Abstract
Background: Ireland is developing novel approaches to addressing secondary and tertiary medical care needs of children who experience social exclusion and material deprivation.
Approach: Fixed-term funding was granted to commence dedicated delivery of equitable inclusion healthcare to paediatric patients in Ireland across four hospital units. Inclusion health (IH) is a method of healthcare delivery that develops integrated care pathways for populations experiencing social exclusion. These pathways are focused on overcoming obstacles to engagement with healthcare services.
To avoid developing disparate and disconnected services we have structured a network to continue to progress paediatric inclusion health in Ireland. We share vision, values and goals with the ultimate aim of a strong evidence base to inform care delivery. Incorporating social determinants of health into practice development is crucial to effective service provision as well as familiarity with intersectional population needs and local, national and global socioeconomic issues. We are progressing towards providing sustainable, practical and equitable care pathways that include hospital, community and intra-agency care.
In partnership our publicly funded health service, we have created a structure within which to share experience, learning, operational strategies as well as engaging with key national stakeholders e.g. child and family agency, international protection applicant services.
Results: Our group includes 6 paediatric consultants with a breadth of subspecialty experience inclusive of neonatology, infectious diseases, child protection and migrant health. Meetings occur regularly online with in-person site visits and combined relevant training (e.g. trauma informed care) as well as relevant targeted education sessions e.g. child trafficking awareness. Strategies and outcomes are shared with our Health Service Executive and Department of Health and work is underway to formalise our governance structure within our post graduate training body as well as with national clinical leads.
The most established of our practices have already demonstrated excellent attendance rates and engagement from socially excluded cohorts. We have successfully identified specific at risk cohorts and are tailoring interventions dependant on individual, cultural and population intersectional need. These populations include children who are homeless, children from the Roma and Irish Traveller communities, children who are international protection applicants or refugees and children who are victims of significant intergenerational poverty and deprivation.
Implications: The next steps are procurement of permanent funding and to build more dedicated patient partnership through agencies and community representatives through focus groups and formal peer support networks. In line with WHO sustainable development goals we plan to formalise equitable health delivery within our national paediatric hospital services with clear and effective integrated pathways of care. We are also incorporating inclusion health into our medical postgraduate training curriculums.