Protection Practitioners Research Articles

Integrating health and child protection systems: towards collaboratively improving health outcomes for children in kinship care in rural Australia

PurposeThere is a growing recognition that the integration of health systems will benefit children in out-of-home care (OOHC), especially those who have experienced trauma. This paper examines the adaptation of existing health systems and the persistent barriers between rural health and child protection programs. It focuses on health systems integration for children aged 0–6 years in kinship care and their siblings.Design/methodology/approachThe study applied a multi-methods qualitative approach involving individual interviews and focus groups with project members from operational or strategic reference groups, child protection personnel and the kinship carer program. We also reviewed documentary evidence.FindingsWe found evidence that health clinicians and child protection practitioners adapted and adjusted services as they collaboratively worked together to improve care delivery to children in kinship care. Yet, despite successful adaptations to systems and the appointment of a health navigator, systemic barriers remain. These include service and staff shortages in rural Australia, complications around information sharing, authority and power dynamics and siloed operations. Such barriers prevent better-integrated health systems and ultimately impair health outcomes for children in kinship care.Originality/valueThis paper contributes to knowledge and practice to improve the integration of child protection and healthcare services in Australian OOHC. It provides valuable insights into the challenges and successes of health systems integration, highlighting the need for continued collaborative effort to create effective, place-based models of care that benefit these children and their carers.

Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: a qualitative analysis of public health case management records

BackgroundShiga toxin-producing Escherichia coli (STEC) infections are a significant public health concern as they can cause serious illness and outbreaks. In England, STEC incidence is highest among children and guidance recommends that children under six diagnosed with STEC are excluded from childcare until two consecutive stool cultures are negative. We aimed to describe the barriers and facilitators to implementing exclusion and the impact of exclusion policies on young children and their families.MethodsIndividual level data was obtained from a wider study focusing on shedding duration among STEC cases aged < 6 years between March 2018 – March 2022. Data was extracted from England’s public health case management system. The case management system includes notes on telephone conversations, email correspondence and meeting minutes relating to the case. Collected data consisted of free text in three forms: (1) quotes from parents, either direct or indirect, (2) direct quotes from the case record by health protection practitioners or environmental health officers, and (3) summaries by the data collector after reviewing the entire case record. We analysed free text comments linked to 136 cases using thematic analysis with a framework approach.ResultsThe median age of included cases was 3 years (IQR 1.5-5), with males accounting for 49%. Nine key themes were identified. Five themes focused on barriers to managing exclusion, including (i) financial losses, (ii) challenges with communication, engagement and collaboration, (iii) issues with sampling, processing, and results, (iv) adverse impact on children and their families and (v) conflicting exclusion advice. Four themes related to facilitators to exclusion, including (i) good communication with parents and childcare settings, (ii) support with childcare, (iii) improvements to sampling, testing, and reporting of results, and (iv) provision of supervised control measures.ConclusionsQualitative analysis of public health case records can provide evidence-based insights around complex health protection issues to inform public health guidelines. Our analysis highlights the importance of considering wider social and economic consequences of exclusion when developing policies and practices for the management of STEC in children.

Approaches to Supporting Young People in Out-of-Home Care Who ‘Self-Place’ in Unapproved Locations: Perspectives of Statutory Child Protection Practitioners

Abstract The responsibilities of statutory child protection practitioners (SCPPs) include supporting the care and protection needs of young people in out-of-home care. SCPPs face challenges in responding to young people’s preferences and rights to self-determination within child protection systems that are often risk averse. This article considers SCPPs’ approaches to working with young people who leave approved placements to stay in other, unapproved locations. This phenomenon is referred to as ‘self-placing’ in Queensland (Australia), where this study was conducted. These young people are often disconnected from support, at increased risk of homelessness and exploitation, have increased contact with the justice system, disengage from education, face barriers to mental and physical health care and experience ongoing trauma and crisis. We draw on data from seven focus groups conducted with twenty-six practitioners from Queensland’s child protection authority to explore how they work with this cohort. Our findings highlight the discomfort that SCPPs experience, due to concerns about risk and a lack of formal practice guidelines. Despite sharing concerns for the safety of young people, SCPPs adopt different approaches to manage the complexities of this work. Understanding these practices can assist in developing more responsive policies and practices for supporting this cohort.

