Our in-service training program with the Well-Baby Clinics, spanning three years of work, after two years of negotiation and preparation, has concentrated on the entire staff of nurses of the Well-baby clinics in Jerusalem. Interestingly, it is the nurses who actually run Well-Baby clinics here as elsewhere in Israel. The Well-Baby Clinics Organization currently operate as a relatively autonomous unit in the Department of Public Health, with a Head Nurse and six supervisory nurses developing policy and planning the in-service training for all the Clinics. Physicians (pediatricians), who are employed part-time in Well-Baby clinics in addition to their positions in Health Maintenance Organizations make weekly visits to a number of Clinics. The Well-Baby Clinics Organization in Jerusalem have a medical advisor but physicians are not in a position of responsibility. The physicians thus have a much lower level of commitment to the organization than do the nurses, and their influence on policy is consequently less.
Each Well-Baby Clinic operates as a unit with three or four full-time public health nurses and a part-time physician who is a pediatrician. The clinics are situated in most of the neighborhoods in Jerusalem, within walking distance of most homes. There are 25 Clinics in Jewish West Jerusalem and six in Arab East Jerusalem.
We have trained 130 nurses and 15 physicians in the in-service training program of the Well Baby clinics. These professionals treat all of the approximately 10,000 infants that are born each year in Jerusalem. The participants in the training sessions have been mostly nurses, all of whom are full-time employees of the Jerusalem Department of Public Health. All the nurses attended regularly and eagerly, while five of the pediatricians attended regularly, some of them making a significant contribution. Our future plans include making new efforts to involve the pediatricians, and/or working through the Health Maintenance Organizations to reach pediatricians.
Content of the work of public health nurses: Since the in-service training included detailed descriptions of many cases brought up by the nurses we have managed to construct a good picture of the content of their work.
Almost all mothers in Israel (about 95%) visit the Well-Baby clinics which perform regular check-ups for their infants and provide inoculations during the first year of the child's life. The timing of the visits varies but generally it is twice a month in the first months of life and monthly thereafter. The nurse covers the following areas with the parent of each child in individual visits to the clinic:
checking height and weight of the child, and giving the parent feedback on the placement of the child in terms of norms for height and weight;
asking the parent a standard set of questions (similar to the Denver Developmental Screening Test), concerning the motor and psychological development of the child, and giving the parent feedback on the child's development;
observing the child and noticing any physical or behavioral characteristic that may deserve further attention;
answering the parent's questions concerning the health and development of the child on issues such as nutrition, sleeping, hygiene and problematic behavior such as excessive crying;
helping the parent on issues such as sleeping and eating routines for the infant, and dealing with parents' problems related to child care, such as fatigue;
providing the parent with current information on issues concerning child care appropriate to the child's age, including home safety and first aid for infants;
referring the parent and infant to specialized medical , social or psychological services as the need arises;
In addition to the nurses' aforementioned responsibilities for each family, which is part of the Clinic routine, the nurse will also:
make home visits to new parents, parents with special needs, and parents who do not come to the clinic;
organizes and leads group meetings for parents on special topics, such as safety and first aid.
- Prof. Charles W. Greenbaum
- Dr. Rivka Nowik
- Ms. Osnat Lavenda
- Ms. Nadia Massarwa
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Last updated: September, 2002