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Carolyn Stolberg & Carina Marten Georg-August-University Goettingen

Pol Chi. Intervention or Prevention? National Child Well-Being Strategies in Germany and Great Britain Instancing Health Behaviour in Early Childhood. Carolyn Stolberg & Carina Marten Georg-August-University Goettingen

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Carolyn Stolberg & Carina Marten Georg-August-University Goettingen

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  1. PolChi Intervention or Prevention? National Child Well-Being Strategies in Germany and Great Britain Instancing Health Behaviour in Early Childhood Carolyn Stolberg & Carina Marten Georg-August-University Goettingen 3rd conferenceofthe International Society for Child Indicators (ISCI): „Children‘s Well-Being: The Research & PolicyChallenges“ York, July 28th, 2011

  2. PolChi Research BackgroundThe POLCHI-Project Embedded in PolChi-Project “Governing ‘new social risks’: The case of recent child policies in European welfare states” • funded within: ORA • start: May 2011 • national team: France, Germany, Great Britain, the Netherlands Aimoftheproject: Analysing the logics of prevention and intervention programmes for parents in four countries Our focus: child health in the early years

  3. PolChi OurresearchwithintheprojectRelevance THE CONVENTION ON THE RIGHTS OF THE CHILD (UN 1989) Guiding principles: general requirements for all rights Right to life, survival and development (Article 6): Children have the right to live. Governments should ensure that children survive and develop healthily.

  4. PolChi OurresearchwithintheprojectRelevance Fig. 1: overallchild well-beingindex (Data from 2006) Source: Bradshaw/Richardson 2009: 324, own excerpt.

  5. PolChi OurresearchwithintheprojectRelevance Fig. 1: overallchild well-beingindex (Data from 2006) Source: Bradshaw/Richardson 2009: 324, own excerpt.

  6. PolChi OurresearchwithintheprojectRelevance Fig. 1: overallchild well-beingindex (Data from 2006) Source: Bradshaw/Richardson 2009: 324, own excerpt.

  7. PolChi OurresearchwithintheprojectAimandresearchquestion Central research question: How do British respectively German policies approach the issue of health behaviour in early childhood? • How are parents’ abilities and potentials in good health behaviour adressed? • Are these institutions based on logics of prevention or rather intervention? • To what extent do programmes balance aspects of social control and supporting parents by empowerment? • Which agencies of policy services are involved? • Do the logics and practices of child-centred policies converge or diverge in the two countries?

  8. PolChi Structure • TerminologyEarly childhood & Health; Intervention & Prevention • Welfareregimeandchild-centredpolicyThe caseof Germany & Great Britain; Typology • Policystrategies in Germany Health Check-ups beforeand after birth; Family-midwiveswithinthepilotproject “Pro Kind”; Opstapje – StepbyStep • Policystrategies in Great BritainThe Healthy Child Programme (HCP); Family-Nurse Partnershipprogramme (FNP); Children‘sCentres • ResultsThe caseof Germany & Great BritainwithintheTypology • SummaryandConclusion

  9. PolChi 1) TerminologyEarly childhood & Health Early childhood: beforebirth – 3 years • “What happens during the very earliest years of a child’s life … influences how the rest of childhood and adolescence unfolds” (UNICEF 2001: 2) Health: “Healthis a stateofcompletephysical, mental andsocial wellbeingand not merelytheabsenceofdiseaseorinfirmity” (WHO 1948) • mainhealthissues: obesityorothernutritiondeficits, inequality in infantmortality, psychologicalhealth, accidents, chronicalillnesses, childneglectandabuse

  10. PolChi 1) TerminologyIntervention & Prevention Intervention & Prevention: Most authorsdifferentiatebetweenprimary, secondaryandtertiarypreventionor (iftheyusethetermintervention) do not distinguishbetweeninterventionandprevention (see e.g. Blair et al. 2010; Jahn 2008) We will focus on thedefinitionsof Parton (2006) • Preventionisbeforediseaseoccurs • syn. withprimaryprevention • allways positive (support) • Intervention isafter diseaseoccured • syn. withsecondaryprevention • positive and/or negative (service)

  11. PolChi 2) Welfare Regime andchild-centredpolicyThe caseof Germany & Great Britain The caseof Germany • Conservative • State driven • Transfers ratherthanservices • Early warningsystemtosafe-guardingchildhealth • Healthwithinthe 13thChildrenand Youth Report More preventionionist? The caseof Great Britain • Liberal • Market driven • Services ratherthantransfers • Healthcontributionbyearlyyearsservices • Healthwithin National Action Plan More interventionist?

  12. PolChi 2) Welfare Regime andchild-centredpolicyTypology Dimensions Threeprogrammes per country: (1) completehealthorientated, (2) importation, (3) country-specific

  13. PolChi 3) Policystrategiesin GermanyHealth Check-ups beforeand after birth The Goal • healthy development of the (unborn) child The Concept • medical monitoring during the pregnancy • medical monitoring and imunisation after birth long tradition in germany Source: BMFSFJ 2009; Khaschei 2006: 52; BzgA 2010.

