PMID- 15525233
OWN - NLM
STAT- MEDLINE
DCOM- 20160423
LR  - 20191026
IS  - 0156-5788 (Print)
IS  - 0156-5788 (Linking)
VI  - 27
IP  - 2
DP  - 2004
TI  - Tensions in maternal and child health policy in Victoria: looking back, looking 
      forward.
PG  - 17-26
AB  - Since the late 1980s, Maternal and Child Health Services (MCHS) in Victoria have 
      undergone significant change. This paper provides an historically-informed 
      analysis of the complex intersection of policy, administrative restructuring and 
      stakeholder interests. It draws on and extends the authors' previous research 
      into MCH Service policy directions and administration, including the impact of 
      Compulsory Competitive Tendering (CCT) on MCH nurses in the 1990s. Historically 
      there has been little explicit debate about either organisational arrangements, 
      or the policy objectives of the MCHS. The dominant focus on health surveillance 
      of infants never adequately reflected nurses' wider role in the community and was 
      not consistent with a wider social model of health. Tensions between 
      professional, consumer and administrative stakeholders became heightened by the 
      implementation of the 1990s neoliberal political agenda. During this period, when 
      restructuring linked funding to service delivery through tendering arrangements, 
      a political and policy settlement further institutionalised surveillance as the 
      basis of the MCHS. The restructured Service has remained constrained by the 
      dominance of health surveillance as the primary program goal even after more 
      varied contracting arrangements replaced CCT. Although recent initiatives 
      indicate signs of hange, narrow surveillancebased guidelines for Victorian MCH 
      Services are not consistent, we argue, with recent early years of life policy 
      which calls for approaches derived from socio-ecological models of health.
FAU - Keleher, Helen
AU  - Keleher H
AD  - School of Health and Social Development, Deakin University, Melbourne, VIC, 
      Australia.
FAU - Reiger, Kerreen
AU  - Reiger K
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Aust Health Rev
JT  - Australian health review : a publication of the Australian Hospital Association
JID - 8214381
MH  - Child
MH  - *Child Health
MH  - *Health Policy/economics
MH  - Humans
MH  - Maternal Health Services
MH  - Nurses
MH  - Victoria
EDAT- 2004/11/05 09:00
MHDA- 2016/04/24 06:00
CRDT- 2004/11/05 09:00
PHST- 2004/11/05 09:00 [pubmed]
PHST- 2016/04/24 06:00 [medline]
PHST- 2004/11/05 09:00 [entrez]
AID - 735 [pii]
AID - 10.1071/ah042720017 [doi]
PST - ppublish
SO  - Aust Health Rev. 2004;27(2):17-26. doi: 10.1071/ah042720017.