Suivi médical des enfants confiés à la protection de l’enfance en Europe : une revue de la littérature

Abstract : Problematic: Following the ESSPER ASE 13 survey carried out between 2013 and 2014 in the Bouches-du-Rhône, where 1,092 health check-ups of children placed in children's homes with social characteristics or among family caregivers have been analysed, lot of problems were raised including difficulties in the organization of medical monitoring impacting the quality of care and therefore the health of children. Goal: The analysis of the organization of the medical monitoring of children placed in Child Welfare System in Europe makes it possible to elaborate hypotheses regarding the optimization of the medical follow-up of the children taken in charge by the Aide Sociale à l’Enfance in France. Methods: The research work carried out is a systematic review of the scientic literature, a scoping review. Formulation of research equations by combining the terms "child welfare", “child protectives services”, "continuity of care", "care", "patient care management" or "children placed" in the databases Pubmed, Sciencedirect, EM Premium, BDSP, Lissa, HAL and Cismef identified 739 references related to my topic. In addition, a search of the grey literature was conducted and 118 documents were selected. The inclusion criteria were: children placed in child welfare system in institutions or foster families, dealing with a European country and speaking of child health care. A total of 37 documents were included in the study. Main results: The bibliography search reveals 9 European countries interested in organizing of the medical care of children placed in child protectives structures and 79% of publications are after 2012. In the United Kingdom, an initial protocol evaluation at the entry into the child protection system, called the Common Assessment Framework, leads to a care plan for the child. Particular attention is done to the coordination of medical and psychological monitoring by the appointment of an agent called IRO (Independent Reviewing Officer) whose main mission is to verify the implementation of health plans. In Belgium, upstream of the final placement, the child can pass in several temporary placement structures including one specialized in the health care of abused children. In Belgium and Sweden there are specialized placement institutions for child victims of sexual abuse or abuse with staff trained in these difficulties. Specific therapies for the treatment of disorders related to child neglect and abuse are implemented in Germany, the Netherlands, Sweden and Belgium, such as the Multi-Dimensional Care Foster Care Program (MTFC) or program ABC (Attachment and Biobehavorial Catch up Intervention) recognized in the United States. Conclusion: Evaluation of the quality of the continuity of care for the children placed in child welfare system depends upon three factors: consolidation of the internal and external networks of caregivers in the placement structures, healthcare professionals training in order to understand and treat suffering’s specificities of placed children and finally, definition of a care plan that is frequently re-evaluated and transcribed as a clinical file following child evolution during institutionalization.
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Marine dos Santos. Suivi médical des enfants confiés à la protection de l’enfance en Europe : une revue de la littérature. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02172741⟩

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