When Social Workers Are Given Dual Mandates: Child Maintenance and the Complexities of Family Situations in the Ghanaian Child Protection System

Abstract Custodial parents, often single mothers, face challenges regarding child maintenance, including a lack of financial commitments from non-custodial parents for their children’s welfare. The evidence suggests that there is a strong link between child maintenance and poverty as well as other family violence issues. In addition to their primary child and family protection duties, child protection practitioners in Ghana have a mandate to assess child maintenance concerns. This dual responsibility may have the advantage of promoting holistic child and family practices, but it could also negatively impact families when practitioners overly focus on one responsibility at the expense of the other. We sought to understand and show whether families who reported child maintenance concerns to the Department of Social Welfare and Community Development in Ghana experienced challenges beyond child maintenance and whether practitioners identified these primary protection concerns in their assessments. Findings from qualitative in-depth interviews with seventeen parents show that these families experienced domestic violence, marital conflict and child abuse and neglect beyond the scope of a standard child maintenance case. The findings highlight the importance of child protection workers conducting comprehensive family assessments to resolve ‘hidden’ family difficulties when establishing child maintenance arrangements.

Science-informed Policy Making for Protecting People and the Environment from Radiation.

The process to arrive at the radiation protection practices of today to protect workers, patients, and the public, including sensitive populations, has been a long and deliberative one. This paper presents an overview of the US Environmental Protection Agency's (US EPA) responsibility in protecting human health and the environment from unnecessary exposure to radiation. The origins of this responsibility can be traced back to early efforts, a century ago, to protect workers from x rays and radium. The system of radiation protection we employ today is robust and informed by the latest scientific consensus. It has helped reduce or eliminate unnecessary exposures to workers, patients, and the public while enabling the safe and beneficial uses of radiation and radioactive material in diverse areas such as energy, medicine, research, and space exploration. Periodic reviews and analyses of research on health effects of radiation by scientific bodies such as the National Academy of Sciences, National Council on Radiation Protection and Measurements, United Nations Scientific Committee on the Effects of Atomic Radiation, and the International Commission on Radiological Protection continue to inform radiation protection practices while new scientific information is gathered. As a public health agency, US EPA is keenly interested in research findings that can better elucidate the effects of exposure to low doses and low dose rates of radiation as applicable to protection of diverse populations from various sources of exposure. Professional organizations such as the Health Physics Society can provide radiation protection practitioners with continuing education programs on the state of the science and describe the key underpinnings of the system of radiological protection. Such efforts will help equip and prepare radiation protection professionals to more effectively communicate radiation health information with their stakeholders.

What is known about Australian child protection practitioners’ participation in the health care of children living in out of home care: a scoping review

PurposeThere is a growing recognition of the urgency to enhance health outcomes for children and young people residing in out-of-home care (OOHC). Research underscores the need to establish effective pathways to quality health care for children and young people who have been exposed to trauma. Child protection (CP) practitioners should play a vital role in proactively improving health outcomes and navigating the intricacies of healthcare systems. Their involvement in initiating and collaborating on healthcare interventions is pivotal for the well-being of these vulnerable children and young people. However, challenges associated with poor health literacy and the complexities of healthcare systems hinder collaborative service delivery in the Australian context. This review explores how CP practitioners support the health care of children and young people in their care.Design/methodology/approachA scoping review followed Arksey and O’Malley’s framework, employing a narrative synthesis to assess the selected studies.FindingsHealth outcomes for children and young people in OOHC remain under-researched and potentially under-resourced within the realm of CP practice. There is room for enhanced practices and system integration in CP service delivery to better address health needs and prevent further health and well-being disparities.Originality/valueThrough this scoping review and involving industry experts in the discussion of findings, this study contributes valuable insights to the existing knowledge base regarding the active participation of CP practitioners in addressing the healthcare needs of vulnerable children.

Experiences of children's self-wetting (including urinary incontinence) in Cox's Bazar's Rohingya refugee camps, Bangladesh.

