A presentation in 2012 by the Centre for International Health at the Burnet Institute in Australia outlines barriers against family inclusive care.
These correspond extremely closely to my experience of promoting engagement of fathers in UK maternity services, strongly confirming that many of the issues I have been tackling for the last 17 years are indeed global.
Barriers exist at every level:
- Families: when family members restrict each other’s roles.
- Local services: when health professionals and their managers do not engage with families.
- National and regional planning and the configuration of international development assistance: when the evidence of the positive impacts of family engagement is not acknowledged.
The Burnet Institute presentation lists the following barriers:
- Cultural and social norms (though these are fluid and can be changed).
- Under-resourced staff unable to stretch to changing their modus operandi.
- Physical arrangement of clinics and messages conveyed to women that do not enlist family engagement.
- Lack of training of staff.
- Staff attitudes: a “deficit perspective” of men, where their motivations are interpreted negatively and where their needs are considered the result of poor choices rather than deserving of help.
- Family engagement regarded as an (expendable) add-on, rather than as something to be integrated into service delivery with the same overall objectives – improved child and maternal health.
My experience in UK is that these barriers are deeply rooted and remarkably resistant to change – indeed, even where change happens, it can quickly be reversed by the smallest change in circumstance.
The aim of the Family Included Global Alliance is to address these barriers and start to challenge the persistently and strategically over a long period. I will address ideas about how to do this in subsequent posts.
Photo: Jayel Aheram. Creative Commons.