Beverley Lawrence Beech comments on two recent reports
Sure Start is a government programme designed to bring together early-years education, childcare, health and family support. The first local programmes were set up in 1999. The Government is committed to delivering a Sure Start Children's Centre for every community by 2010.
A study has just been published1 which looks at different Sure Start Groups to see which elements are important in contributing to successful outcomes, and why the 'hard to reach' groups did not attend.
The quality of Sure Start centres varies around the country, as we know from the telephone calls we receive. Those successful centres demonstrated that empowerment was the only dimension where significant effects were identified for parent outcomes both for families with nine month olds and for families with three year olds. Their actions included progressively involving the users in service planning and delivery through volunteering, targeted training, employment opportunities and competent representation on decision-making committees and boards.
A second notable feature was the element of mutual respect for all parties where the contributions of parents to child development were genuinely respected and valued. This resulted in parents feeling more confident in their abilities to make these contributions. They were also more likely to feel a sense of common purpose with the service providers. Things were not just done to or for them; they took an active role in improving their own lives and those of their children. The mutual respect of Sure Start parents may explain the link with higher maternal acceptance of services.
There were, however, problems highlighted in some Sure Start programmes, for example:
These emerge as by-the-by examples, but the ethical implications are not discussed.
Non-users of services, including particularly vulnerable groups, (such as travellers, asylum seekers, those involved in domestic violence, those involved in substance abuse)were asked in semi-structured one-to-one interviews why they did not use services. They reported barriers:
The repor t made a series of comments about these issues:
The Report's authors went on to state, 'Our evidence was that these were often the least troublesome and more articulate parents in the communities, and not representative of the majority of local families.'
The government is to be congratulated for ensuring that this new initiative was subjected to an evaluation from the beginning. It is clear from the studies that empowering the parents produces the most significant positive effects, however, the study also found, in common with other studies, that among the disadvantaged families living in the Sure Start areas, parents and families with 'better human capital' than those with less human capital (i.e. teen parents, lone parents, parents in workless households) were more able to take advantage of the services on offer. The approach of 'empowering' parents2 should be embraced by the maternity services and instead of offering the hollow chalice of 'choice' the services might begin to respond to women and babies' needs and truly respect individual parents and understand the difference between support and control.
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