Self-wetting is the leakage of urine, either due to the medical condition of urinary incontinence (UI), or because a person does not want to, or cannot, access a toileting facility in time. This study explored the attitudes towards self-wetting and experiences of children (aged five to 11), their caregivers, community leaders and humanitarian practitioners in the Rohingya refugee camps in Cox's Bazar, Bangladesh. We particularly focused on how water, sanitation and hygiene (WASH) and protection interventions might assist in improving these experiences. We purposively selected participants from two camps where our partner organisation works. We conducted Key Informant Interviews (KIIs) with community leaders and camp officials, Story Book (SB) sessions with Rohingya children and in-depth Interviews (IDIs) with caregivers of children who participated in the SB sessions, as well as surveying communal toilets. Self-wetting by children was common and resulted in them feeling embarrassed, upset and uncomfortable, and frightened to use the toilet at night; many children also indicated that they would be punished by their caregivers for self-wetting. Key informants indicated that caregivers have difficulty handling children's self-wetting due to a limited amount of clothing, pillows, and blankets, and difficulty cleaning these items. It was evident that the available toilets are often not appropriate and/or accessible for children. Children in the Rohingya camps appear to self-wet due to both the medical condition of UI and because the sanitation facilities are inappropriate. They are teased by their peers and punished by their caregivers. Although WASH and protection practitioners are unable to drastically alter camp conditions or treat UI, the lives of children who self-wet in these camps could likely be improved by increasing awareness on self-wetting to decrease stigma and ease the concerns of caregivers, increasing the number of child-friendly toilets and increasing the provision of continence management materials.

Image steganography techniques for resisting statistical steganalysis attacks: A systematic literature review.

Information hiding in images has gained popularity. As image steganography gains relevance, techniques for detecting hidden messages have emerged. Statistical steganalysis mechanisms detect the presence of hidden secret messages in images, rendering images a prime target for cyber-attacks. Also, studies examining image steganography techniques are limited. This paper aims to fill the existing gap in extant literature on image steganography schemes capable of resisting statistical steganalysis attacks, by providing a comprehensive systematic literature review. This will ensure image steganography researchers and data protection practitioners are updated on current trends in information security assurance mechanisms. The study sampled 125 articles from ACM Digital Library, IEEE Explore, Science Direct, and Wiley. Using PRISMA, articles were synthesized and analyzed using quantitative and qualitative methods. A comprehensive discussion on image steganography techniques in terms of their robustness against well-known universal statistical steganalysis attacks including Regular-Singular (RS) and Chi-Square (X2) are provided. Trends in publication, techniques and methods, performance evaluation metrics, and security impacts were discussed. Extensive comparisons were drawn among existing techniques to evaluate their merits and limitations. It was observed that Generative Adversarial Networks dominate image steganography techniques and have become the preferred method by scholars within the domain. Artificial intelligence-powered algorithms including Machine Learning, Deep Learning, Convolutional Neural Networks, and Genetic Algorithms are recently dominating image steganography research as they enhance security. The implication is that previously preferred traditional techniques such as LSB algorithms are receiving less attention. Future Research may consider emerging technologies like blockchain technology, artificial neural networks, and biometric and facial recognition technologies to improve the robustness and security capabilities of image steganography applications.

Why do mothers stay? Challenging attitudes in decision making about children at risk because of domestic violence

BackgroundThis article reports findings from research commenced in 2019. Stage one assessed the attitudes and beliefs of child protection practitioners towards domestic violence. Stage two considered the impact of combining Structured Decision Making (SDM - the standard assessment approach) with Response Based Practice (RBP - a contemporary approach to understanding violence), on child protection decisions. ObjectiveTo improve the child protection response to children who experience domestic violence. This article reports on stage three; considering the impact of practitioner attitudes and beliefs on child protection decisions and whether the combined assessment approach (SDM + RBP) moderated the impact of practitioner attitudes and beliefs. Participants and setting1041 child protection practitioners participated in the research while attending one of 17 practice conferences across New South Wales, Australia. MethodsAn innovative video vignette experiment with a between-subjects design was used, relying on professional actors to play the roles of practitioner and mother of the children reported. Participants watched a video interview of a safety assessment and completed a survey. ResultsPractitioner attitudes and beliefs were not significantly correlated with assessments about the children's safety; but attitudes did impact decisions about the likelihood of the children being brought into care. Attitudes and beliefs moderated the impact of misinformed attitudes, to some extent. ConclusionsThe research confirms the value of the combined SDM + RBP approach to guide practitioners to a more holistic understanding of domestic violence. It also confirms that assessment approaches are only ever as good as the beliefs and attitudes of the people who apply them.

