Patronage Nurses: A Modern Approach to Supporting Families with Children Aged 0 to 3 Years

Patronage nurses play a key role in implementing the universal-progressive model of home visits, which has been successfully operating in many regions of Ukraine. Through their work, families receive comprehensive support that combines medical, psychological, and social aspects of child care. Based on the experience of the Zhytomyr region, we are expanding the implementation of this model to other regions of Ukraine and inviting medical professionals to join our team.

The Unique Role of Patronage Nurses

• Partnering with families to provide comprehensive support in child care and strengthening parents’ resilience.
• Combining medical knowledge with psychological and social work using developed tools, such as eco-maps, individualized family support plans, the Edinburgh Postnatal Depression Scale, and more.
• Collaborating with psychologists, social services, and other organizations to ensure a holistic approach to supporting families.
• Planning and implementing patronage services through universal and progressive packages that consider the individual needs of each family.
• Case management for families with identified risks, allowing for timely detection and resolution of potential threats to the child’s health.

Why Was Improvement Necessary?

The role of patronage nurses extends far beyond traditional medical care. Until 2023, their work was regulated by Ministry of Health Order 149, which focused only on the medical aspects of visits. However, the need for improvement arose due to several issues:

• A focus solely on medical matters.
• Insufficient training for nurses in identifying social risks.
• Failure to account for the individual characteristics of the child and family.
• Limited trust from families towards nurses.
• Inadequate communication skills among healthcare professionals.

The armed conflict, the increase in internally displaced persons, staff shortages, and rising risks demanded an enhanced approach to care delivery. The universal-progressive model of home visits allows patronage nurses to significantly expand their role, considering the social, psychological, and individual needs of each family.

The Responsibilities of a Patronage Nurse: More Than Just Medical Care

In the new home visit model, the patronage nurse not only oversees the physical health of the child but also delves deeper into the context of the child’s life.

• Identifying potential risks to the child’s health and development, such as emotional instability, lack of attention, or poor treatment of the child.
• Taking an individualized approach to each family, considering the child’s specific needs and social environment.

Thanks to the home visit system, patronage nurses can not only provide medical care but also establish trusting relationships with families, facilitating early detection and prevention of potential problems.

Benefits for Children and Families

Patronage nurses provide support for all families with children under the age of three, offering universal services that assist with child-rearing and development, as well as creating a safe and healthy environment. They help families navigate difficult situations, particularly regarding health, psycho-emotional development, and social protection.

Structure of Home Visits

Patronage nurses conduct detailed home visits, each consisting of several stages:

Preparatory Stage:

• Receiving information about the child’s birth from the coordinator.
• Planning the visit according to the individual needs of the family.

Home Visit:

• Getting acquainted with the family and establishing rapport.
• Conducting an indicative interview to assess the child’s health and potential risks.
• Evaluating the mother’s psychological and physical condition.
• Assessing the family’s social conditions.
• Completing the necessary documentation, providing consultations, and educating the parents.
• Planning future visits and offering ongoing support.

Supported by UNICEF

The “In Touch Ukraine Foundation” is working on establishing 12 training and resource centers for the implementation of the universal-progressive home visit model for families with children, supported by UNICEF:

Training
A comprehensive training program for nurses:

• A one-day workshop for primary healthcare center (PHC) leaders and profile deputies.
• A three-day training for nurses and doctors focused on working with children from birth to 6 months.
• A two-day training for working with children from 6 months to 3 years.
• Ongoing online supervision to continuously improve skills.

Equipment
Nurses are provided with portable kits for child check-ups, tablets for demonstrating child care techniques, and other tools to enhance their work quality. The facilities where they work receive additional equipment, furniture, and transportation to ensure effective organization of the visits.

Success of the Model in the Zhytomyr Region: We Invite Medical Professionals to Join

In the Zhytomyr region, the universal-progressive home visit model has already demonstrated its effectiveness. Thanks to the efforts of patronage nurses, the quality of child care and family support has significantly improved. Now, we are expanding this successful experience to other regions of Ukraine.

Patronage – Regions Involved

For those who want to learn more about the UPM, stay tuned for updates. Information sessions for medical professionals will be held in the newly established training and resource centers.

The activities are carried out within the framework of the project “Implementation of the Universal Progressive Home Visit Model and Child-Oriented Integrated Medical Services at the Local Level in Specific Regions of Ukraine” supported by UNICEF Ukraine.