Family Counselling Bureaus:
the First Level Health Services
Maria Edoarda Trillò
materno.infantile@aslrmc.it
The First Level Health Services
The integrated set of services
targeted to a person.
Activities and services to promote
the wellbeing of all people
needing social-sanitary support
The First Level Health Services:
a network
The primary health care
The family paediatrician
The family counselling bureau
The vaccination services
The mental health centres
The services for the protection of
mental health and handicap
The drug addict services (Ser.T)
The services for adolescents
The health education services
The screening programmes
The ambulatories for foreign people
temporary in Italy and cultural mediation
The birth houses
The hygiene and public health services, and worker protection
The pharmaceutical assistance
What is the Health Services Network?
anamnesis
The integrated set of services targeted to a person
It goes out from the paradigm of assistance :
objective examination
diagnosis and prognosis
care
towards the model of taking in charge
of “global taking in charge" of the person in her/his territorial context and unique
approach. It has a guiding role in integrated interventions for people with special
assistance needs.
It consists in activating, in each single case, systematically, an integrated process of
taking in charge of the socio-sanitary needs between Health Services with
different professionalism.
Eg. One Entry Point (PUA)
For chronic diseases
Eg. Active Offer
To build a network in the Health
Services
To map the Territorial Health and Social Services and
professional staff
To choose the appropriate counterpart - target
To know the respective fields of expertise, objectives and
activities
To know the respective prevention, diagnosis and
treatment programmes
To meet in order to define the assistance needs and
possible solutions
To define a common and shared approach and indicators
for the evaluation process
Institutional recognition of the chosen approach
To try and implement
The First Level Health Services:
a network
To make a network is a
public health activity
What is the meaning of Active Offer?
It is a process of communication
using all potential channels acting synergistically, starting from the institutional
ones…. with modalities adapted to specific characteristics of each person and
group of population to be involved, fully aware of the complexity of dimensions
in which the communication is embedded (physical, relational, psychological,
ethical, cultural, social, anthropological)… (source: P.O.M.I.)
Offer : approach people with kindness, empathy, compassion and
humility, which are professional competencies and not only ethical
options
Active : feel oneself responsibility to be accepted and question oneself,
as serious professional, on factors constituting possible barriers
Result: better quality and better values of health indicators
The Italian and Foreign Women:
what does she want from the Health
Service?
To understand what is happening to her
Easy accessibility
Integrated prevention, assistance and
diagnostic services
Communication
Efficiency and professionality
Quality
.......................
Complete wellbeing with herself, with her
children and her family !
The Family
Counselling Bureau
Primary Health and Gender Services
with a low threshold of access
characterized by
horizontal, non directive and non paternalistic
communication
SEXSUALITY
AND
REPRODUCTION
The Family
Counselling Bureau
The Family Counselling Bureaus, formally established in
1975 (law 405/75), were implemented in Italy in
different periods and with different modalities,
following the approval of the Regional laws.
Born during the first Health Reform on the wave of the
“women movement” including, among its claims, the
re-appropriation of health –empowerment – and the
recognition of the sexed body.
The originality of the Family Counselling Bureau services
(multidisciplinary, non directivity, gender vision) is a
common heritage and should not be missed, in fact the
Mother and Child Project constitutes an integral part of
the National Health Plan since 1998-2000.
The role of Family Counselling
Bureau
To spread the culture of prevention of the
health of woman, intended as human
being, within the couple and family
context, in the all-day life concerning
health, psychological and social aspects.
Important role in the women empowerment
on the reproductive sphere: sexual
behaviours and health, contraception,
and maternity awareness.
Family Counselling Bureau:
individual activities
Fields of activity:
Maternity and Paternity Awareness:
pregnancy,
puerperium, infertility, sexual psychological and social counselling,
contraception, Italian law 194/78 on abortion, abuse prevention and
child abuse, cultural mediation
Marital and Parenting:
adoptions, family mediation
breastfeeding promotion and support,
Woman wellbeing:
sexually transmitted diseases prevention.
cancer prevention, menopause, assistance to abused women,
psychological counselling, specific empowerment for foreign women
Infant wellbeing: health checks, vaccinations,
correct lifestyle promotion, counselling
education and
Adolescent wellbeing: “space for young people”,
vaccinations, sexually transmitted diseases prevention
Family Counselling Bureau:
group activities
Preconception counselling for groups of students (at school,
in the family Counselling), for young couples, for women
promotion, information, education on contraception (for
groups, in Family Counselling, at school)
antenatal and birth preparation courses
information and health education for groups of parents of less
than 1 year children
Breastfeeding support
Groups on adolescent problems
Groups for parents preparation in couples asking to adopt a
child
prevention and information groups on problems caused by
menopause
The Mother and Child Project
P.O.M.I.
•
establish requirements and standards of
needs for Family Counselling Bureaus
• give them an important role in the health
promotion for women and adolescents
The organizational model is the departmental
one, allowing:
the coordination of interventions to fulfil
health promotion and health prevention
objectives, through a synergic integration
of Hospitals and Territorial Services
The institutional mandate of
Family Counselling Bureau
It is ensured by a multi-professional equipe
where all participants have the same dignity
(the social assistant is the key person)
Working in equipe is the key factor to
guarantee an unique and global preventive
approach in the complete consciousness
that working together with different
professional roles is not easy, but a must
The multi professional staff
of Family Counselling Bureau
Social assistant
Midwife
Health assistant
Nurse
Psychologist
Gynaecologist
Paediatrician
Cultural mediator
Reception and information
Interview, examination of
histories, requests and resources.
Taking in charge
Gynaecologic visits, pregnancy
status and certificate
Appointment for examinations and
intervention and post abortion control
Contraception and prevention of
repeated abortion
The multi professional staff
of Family Counselling Bureau
Social assistant
Midwife
Health assistant
Nurse
Cultural mediator
Reception and information
Interview, examination of
histories, requests and
resources.
Taking in charge
Appointment for examinations
and intervention and post
abortion control
Contraception and prevention of
repeated abortion
The multi professional staff
of Family Counselling Bureau
Health assistant
Psychologist
Gynaecologist
Cultural mediator
Interview, examination of
histories, requests and
resources.
Taking in charge
Gynaecologic visits, pregnancy
status and certificate
Appointment for examinations,
intervention and post abortion
control
The multi professional staff
of Family Counselling Bureau
Midwife
Health assistant
Nurse
Contraception and prevention of
repeated abortion
Psychologist
Care of family health and
Gynaecologist
psychological problems
Paediatrician
Cultural mediator
A girl
The Family Counselling
Bureau is the place
where they give you a
hand
Thank you for your
attention