Partnering with families known to child protection in an interprofessional context

BackgroundTo meet the diverse needs of children and their families known to child protection, interprofessional collaboration across a range of services is critical. Children and their parents/caregivers are key stakeholders in these collaborations and current research highlights the need to strengthen their participation in these service responses. Practitioners have a critical role in strengthening family member participation in child welfare and protection responses. ObjectiveTo explore professional's experiences and perceptions of working in partnership with children and families known to child protection in an interprofessional context. Participants and setting14 professionals with extensive experience in the fields of family support and child protection. MethodsSemi-structured interviews were completed, recorded, transcribed, and then coded using NVivo 12 Pro. Reflexive thematic analysis was used to guide data analysis. ResultsTrusting practitioner-family relationships were affirmed to be critical to engaging and partnering with families. Results pertaining to the interprofessional context encourage a more community-oriented perspective of practitioner-family relationships, where practitioners have a collective responsibility to welcome families into an integrated network of community services. Further, the conflict for child protection practitioners between their legislated role and their need to build trusting relationships with families to support partnered work is discussed. ConclusionsThe centrality of practitioner-family relationships needs to be better recognized and supported in policy and practice across all sectors supporting children and families known to child protection. An interprofessional approach to building practitioner-family relationships across this range of services may enhance family engagement and partnerships in their service responses.

“Unless we Value the Intangible Heritage, the Tangible will never be Safe!” Linking the Tangible and Intangible Aspects of Heritage Sites in Africa

ABSTRACT A few heritage researchers and protection practitioners in some African countries define heritage sites and cultural objects based on European and North American criteria. Such criteria emphasize visual material remains like monumental structures and their aesthetically pleasing features. This Western view overlooks some critical aspects. For example, to local people, the meanings and associated values make the monuments and sites relevant. Despite the inseparability of the tangible heritage and associated intangible aspects such as spiritual practices, some researchers and heritage practitioners, including antiquities department officials, need to pay more attention to the invisible meanings embedded in the sites and cultural objects. Notably, it is these immaterial aspects which the local people value the most. In this article, we survey three fishing villages: Batini, Mkadini and Winde, on the Swahili coast in East Africa, and document what heritage means from the local people's perspective. We argue that fishing communities value features like reef crests, sacred mangrove forests, the ruins of stone-built tombs and sacred baobab trees not because of their physical appearance but the spiritual practices (e.g., healing, rituals, and offerings) the local people undertake within and around these sites. We further contend that to achieve heritage preservation sustainability, government officials and heritage scholars should pay greater attention to the spiritual aspects associated with these places.

Re-envisaging professional curiosity and challenge: Messages for child protection practice from reviews of serious cases in England

Learning lessons from cases where children have been killed or seriously harmed from abuse or neglect is important for child protection policy and practice around the world. In England there is a long-established system of locally based, multi-agency reviews. Three recurrent themes over the years have been the poor quality of assessments, shortcomings in inter-agency working and information sharing, and not knowing the children and understanding their experiences. The reviews often identify a lack of ‘professional curiosity’ and insufficient ‘challenge’ on the part of child protection practitioners as the cause of these problems. This paper analyses these concepts, drawing on four recent studies of child safeguarding reviews conducted by the authors and their research team. It uses qualitative data from the reports and the views of local professionals in online focus groups. The reviews tend to use the perceived lack of curiosity and challenge as the explanation for poor practice without interrogating why, when and in what circumstances it becomes more difficult for professionals to remain curious and appropriately challenging. Professional curiosity and challenge are complex, multifaceted concepts, and applying them in practice is difficult and skilled work. The paper argues for a more nuanced and grounded understanding of the concepts and their application in practice. It sets them in wider frames of communication and courage, and the ambiguous policy context of a preference for cooperative engagement with families but high expectations about protecting children. It offers recommendations for future research into the review process, authorship style, practice in local agencies and national government policy.

UK experience of professional registration in radiation protection.

