Challenges in Changing Health Systems

18.11.12

Many countries do not have systems of community nurses, or health visitors, who visit families at home every time a new baby is born.  Without this system, it is difficult to identify problems early on and intervene to prevent a crisis.  Often the health services are reaching children when they are already seriously ill or malnourished.

All countries in the world except two have signed and ratified the UN Convention on the Rights of the Child, which includes a child's right to free healthcare.  Despite this, in many countries, healthcare is not provided for free and because of this, poor families put off going to the doctor until a child is seriously ill.  When a child who is very ill is admitted to hospital, families are often accused of neglecting their children.  As a result, children are admitted to institutions because it is believed that this will be safer than keeping them in the family.  But there is a difference between willful neglect and the neglect caused by grinding poverty.

In some countries, it is still the case that hospitals separate babies from their mothers at birth and keep them in separate wards.  For any mother who is considering giving up her child, this is a dangerous practice.  The early time spent together can have a dramatic impact on forming a bond between mother and child.  As a result, the mother is less willing to give up her child.

Many countries do not provide health education to prospective parents or new parents.  Because of this parents can miss signs of serious illness and their children can be at risk of severe harm.

In some countries, paediatricians resist the process of change because they do not accept the scientific evidence of the harm to early brain development caused by institutionalisation.  These paediatricians represent a strong lobby, because their views on child health and development are respected by politicians and society alike.

In many countries, it is still the case that doctors in hospitals advise parents to place their children with disabilities in institutions. There is a residual belief that the State knows better how to care for children than do their parents.  Young parents who are devastated by the news that their child has a disability are likely to take the advice of the doctors.

It is often the case that different professional departments work in isolation.  Medical professionals in many countries are not compelled to work in cooperation with social workers in addressing the needs of children in socially vulnerable families.  This means that poor families and children often fall between the gaps of service provision.

In many countries, healthcare is not provided for free and because of this, poor families put off going to the doctor until a child is seriously ill.

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