Orienting child- and family-centered care toward equity

Abstract

Child- and family-centered care (CFCC) is being increasingly adopted internationally as a fundamental philosophical approach to the design, delivery, and evaluation of children’s services in diverse primary and acute health care contexts. CFCC has yet to be explored in the context of families and children whose health and health care is likely to be compromised by multifaceted social and structural factors, including racialization, material deprivation, and historically entrenched power imbalances. To date, an equity orientation for CFCC has not been examined or developed. This is a critical area of inquiry, given the increasing evidence that children in families who face such inequities have poor health outcomes. This article examines dominant discourses on CFCC in the context of families and children who are at greater risk of health inequities in wealthy countries, drawing on Canada as a useful example. It outlines an evidence-based approach to equity-oriented care that the authors contend has the potential to orient CFCC toward equity and provide greater clarity in the conceptualization, implementation, measurement, and evaluation of CFCC in ways that can benefit all families and children including those who have typically been excluded from research.

Re-Envisioning an Early Years System of Care towards Equity in Canada: A Critical, Rapid Review

“…In the equity-aligned international literature, there are also specific philosophical approaches to understanding, designing and delivering programs with families and children that are distinct in their origins and focus but share a relational orientation. These include anti-racist programming [ 44 , 104 , 117 ], cultural safety [ 11 , 118 ] and trauma-informed [ 94 , 101 , 119 ], or trauma- and violence-informed approaches [ 61 ]. This relational orientation to early years programs and practices is predicated on funders’, managers’ and service providers’ understanding of and capacity to respond to how structural inequities and structural violence are differentially impacting families and young children [ 67 , 116 ].…”

“…The authors both identify as White settler, cis-gender, privileged women and mothers currently living in western Canada and with extensive practice backgrounds in pediatric occupational therapy (Gerlach) and public health nursing (McFadden) with diverse families and children that experience a greater risk of health inequities. Gerlach has also been involved in researching equity issues in the early years sector for the past 20 years [ 16 , 61 , 62 , 63 , 64 ].…”

Constructing a Compelling Case: Nurses' Experiences of Communicating Abuse and Neglect

“…Although nurses were aware of relevant guidelines, the application of guidelines is based upon individual judgement within unique social and organisational contexts (Munro, 2018). Furthermore, guidelines are produced and enacted in health systems that perpetuate structural inequalities and institutional racism (Burnett et al ., 2020; Gerlach and Varcoe, 2020), both of which contribute to disadvantage that is linked to child abuse. In this context, the findings suggest that nurses need ongoing support to reflect critically on the quality of their decision‐making (Munro, 2018) and to develop inclusive practices that address root causes of disadvantage, marginalisation and inequality (Burnett et al ., 2020).…”

Childhood functional constipation : Parents' everyday life experiences

“…Healthcare professionals use different approaches to deliver healthcare; child-centred care (CCC), person-centred care (PCC) and family-centred care (FCC) are some examples (Coyne, Holmström, & Söderbäck, 2018). Lately, child-and family-centred care (CFCC) has increasingly been adopted in paediatric domains as an approach to child health and healthcare delivery (Gerlach & Varcoe, 2021;Shields, 2018). The differences between approaches are whether the child, person and/or family as a unit are at the forefront of care delivery and the focus of care (Foster & Shields, 2020).…”