The UK Radiation Protection Council (RPC) was established in 2019, under the Royal Charter of the Society for Radiological Protection. The RPC holds the registers for three grades of professional registration-Chartered, Incorporated and Technical Radiation Protection Professional. Individual radiation protection practitioners may apply for registration through any society or organisation that has been accepted as a Licensee of the RPC. This paper will give an overview of the criteria used for registration at each level, along with the benefits of professional registration to individuals, employers, the radiation protection profession and the public. We will discuss the operation of the RPC and share the experience of its establishment, identifying key issues and potential pitfalls for other Societies wishing to go down this route. Future expectations for professional registration will be considered.

The European NORM Association (ENA)-promoting radiation protection in the field of norm in Europe.

The European NORM Association (ENA) was founded in 2017, merging previously informal European networks. It has the statute of an International Non-profit Organization established under Belgian Law. The objective of ENA is to promote and advance radiation protection in the context of exposure to NORM. It operates as a European platform and forum for discussion, dissemination and exchange of information, training and education and by supporting scientific knowledge and new directions of research related to NORM issues. A key activity of ENA is to share practical solutions. To this end, ENA gathers radiation protection practitioners, regulators, scientists and industry representatives in order to support the management of NORM in compliance with European standards and according to best practices. Since its foundation, ENA has organized three workshops where topical issues on NORM have been discussed. It has established close working relationships and links with IAEA, HERCA, IRPA and other international initiatives-getting a recognition at international level. ENA has set up working groups on NORM in the industry, in the environment, in building materials and, as recently as in 2021, a working group on decommissioning of NORM facilities. A series of webinars have been organized to present case studies on NORM decommissioning and discuss associated challenges and practical solutions.

Integrating health systems for children and young people in out of home care: Challenging the nature of siloed service delivery in rural Australia.

The purpose of this paper is to report on enablers and barriers during the first 2 years of the health systems integration project that included the implementation of a health navigator role. The project aims to improve health outcomes for children and young people residing in out of home care in rural Australia with a health navigator co-located between child protection practitioners and community health services clinicians. Rural Northwest Victoria. Sunraysia Community Health Services and the Department of Health and Human Services. The qualitative design of the project evaluation involved semi-structured interviews and documentary evidence analysis. Analyses of interviews and documentary data demonstrate the challenging nature of siloed service delivery in rural Australia, particularly during a time that comprised multiple interruptions due to COVID-19. A limited synergy between organisational priorities and reporting systems hindered project progress. The lack of a shared definition of 'health' challenged the effective collaboration between health clinicians and child protection practitioners and the role of the health navigator. The health navigator raising health awareness through project involvement, training and sector-wide stakeholder engagement resulted in a slow but steady process of increased prioritisation of health care, increased health literacy among the child protection workforce, and broadening participation of area-based stakeholders, but did not translate to increased access to health plans for children. Integrating health systems across multiple sites with support of a health navigator revealed difficulties, particularly during COVID-19. The first phase of the project demonstrated the value of shared governance and partnerships as an imperative foundation for fundamental change. Relationships strengthened throughout the project, leading to a better understanding of area-based strengths, which in turn supports improved pathways to health care for children and young people in OOHC within rural communities and driving the subsequent phases of the 10-year project.

Placement Matching of Children and Young People within Out-of-Home Residential Care: A Qualitative Analysis

Residential care for children and young people is typically regarded as the least preferred option in out-of-home care by child welfare and protection practitioners. Increasingly, residential care is only used to place young people after multiple unsuccessful placements in kinship or foster care. Consequently, these young people often come into residential care with complex needs and entrenched emotional and behavioural difficulties. Coplacement of these young people in residential care has raised significant and persistent concern of peer victimisation while in residential care. Improved matching of peers within residential care may enhance safety and stability, a proposal for which young people themselves have expressed support. However, the matching of young people in residential care has received little attention in research. This article reports the qualitative findings of a multiinformant study, drawing on the first-hand experiences of 34 participants comprising eight young people and 26 practitioners in residential care, to identify the considerations they perceived as important when matching young people in residential care. Framework analysis of young people's and practitioners’ perspectives identified three matching strategies that may more effectively address the concern of peer victimisation in residential care including (1) balancing risks and strengths; (2) steering into collective duty of care; and (3) involving young people in planning and transition. Implications of the findings directly point to the need to prioritise young people’s rights to protection and participation, and to provide independent oversight to assist residential care organisations and the broader child welfare system to navigate the complexity in the practice of matching young people in residential care.