  14. PolChi 3) Policystrategiesin GermanyHealth Check-ups beforeand after birth Dimensions Dimensions Source: BMFSFJ 2009; Khaschei 2006: 52; BzgA 2010.

  15. PolChi 3) Policystrategiesin GermanyFamily-midwiveswithinthepilotproject “Pro Kind” The Goals • improvement of health behaviour within the pregnancy • health promotion in the first two years of the child The Concept: • Family-midwives are going into the families (idea of the Nurse-Family Partnership, USA) pilot project in germany since 2006 Source: Ziert et al. 2010; NZFH 2010.

  16. PolChi 3) Policystrategiesin GermanyFamily-midwiveswithinthepilotproject “Pro Kind” Dimensions Dimensions Source: Ziert et al. 2010; NZFH 2010.

  17. PolChi 3) Policystrategiesin GermanyOpstapje – StepbyStep The Goals concerning • the parents: support in childraise • the children: guarantee age-related development • the family: strengthening parent-child-relation The Concept: • early support; health as an sub-aspect (grow up healthily) • house visiting over two years exists in germany since 2001 Source: Sann/Thrum 2005.

  18. PolChi 3) Policystrategies in GermanyOpstapje – StepbyStep Dimensions Dimensions Source: Sann/Thrum 2005.

  19. PolChi 4) Policystrategiesin Great BritainThe Healthy Child Programme (HCP) The Goals • improvement of child health and well-being • “parenting support” (DH 2009: 10) The Concept: • “begins in early pregnancy and ends at adulthood…” (DH 2009: 7) • “…screening tests, immunisations, developmental reviews, and information and guidance to support parenting…” (DH 2009: 8)

  20. PolChi 4) Policystrategiesin Great BritainThe Healthy Child Programme (HCP) Dimensions Dimensions Source: DH 2009.

  21. PolChi 4) Policystrategiesin Great BritainFamily-Nurse Partnershipprogramme (FNP) The Goals aretoimprove (DH 2011: 13): • “maternal and child pregnancy outcomes” • “child health and developmental outcomes” • “parent’s economic self-sufficiency” The Concept: • Nursesaregoingintothefamilies (ideaofthe Nurse-Family Partnershipfromthe USA) pilotproject in Great Britainsince 2006 Source: DH 2011.

  22. PolChi 4) Policystrategiesin Great BritainFamily-Nurse Partnershipprogramme (FNP) Dimensions Dimensions Warum hier beides? Source: DCSF/DH 2009.

  23. PolChi 4) Policystrategiesin Great BritainChildren‘sCentres The Goals • “…helpingeverychildgetthebeststart in lifeandhelpingthemtobehealthy, staysafe, enjoyandachieve, make a positive contribution, andachieveeconomic well-being – thefive vital Every Child Mattersoutcomes” (DCSF/DH 2010: 2f.) The Concept: • “…place …through which early childhood services are made available…” (DfE 2010: 6) exists in Great Britainsince2004

  24. PolChi 4) Policystrategies in Great BritainChildren‘sCentres Dimensions Dimensions Source: Lewis et al. 2011; DCSF/DH 2010; DfE 2010.

  25. PolChi 5) ResultsThe caseof Germany & Great BritainwithintheTypology Is Germany morepreventionistand Great Britainmoreinterventionist? Prevention (self-control ↑) Intervention (self-control ↓)

  26. PolChi 5) ResultsThe caseof Germany & Great BritainwithintheTypology Is Germany morepreventionistand Great Britainmoreinterventionist? Prevention (self-control ↑) Intervention (self-control ↓) Health Check-ups beforeand after birth (GER) Family-midwiveswithinthepilotproject “Pro Kind” (GER) Opstapje – StepbyStep (GER) The Healthy Child Programme (HCP) (GB) Family-Nurse Partnershipprogramme (GB) Children‘sCentres (GB)

  27. PolChi 5) ResultsThe caseof Germany & Great BritainwithintheTypology Is Germany morepreventionistand Great Britainmoreinterventionist? Prevention (self-control ↑) Intervention (self-control ↓) Health Check-ups beforeand after birth (GER) Family-midwiveswithinthepilotproject “Pro Kind” (GER) Opstapje – StepbyStep (GER) The Healthy Child Programme (HCP) (GB) Family-Nurse Partnershipprogramme (GB) Children‘sCentres (GB)

  28. PolChi 6) Summary andConclusion • Historical developmenttojudgeaboutdivergenceorconvergence • Germany: pilotprojects • Great Britain: longtraditionofearlyyearsservices • Outcomesdiffer also within countries • after analysingthelogicofhealthprogrammesin moredetail, • theireffect on different groupsofchildrenhastobeevaluated

  29. PolChi Thank you! Carolyn Stolberg Institute of Sociology Dept. Political Sociology and Social Policy Georg-August-University Goettingen Platz der Goettinger Sieben 3, 37073 Goettingen Dr. Carina Marten Institute of Sociology Dept. Political Sociology and Social Policy Georg-August-University Goettingen Platz der Goettinger Sieben 3, 37073 Goettingen http://www.parenting.eu

  30. PolChi Appendix Tab. 1: Summary ofindicatorscomponentsanddomains Source: Bradshaw/Richardson 2009: 322.

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