Post-natal depression is much discussed yet definitions and approaches are not homogenous, neither in terms of the cause of post-partum mental ill health, its treatment or how further research in the area should proceed. This paper seeks to examine post-natal 'upsets' and to consider the different explanations that have been and could be made of post-partum mental ill health. The paper reviews the dominant biomedical and psychological approaches, evaluating their ability to explain post-natal mental illness. The writer believes biological and psychological approaches are in the ascendance but seeks to demonstrate that they do not present a full picture. Sociological approaches drawing upon stress, labelling and feminist models are examined, exploring new ways of looking at post-natal illness. The paper concludes that biological and psychological approaches do not provide complete explanations and a multidisciplinary approach is needed. Most significantly the woman's own perception of post-natal ill health is largely absent from the literature. The need for an approach using ethnographic methods is highlighted.

The UK Standing Conference on Specialist Community Public Health Nurse Education represents the interests of those most intimately involved with specialist community public health nurse (health visitor) (SCPHN (HV)) education in higher education institutions across the UK. This paper summarizes issues currently affecting the education of SCPHN (HV)s and the delivery of health visiting and public health nursing services across the UK. Difficulties in recruitment, numbers of practice teachers and tensions created by the gap between expected and actual practice roles for health visitors are discussed. This discussion takes place in the context of the Programme of Action on Health Visiting, which was launched in 2009 by the Department of Health in England. Recommendations for action by HEIs are made in response to the difficulties identified in particular. Although this paper applies to all the UK SCPHN education programmes the majority of these are in England, which has resulted in a focus being placed on challenges in England.

IntroductionHealth research in low-income and middle-income countries, which face the greatest burden of disease, is a vital component of efforts to combat global health inequality. With increased research, there has also been concern about ethical and regulatory issues and the state of research ethics committees, with various attempts to strengthen them. This scoping review examines the literature on ethics committees for health-related research in sub-Saharan Africa, with a focus on regulatory governance and leadership, administrative and financial capacity, and conduct of ethical reviews.Methods and analysisWe will use the methodological approach proposed by Arksey and O’Malley and adapted by Levac et al and the Joanna Briggs Institute. Inclusion and exclusion criteria are based on the ‘Population–Concept–Context’ framework. Literature (from January 2000 to December 2020) will be searched in multiple databases including Embase and PubMed and websites of relevant organisations. All records will be screened by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review flowchart: two reviewers will independently screen titles and abstracts, and full text of included records. Using an inductive approach, we will synthesise the literature, identify best practice and gaps in evidence on strengthening research ethics committees.Ethics and disseminationEthical approval is not required as the review will include only published literature. The findings will be published in a peer-reviewed journal and presented at stakeholder meetings and conferences.

Aim: This study aimed to explore the extent to which health visitors who trained and qualified in both Greater London and the South West of England between September 2011 and January 2016 were employed in health visiting posts and have remained in the profession. Background: In 2011, the UK Government launched the Health Visitor Implementation Plan ‘A Call to Action’ (Department of Health, 2011) to develop the health visitor workforce by training 4200 health visitors over a four-year period. By April 2015, 4000 additional health visitors were trained, but the total workforce has since fallen back to pre-Implementation Plan size. Methods: Data were collected using a survey, completed online by participants. All participants had undertaken a health visitor education programme at one of two participating universities. The survey was distributed in January 2017 and completed by 180 individuals. Quantitative data were analysed using SPSS; association was assessed using individual chi-square tests or Fisher’s exact test. Free-text responses were thematically analysed. Findings: Most (153; 87%) participants were still working as health visitors. Length of time spent working in the community prior to completing health visitor training was associated with staying in the role ( χ2 (with Fisher’s exact test = 7.998, P = .027). Current pay was associated with attrition from the health visitor workforce ( χ2 (with Fisher’s exact test) = 67.559, P < .001.). The majority who had left the health visitor role were on higher pay bands in their new post compared to those that had stayed (12; 60%). Bronfenbrenner’s (1979) theory of socio-ecological development was used as a framework to interpret the results. While participants made an active choice to join the profession, leaving was influenced more by factors outside their control. To influence health visitor retention, both local and strategic changes are required.