Over the last twelve months members of the Institute of Health Visiting and Department of Health have been involved in sharing experience and knowledge of UK health visiting with The United Nation’s Children’s Fund, (UNICEF) Central East European /Commonwealth of Independent States (CEE/CIS) Regional office (recently with Cheryll Adams delivering a keynote speech at a Geneva meeting).
As contributors to an International Technical Advisory Group on Home Visiting, there has been the opportunity to share and learn about home visiting practice and join in debates on how to design, develop and maintain comprehensive models of support capable of meeting the needs of all pregnant women, infants and families with young children. Interest by UNICEF in the England model of universal progressive health visiting was established at a UNICEF conference in Ankara 2012.
As part of the UK involvement in developing the UNICEF work on home visiting, I was very fortunate to visit the Republic of Kosovo[i], and participate in an intersectoral conference held on 20-21 November 2013. The conference titled: “Support to Early Childhood Development in Kosovo – The Role of Home Visiting and Outreach Services” was hosted by UNICEF Kosovoi, in collaboration with Kosovar Government Ministries and NGO partners.
The conference heard from other Eastern European countries also developing nurse home visiting systems; specifically Croatia and Bosnia and Herzegovina. Attendees were also interested to hear about the UK system of health visiting which I presented on. The presentation introduced the UK health visitor role by explaining its nineteenth century volunteer origins and now development as a key role involved in the delivery of UK child health policy. Emphasis was made on working with principles of proportionate universalism – and thereby providing a service for everyone with additional support for those with greater need. The inclusion of a universal home visiting service model provided by health visitors is of particular interest to CEE/CIS countries seeking to address health inequalities and develop services informed by evidence indicating the importance of early life experiences (UNICEF, 2012).
During the conference, the situation of many children and families was noted as being less than satisfactory with few, being able to access quality services. Difficulties are particularly faced by those from minority groups (e.g. Roma, Ashkali and Egyptian communities), those with disabilities and children in poverty and living in rural areas. Therefore UNICEF CEE/CIS regional office is championing proposals for investing in universal maternal and child home visiting services as a viable mechanism for targeting all families and reaching those most vulnerable, to provide them with the comprehensive support they need.
Participation in the event was humbling and inspiring. On reflection, I am compelled to consider how we must not underestimate the assets we have in the UK; as the very presence of skilled, educated workforce, developed with the aid of a comprehensive system of education and existing service structure for universal provision that is common place here, is not yet a reality in other parts of Europe. The UK health visitor workforce has lots of experience to share, but also an opportunity to learn alongside European partners as we all seek to resolve challenges of best workforce recruitment, retention and service delivery that can result on tangible outcomes for children and families.
Acknowledgement to: Bettina Schwethelm, Intersectoral Consultant, UNICEF CEE/CIS Regional Office
Karen Whittaker, Senior Lecturer, School of Health, University of Central Lancashire
UNICEF (2012). Securing the foundations of human development. Policy Brief No. 1. 2012. Geneva, Regional Office for Central & Eastern Europe, Commonwealth of Independent States. UNICEF. http://www.unicef.org/ceecis/ECD_Policy_Brief_-_Securing_the_Foundations_of_Human_Development_2012.pdf Accessed 09/03/14
[i] Under UNSC 1244