In Europe, the increase in poverty, the isolation of people, new critical issues raised by migration flows and various addictions are a multitude of factors among others to which people are exposed. Women in the perinatal period are naturally vulnerable and experiencing an increased need for security. If this condition is combined with deep bio-psycho-social problems, the arrival or presence of the child can turn into a nightmare. Professionals facing this public are often powerless to identify, assess and support the quality of the mother-child relationship in a vulnerable situation and act in the interest of the mother and child, while ensuring them legitimate protection. Thus is born the CAPEVFAIR project (Taking Care of Vulnerable females Pendant PErinatality in France, Austria, Italy and Romania), carried by the Association Suerte (France). There is no specific training in observation and accompaniment of the mother-child bond with a distressed population in the four partner countries; nor in the initial training of social and medico-social workers, and nor in university curricula. In France, there are study days on the theme of parent - child relationship, but the participation of professionals in these days remains a voluntary process and is not included in basic training. The issues of immigration and addiction are rarely taken into account. ISSUES Starting from a sharing of our practices, CAPEVFAIR aims to develop or adapt tools and training content in order to give a better qualification to professionals who work with people in vulnerable circumstances and / or dependence during the perinatal (pregnancy and early childhood). Our project includes 4 countries: Austria, France, Italy and Romania. In each country, a pair of partners are gathered, consisting of a university and a "field worker" (social institution or nursing home). Universities are those of Vienna, Verona, Paris X and Iasi. Field agents are the University of Vienna (which takes both roles because it has a clinical unit hosting vulnerable women), the Municipality of Verona (with its unit Casa di Ramia), Holtis and Suerte. The project aims the following operational goals: Train professional staff to better detect and understand the vulnerability of pregnant women and mothers of young children. Stimulate university research on and analysis of the different facets of vulnerability, by changing their vision by confronting them to our experience and our field practices. Improve our professional practice by crossing and comparing our different approaches. Educate and train professional staff and organizations involved in the care and accompaniment of women in vulnerable situations. Promote multidisciplinary approach and the networking of these organizations, including disseminating among them a common 'culture' and approach. Integrate the dedicated training module we will develop to university degrees and existing training content in our countries. FINAL GOALS For the mother, it is to accompany her in finding ways to be a "good enough" mother, that is to say, enabling her to be able to adapt and respond to their child's needs . For the child, it is to ensure its protection and to promote conditions for good physical and mental development. The main activities of the project will be: Define vulnerability and its medical, psychological and social criteria. Develop a self-assessed tracking tool of vulnerability. Conceiving a European observation tool of hte mother-child bond. Building a roadmap for the accompaniment of vulnerable persons for professional staff. Define a repository of skills of tracking, identification and accompaniment of vulnerability of pregnant women or mothers of a new-born child. Produce training contents and a 5-days' training module. The results and impacts that we expect are: Professionalize or at least educate professional staff in the detection of vulnerability, its identification and the accompaniment of vulnerable groups. Promote a multidisciplinary approach and networking in the accompaniment of these people. Encourage a better consideration of the specificity of vulnerability, better identify the situations and provide appropriate responses. Generate support and commitment of the institutions and authorities in charge of public policies on these issues. Change public policies and systems towards a real approach to vulnerability and networking around the care of vulnerable mothers. Include the dimension of vulnerability in university curricula and existing training ; and directly integrate our module in some degrees, existing qualifications in the 4 partner countries.
THE PROJECT: Caring for vulnerable women in perinatal period is currently at the heart of Public Health's concerns. Society has a duty of assistance and intervention to better protect them. According to a Médecins du monde survey (2014 report) on access to healthcare in Europe, 2/3 of pregnant women do not have access to perinatal care. While pregnant women, mothers and their young children should be given specific protection because of their vulnerability, this report shows that access to care for the most precarious is not sufficiently taken into account. Risk factors aggravate vulnerability. In the context of the CapeVfair European project, participants from the four partner countries (France, Italy, Romania, Spain) note that professionals are still powerless regarding this type of public as well as its problems. There is no specific training for observation and support of the mother-child relationship with a population in difficulty in the 4 partner countries; neither in the basic training of social and medico-social workers, nor in university courses. STRATEGIC PARTNERSHIP: This project was initiated by France within the « Centre de Soin, d’Accompagnement et de Prévention en Addictologie » (Center of Care, Accompaniment and Prevention in Addiction) "Broquedis" of the Caminante association. The idea was to cross CSAPA's professional practices with those of other offshore social or medico-social institutions, welcoming women and vulnerable children in the perinatal period. Thanks to our French academic partner, A.M. Doucet Dahlgren, professor-researcher in Sciences of education at Paris X Nanterre University (FR), we made contact with professors-researchers from the universities of Barcelona (ES), Iasi (RO) and Verona (IT). These academics helped us build the institutional partnership. The CapeVfair project involves 8 partners for 4 countries: a university and a social or medico-social structure per country, namely HoltIS (RO), Eduvic (RO), Comune di Verona - Casa di Ramia (IT) and Caminante (FR ). OBJECTIVES: Our project aims at raising awareness and training professionals to specifically support pregnant women / or with very young children, in vulnerable situations. RESULTS: The 2 years of collaborative work of the 8 partners involved in CapeVfair have resulted in rich and fruitful exchanges of professional practices and a real work stimulation on the issue of vulnerability in the perinatal period. This perspective of technical knowledge, theoretical and complementary field experiences allowed the specialists of the 4 countries involved in the project to highlight skills and tools specific to quality professional support . Partners in the CapeVfair project are now able to offer training and / or educational modules of specific support for mothers and vulnerable children during the perinatal period. We have co-built operational technical documents, support to this training: • A definition of mothers and children vulnerability during the perinatal period • A document describing and explaining the tools for identifying vulnerability factors used by field professionals working in different countries, contexts and cultures • A document describing and explaining the tools used to observe / analyze vulnerability factors used by field professionals working in different countries, contexts and cultures • A document describing and explaining support tools for mothers and children in vulnerable situations, allowing to support the mother-child bond, to enhance maternal skills. IMPACTS: Thanks to the 3 key moments of valorization of our work, many sector professionals , in each of the countries that are concerned, were sensitized to the care specificity of the target public: tracking and identification of vulnerability factors, accompaniment of the vulnerable public, importance of multidisciplinary approach and networking. The work results (6 intellectual outputs) are all available in the 4 partner country languages as well as in English. They will serve as a support for the training offered in each of the countries, integrated into initial and / or continuous training. A final conference was organized in France on June 14th, 2017, gathering more than 150 participants. The partners were able to present some of the results of their work. The various video presentations are available on the internet (Youtube) and on the capevfair.eu website. The idea is to disseminate as widely as possible the results of our work and the reflections they can generate.