|Description||The U.S. Department of Health and Human Services (USDHHS, 2015) reported that the estimated number of child maltreatment victims nationally was 679,000. The same report noted that 1,520 children died as a result of child maltreatment. These national rates indicate that by 18 years of age, 1 in 8 children will have a substantiated report of maltreatment (Jackson, Kissoon, & Greene, 2015). All forms of child abuse and neglect are far too prevalent. Risk factors include single parent, low income, lack of social support, substance abuse, domestic violence, and lack of public support services. The purpose of this project is to compare current assessment and identification practices for children at-risk of maltreatment in a local health department with evidence-based practice strategies.
This honors project was conducted at a county health department located in rural eastern North Carolina in collaboration with a public health nurse. This project took place over seven weeks and included routine home visits with post-partum women and their infants. The objectives for this project completed were to: 1) interview key informants, 2) conduct a record audit of postpartum women and their newborns, and 3) review the child fatality task force cases from 2012 to 2014. Of the 59 child fatality cases reviewed, a major finding was that late prenatal care and premature rupture of membranes were risk factors. In the record audit, many mothers were single, young, and had not finished high school. A majority had entered into prenatal care later than recommended. Observations made during the home visits identified one or more risk factors for child maltreatment as defined by the literature. Key informants identified numerous programs in the community to help new mothers and infants, but space was often limited and some mothers refused these services. Recommendations from this program evaluation include: community forums on the prevention of child maltreatment, increased post-partum home visits, and a unified county-wide approach to child abuse prevention which highlights the importance of early prenatal care.||