Advocacy as a Human Rights Enabler for Parents in the Child Protection System

ABSTRACT Parents and guardians in child protection systems are in unequal power relationships with child protection practitioners. This relationship is experienced as exclusionary or even oppressive by many parents and guardians. For families and communities in the child protection system who experience intersectional discrimination and disadvantage, such as people with intellectual disabilities and First Nations people, this unequal relationship and subsequent potential exclusion and oppression can be even more profound. A growing body of literature indicates that advocacy can assist in addressing unequal relationships in other contexts, such as involuntary mental health. This paper explores the role of representational advocacy in supporting parents in child protection settings through a case study of an advocacy service in Victoria, Australia. Using a human rights framework to guide the analysis, the paper highlights how advocacy can help support rights, but that broader structural change will be required to consistently uphold the rights of parents.

A Long, Long Journey

Abstract This article considers the practical implications and effectiveness of a rights-based approach to delivering child protection programming in communities in which notions of children’s rights and child protection concerns may sit awkwardly with pre-existing cultural traditions. It reports on the findings of a qualitative study of child protection practitioners in two poor rural districts of Uganda and uses these to reflect on the key differences between international children’s rights norms as expressed in the United Nations Convention on the Rights of the Child and traditional African values as reflected in the African Charter for the Rights and Welfare of Children. It explores the perceived challenges posed by a children’s rights-based approach to parental authority and community practices in the context of the Ugandan legislation and the culture of the study communities and considers the key factors that appear to be influential in enabling changes in attitudes and behaviours towards children.

Personalizing Child Protection: The Clinical Value and Usability of a Needs Assessment Instrument in The Netherlands.

Studies on child maltreatment prevention programs show that the effects of these programs are rather small. Drawing on the need principle of the Risk-Need-Responsivity model, program effects may be enhanced by properly assessing all the needs of individual families involved in child protection so that programs can be adapted to those needs. Recently, a needs assessment tool (ARIJ-Needs) has been developed in the Netherlands to support child protection practitioners in not only the assessment of treatment needs in individual families, but also in selecting the program(s) and/or intervention(s) that best target those needs. This study assessed the clinical value and usability of ARIJ-Needs by interviewing Dutch child protection practitioners (N = 15). A vignette describing a child protection case was used to examine differences between needs assessments based on unstructured clinical judgment (i.e., without using the assessment tool), and structured clinical judgment in which the assessment tool was used. The results showed that significantly more treatment needs were identified when ARIJ-Needs was used relative to clinical judgment in which ARIJ-Needs was not used. Specifically, needs related to parenting, the parent(s), and the family were identified more often when the assessment tool was used. This is an important finding, as these needs comprise the (changeable) risk factors that are most predictive of child maltreatment and should be addressed with priority to prevent child maltreatment. This study shows that ARIJ-Needs supports practitioners in assessing relevant needs in families at risk for child maltreatment. Study implications and recommendations for improvement of the ARIJ-Needs are discussed.

The attitudes and beliefs of the child protection workforce and why they matter to children who live with violence

AbstractIn Australia, like other developed countries, there has been an increase in reports to child protection services about children experiencing domestic violence. While there is research on the importance of the skills and knowledge of the child protection workforce for this growing problem, little is available about practitioner attitudes and beliefs. This paper presents findings on research undertaken in New South Wales, which is the most populated state in Australia. The research considered the attitudes and beliefs of the statutory child protection workforce about domestic violence. It relied on a large‐scale survey of 1041 child protection practitioners. In order to compare the attitudes and beliefs of child protection workforce with those of the general community, the survey replicated questions from the Australian National Community Attitudes towards Violence against Women Surveys. Overall, the attitudes and beliefs of the workforce more closely reflected contemporary theory and evidence about domestic violence than those of the community. The research also examined variations in the attitudes and beliefs of the child protection workforce according to practitioner characteristics, finding variations by gender. The implications for the fields of child protection and social work are discussed.