Article 42: Awareness of the United Nations Convention for the Rights

of the Child (UNCRC) Amongst Child Health Practitioners (CHPs) in

Wales.Christina HudsonSave the ChildrenDr Elspeth Webb

Good Examples.• Promoting awareness. Children’s Rights Week

Children’s Hospital, Wales.• Professional training. Cardiff two Part 8 reviews

into child maltreatment deaths led to local development of rights-led child protection training materials.

• Using the UNCRC as an auditing tool.• Using the UNCRC to improve the public health

of children.

Training.• Undergraduate lecture before Child Health

block in Year 4.– Incorporate rights ‘into their core professional

values’ (Webb et al, 2009)

• Postgraduate – Becoming ‘increasingly core’ component of speciality training programme thanks to RCPCH (Reading et al, 2008).

Models in Healthcare.

• Biomedical Model – focuses on physical processes. Paternalistic, “doctor knows best”.

• Bio-Psycho-Social Model – all have a role in the context of disease or illness.

• Patient-centred.

Rights-Based Approach.

• Using the UNCRC as a guide for how CHPs deliver and structure services.

• The four core principles: non-discrimination; devotion to the best interests of the child; the right to life, survival and development; and respect for the views of the child.

RBA Continued...Act in the child’s best interest.

Life and good health. Privacy and confidentiality.

Respect and dignity.

Education and play.Information.

Protection from harm.Participate – Consent.

Project.• Interviewing CHPs throughout Wales,

questioning:– What they know about the UNCRC, – What teaching they have received on the UNCRC,– If and how they implement this in practise, – To find out about how CHPs could be made more

aware of the UNCRC, and– How a rights-based approach (RBA) might affect

clinical practise and child well-being.

Method.

• Qualitative, semi-structured interviews.

• Approached 20 CHPs across Wales LHBs.

• Recruited 9 CHPs, verbally consented.

• Transcribed, thematic analysis.

Results.

Teaching for Current CHPs:

• 6/9 never received formal teaching on UNCRC.

• 100% had noticed UNCRC mentioned in other teaching.

• Ideas for teaching their cohort of CHPs.– Constant assessment.– Using WPS.

Future Teaching Directions for Potential CHPs:

• 100% wanted continual exposure to UNCRC, with an introduction at undergraduate level.

• Format – seminars, taught by example.

• Challenges – “training the trainer”, attitudes, curriculum space.

Results.

MDT and Outside Agencies:

• 6/9 UNCRC delivered to MDT in Child Health.

• Others: GPs, A&E.• Outside agencies:

– School nurses, education, policy and managerial positions.

RBA to Child Health:

• 7/9 though RBA was valid.• “encompasses a holistic

approach”.• 8/9 improve quality of

healthcare.• 4/9 currently RBA.• 6/9 raising awareness and

teaching on UNCRC increase uptake of RBA.

Results.

Policy:• 5/9 would like to see RBA

applied at policy level:– “more important”

• 5/9 using WHP to make UNCRC compulsory at UG was a good idea.– “heavy-handed”.

• Under-funded and politically under-represented in the WAG.

Implications.• Unanimous view – CHPs in Wales want

continual exposure to UNCRC training.– Training the trainers, how to deliver training.

• 8/9 thought a RBA could improve the quality of care children receive.

• Children’s Right Measure, put policy into practise.– Guidelines written by WAG & RCPCH, delivering

training.

Critique.• Limited by time constraints placed on the

project. • Future directions:– Using a more random recruitment method.– Recruiting CHPs from other trusts.– Recruiting more Paediatric Surgeons.– Expanding to A & E and GP staff.

Conclusion.“People know to wear a seatbelt. People

occasionally put a seatbelt on because a policeman will be watching, but for the most it’s natural, and they’d feel unsafe if they didn’t. That’s where this needs to be. Constant. And then we would have succeeded. If you want a RBA then we have a way to go.”

– CHP interviewee.

References.• Coyne, I; “Children's participation in consultations and decision-

making at health service level: A review of the literature.” International Journal of Nursing Studies. Vol. 45, Issue. 11, Pages 1682-1689. 2008.

• Goldhagen. J; “Intergrating Paediatrics and Public Health”. Paediatrics. Vol. 115, No. 4. Pages 1202-1208. 2005.

• Horsmann. C; “The particular needs of children and adolescents – not just little adults”. The Foundation Years. Vol. 5, Issue. 2, Pages 75-78. 2009.

• Leygue. C, Maio. G, Gebauer. J, Karremans. J, Webb. E; “Prejudice Against Children”. In press.

• Mulley. C; “The Woman Who Saved the Children”. Oneworld Oxford. 2009.

References.• Perera. A; “Can I Decide Please? The State of Children’s Consent in the

UK”. European Journal of Health Law. Vol. 15, No. 4, Pages 411-420. 2008.• Reading. R, Bissell. S, Goldhagen. J, Harwin. J, Masson. J, Moynihan. S,

Parton. N, Santos Pais. M, Thoburn. J, Webb. E; “Promotion of children’s rights and prevention of child maltreatment”. Child Maltreatment 4. 2008.

• Rees. C; “An Introduction to Research for Midwives”. Second Edition. Books for Midwives. 2003.

• Save the Children; “Stop, Look, Listen, the road to realising children’s rights in Wales”. 2007.

• Webb. E.; “An Exploration of the Discrimination-Rights Dynamic in Relation to Children”. In press.

• Webb. E, Horrocks. L, Crowley. A and Lessof. N.; “Using the UN Convention on the Rights of Children to Improve the Health of Children”. Paediatrics and Child Health. Vol. 9, Issue 9, Pages 430-434. 2009.