Parents’ perspectives on preparing for parenthood: a qualitative study on Greenland’s universal parenting programme MANU 0–1 year

Background The transition to parenthood has received increasing attention in research, partly due to evidence pointing out the crucial developmental period of a child’s first thousand days. Parenting programmes aim to prepare and support families in their transition and distress. For a programme to be implemented successfully it is important to consider parents’ needs and resources. Bringing parents’ perspectives and experiences to the forefront of the implementation of the Greenlandic parenting programme MANU 0–1 Year (MANU) is important for determining if the programme can meet its aim of contributing to thriving families. This study aims to investigate how parents’ notions and experiences of parenthood are reflected and challenged in MANU. Method Data were collected in three of Greenland’s five municipalities. Qualitative interviews were held with 38 mothers and 12 fathers either individually or as couples: a total of 40 interviews. Additionally, a Sharing Circle with three fathers was held. Interviews were in Greenlandic or Danish. A thematic, inductive analysis was applied. Results In their transition to parenthood, participants experienced a reprioritisation of their life and changes in their network. It is important to parents that their child experiences security and care, and participants describe this in contrast to their own childhood. Community is the most important value in child-rearing. Conversations and advice from family members and friends are mentioned as a means to prepare for birth and parenthood. Additionally, conversations with midwives and MANU sessions were also used for preparation. Parents appreciated learning from and listening to other parents in MANU sessions. However, accessing MANU depends on the individual parent’s interest and ability to attend sessions. Conclusions Parents’ notions and experiences of parenthood are addressed in the programme, but the use of MANU depends on the parents’ attendance and how it is organised and locally offered. The study suggests that MANU has the possibility to create a space for parents to reflect and prepare. However, for MANU to be universal as intended and to reach both mother and father the facilitation of sessions could be revisited

A scoping review : Well-being among indigenous children and youth in the Arctic – with a focus on Sami and Greenland Inuit

Children and young people from the Inuit and Sami populations in the Nordic countries can be identified as a vulnerable group. Young Sami and Inuit experience a higher degree of violence, abuse, suicidal thoughts and suicide rates compared to their peers in the majority populations in the Nordic countries. Their living conditions are in most cases influenced by a limited access to welfare benefits such as the healthcare system, social services and educational opportunities. Career prospects in the Arctic region are also narrow compared to the more densely populated and central regions in the Nordic countries. In order to understand and act upon the challenges the populations face, an in-depth and systematic review of the existing literature and experiences of children’s and youth’s well-being and their existing living conditions in the Arctic Region is essential

Determinants of an integrated public health approach: The implementation process of Greenland's second public health program 11 Medical and Health Sciences 1117 Public Health and Health Services

Background: Greenland struggles with a high prevalence of smoking, alcohol and drug abuse. In response to the increasing need for preventive initiatives, the first public health program Inuuneritta was introduced in 2007. Internationally, frameworks focus primarily on the implementation of a single, well-described intervention or program. However, with the increasing need and emergence of more holistic, integrated approaches, a need for research investigating the process of policy implementation from launch to action arises. This paper aims to augment the empirical evidence on the implementation of integrated health promotion programs within a governmental setting using the case of Inuuneritta II. In this study, the constraining and enabling determinants of the implementation processes within and across levels and sectors were examined. Methods: Qualitative methods with a transdisciplinary approach were applied. Data collection consisted of six phases with different qualitative methods applied to gain a comprehensive overview and understanding of Inuuneritta II's implementation process. These methods included: observations and focus group discussions at the community health worker (CHW) conference, telephone interviews, document analysis, and a workshop on results dissemination. Results: Enabling determinants influencing the implementation process of Inuuneritta II positively were high motivation among adopters, local prevention committees supporting community health workers, and the initiation of the central prevention committee. In contrast, constraining determinants were ambiguous program aims, high turnovers, siloed budgets and work environments, and an inconsistent and neglected central prevention committee. Conclusion: Inuuneritta II provided a substantial framework for an integrated health policy approach. However, having a holistic and comprehensive program enabling an integrated approach is not sufficient. Inuuneritta II's integrated approach does not harmonise with the government's inflexible organisational structure resulting in insufficient implementation

Parents’ perspectives on the role of kin in child-rearing: a qualitative study on Greenland’s universal parenting programme MANU

