Article 42: Awareness of the United
Nations Convention for the Rights
of the Child (UNCRC) Amongst Child
Health Practitioners (CHPs) in
Wales.
Christina Hudson
Save the Children
Dr 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, semistructured 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:
RBA to Child Health:
• 6/9 UNCRC delivered to
MDT in Child Health.
• Others: GPs, A&E.
• Outside agencies:
• 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.
– School nurses, education,
policy and managerial
positions.
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 underrepresented 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 decisionmaking 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.