Safeguarding children and public health: midwives' responsibilities

Using a healthy settings framework, this study aims to compare and contrast how midwives working in either hospital or community settings are currently responding to the co-occurrence of domestic and child abuse; their perceived role and willingness to identify abuse; record keeping; reporting of suspected or definite cases of child abuse; and training received. Methods: A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland, which resulted in 488 midwives completing the questionnaire, a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation and the questionnaire was validated using exploratory factor analysis. Results: Community midwives reported receiving more training on domestic and child abuse. Although a high percentage of both hospital and community midwives acknowledged a link between domestic and child abuse, it was the community midwives who encountered more suspected and definite (p

Does the Child Health Computing System adequately identify children with cerebral palsy?

Background This paper assesses the usefulness of the Child Health Computing System as a source of information about children with cerebral palsy.

Methods A comparative survey of information held on the Child Health Computing System (CHCS) and the Northern Ireland Cerebral Palsy Register (NICPR) in one Health and Social Services Board in Northern Ireland was carried out. The sample comprised children with cerebral palsy aged 5–9 years.

Results Of the 135 cases recorded on the NICPR, 47 per cent were not found on the CHCS; the majority of these children had no computer record of any medical diagnosis. Of the 82 cases recorded on the CHCS, 10(12 per cent) were not found on the NICPR; five of these cases (6 per cent) were found on follow–up not to have CP.

Conclusions Unless improvements are made in case ascertainment, case validation and recording activities, the evidence suggests that the CHCS will not be able to provide the same quality of information for needs assessment and surveillance of very low birthweight infants in relation to cerebral palsy as is provided by a specialist case register.

‘Papers from ‘A Symposium with Professor Roger Brownsword: Super-stewardship in the Context of Public Health’’

This special issue seeks to engage the term 'stewardship' and the practical and theoretical work around it, both of which are destined to remain items of unfinished business as governance struggles to keep up and connect with its fast moving technological and societal targets. While this special issue is testament to that observation, it also helps to foster much needed scholarly discussion and critique – and to ensure this field is not unwittingly formed and deployed by and as a legitimating support for governance, but rather opened up, elaborated and contested. The articles provide innovative insights and food for thought on the conception and legal-political practice and potential of stewardship and ‘super-stewardship’ in national, supranational and international settings.

An Introduction to 'A Symposium with Professor Roger Brownsword: Super-stewardship in the Context of Public Health'

Introduces the articles in the special issue.