Nurturing care and protection from parents and community in the early years of life are fundamental for a child’s development. The article aims to explore what relations parents see as meaningful in their child’s upbringing and how these are shaped, and how these perspectives are reflected in MANU. MANU is a universal parenting programme in Greenland. Ten of 40 interviews with parents were selected for the analysis of this article’s objective. Five grandparents were interviewed. Grandparents are the child’s closest extended family members and provide support to parents. Parents placed between one to 19 extended family members in their child’s network. Eating and being in nature together, along with familial and intergenerational connectedness, were deemed valuable and important aspects in child-rearing. Parents’ own experiences in childhood can influence and complicate how parents place their new family within the extended family. The MANU materials address aspects in the role of kin that parents and grandparents described in interviews. The format and delivery of MANU aims to be universal and mostly addresses Western epistemologies, but both Western and Inuit epistemologies coexists in Greenland. This article creates a window into the existing context parents navigate in. It is important that initiatives are built within this context to ensure they are relevant to families

Nabo – unges stemmer om social inklusion på Grønland

Nabo er et projekt, der blev lanceret under det svenske formandskab i Nordisk Ministerråd 2018. Projektet ledes af den svenske Myndigheten för ungdoms- och civilsamhällesfrågor i perioden 2018-2020 og sigter mod at skabe nordiske unges perspektiver på det sociale inklusion. Unges stemmer høres i spørgsmål om deres liv. og baseret på denne viden, får de muligheden for at deltage i og påvirke politiske beslutninger. Unge mennesker bliver bedt om at beskrive deres hverdag og hvordan de oplever deres muligheder og forhindringer. Fra deres historier bygger Nabo en ramme af succesfaktorer for social integration i de nordiske lande. Denne rapport er baseret på fokusgruppeinterviews med unge mennesker forskellige steder i Grønland. Lignende undersøgelser gennemføres i de andre nordiske lande på Færøerne og Åland

Informal social accountability in maternal health service delivery: A study in Northern Malawi

Despite the expansion of literature on social accountability in low-and middle-income countries, little is known about how health providers experience daily social pressure and citizen feedback. This study used a narrative inquiry approach to explore the function of daily social accountability relations among maternal health care workers in rural Malawi. Through semi-structured interviews with 32 nurses and 19 clinicians, we collected 155 feedback cases allowing the identification of four main strategies social actors use to express their opinion and concerns about maternal health services. We found that women who used delivery care express their appreciation for successful deliveries directly to the health worker but complaints, such as on absenteeism and poor interpersonal behaviour, follow an indirect route via intermediaries such as the health workers’ spouse, co-workers or the health committee who forward some cases of misbehaviour to district authorities. The findings suggest that citizen feedback is important for the socialization, motivation and retention of maternal healthcare workers in under resourced rural settings. Practitioners and external development programmes should understand and recognize the value of already existing accountability mechanisms and foster social accountability approaches that allow communities as well as health workers to challenge the systemic obstacles to quality and respectful service delivery

An in-depth implementation study of the Greenlandic parenting program MANU’s initial stages of implementation

In Greenland, the universal parenting programme MANU was developed in 2016. After documenting the initial years of MANU’s implementation, this study aimed to identify implementation determinants focusing on i) which context MANU was conceptualised in and how it was developed and ii) how MANU was implemented and initially received in the healthcare system. A qualitative in-depth implementation study was conducted: document analysis, 38 interviews, one focus group discussion, and observations at two trainings for professionals and four parent sessions. Participants included stakeholders from both the health and social sector and from management to practitioner level. MANU was conceptualised based on a political desire to ensure children’s well-being by providing parents with the essential parenting skills, and a desire to create a programme for the Greenlandic context. Professionals welcomed the MANU materials, but anticipated or experienced barriers in implementing MANU. The first years of MANU focused on disseminating material and training professionals. Despite political support and financial security enabling implementation, an assessment of the implementation capacity from the very beginning could have prevented some of the implementation challenges identified. Insights on parents’ perspectives and local implementation are lacking and need to be brought to the forefront of the implementation process

Types and frequencies of social actors featuring in the feedback cases (total n = 155).

<p>Types and frequencies of social actors featuring in the feedback cases (total n = 155).</p