Family Centered care is a model that is practiced and encouraged in child health care. It considers family as partners and collaborators in care of children. It aims at involving family in all aspects of child care. Family centered care also mentions involvement of child. However, emphasis is given more on family than child and does not take into account the older child’s capacity for independent decision making and right to privacy. As such, child’s needs are missed out. With child centered care, children are involved and supported at all levels of care based on their age and developmental stage. This paper aims to stress the importance of involving children within family centered care. Involving children in their care, makes them feel less threatened by the health care professional and their self esteem is promoted. Currently, no studies have been identified in Malawi that demonstrates full partnership between the family, child and the nurse. Furthermore, Family Centered Care and Child Centered Care as models are not fully practiced. It is therefore important to practice both family and child centered care in child health care if the needs of both family and children are to be addressed concurrently.
Family Centered care (FCC) is a model of care that is encouraged in the care of sick children [
“a way of caring for children and their families within health services which ensures that care is planned around the whole family, not just the individual child, and in which all the family members are recognized as care recipients”. (Shields et al., 2006, p. 1318) [
Franck & Callery (2004), Coyne (1996), Ahmann & Johnson (2000) and Shields et al. (2007) assert that FCC stresses the importance of considering families and significant others as partners and collaborators in the health care of children and care of family members [
FCC is built around the following beliefs: empowerment, respecting personal autonomy and recognition of human rights [
In order to provide FCC and support the family, Mullen & Pate (2006) suggest development of full partnership between the family of a child and the nurse [
With acute shortage of health care workers in Malawi, Family centered and child centred care are significant during hospitalization. Currently, no studies have been identified that demonstrate full partnership between the family, child and the nurse. In addition, FCC and Child Centered Care as models are not fully practiced.
Malawi’s health system is understaffed and FCC becomes inevitable. Hoffman et al. (2012) reported a health care professional to in patient population ratio of 1:277 [
Family centered care has benefits for children, family, and health professionals. It has proved to produce improved health outcomes for children through reduced length of hospital stay, readmission rates and emergency visits [
FCC also mentions involvement of children in their care [
To make sure that children’s needs are met, it is important to involve and support them at all levels of care and the involvement should depend on their age and developmental stage [
Several times during clinical consultations, health care professionals interact with parents/guardians and information is given to them without involving the child yet the child is there [
Another aspect to be considered when managing children is privacy. In a study by Bray (2007), privacy was one of the issues that children indicated that they need during consultations [
It was a bit awkward (to ask questions) cos there was lots of people in the room, it would have been easier if they weren’t there (r4)
Similary, Espezel and Canam (2003) recommend an assessment area that is private, relaxed and comfortable to ensure effective information giving and provision of optimum holistic care in children [
It is important to make sure that a child’s voice should be heard within the FCC framework as children and families may have differing objectives, preferences and perspectives [
Health care professionals should put themselves at the same level with the child if child participation is to be meaningful. This can be achieved by communicating in a language of the child, using simple language that a child can understand and playing with the child where necessary. Aynsley-Green (2001) regards children and young people as competent in defining their needs. He further recommends that their opinions should be included in service evaluation and the planning of care [
Giving children chance to express themselves and describe how they are feeling helps them to gain confidence and trust in the health care worker. It has shown that when children are given information that they can understand, they have increased self-esteem and are empowered to take a leading role in issues affecting their health [
When children are not involved in FCC, they become invisible and are missed out completely. Attention is given to family’s needs and the child is forgotten in the process.
As such children become dependent on guardians on everything, fail to express themselves and do not develop confidence. Children believe that guardians are better placed to communicate their needs to health care workers and think that their views cannot be taken into consideration hence lack confidence [
In terms of treatment, children do not comply with treatment as they do not understand the importance and feel guardians are just forcing them. This makes them feel victimized. It is therefore important to remember that children are key stakeholders in health and healthcare, and not beneficiaries or passive recipients of services [
Children are essential partners in health, involving them in decision affecting their health helps to make sure that their needs are met and their preferences considered. In addition, child participation increases success of care. To make sure that children and family needs are met in child care, it is important to balance Family Centered Care and Child Centered Care in the management of sick children.
All authors for their valued contributions.