The public health role of health visitors in relation to teenage pregnancy and breastfeeding within current models of practice in one Scottish Health Board

Recent policy identifies health visitors as being best placed to lead on local public health initiatives. However, the evidence to support this assumption is lacking. Against this background and the recent implementation of Health for All Children (Hall 4) recommendations, this study explores the public health role of health visitors within the context of current models of practice. Within this qualitative study, focus group discussions and an individual interview were conducted with 24 health visitors in NHS Greater Glasgow to elicit their beliefs, attitudes and experiences in relation to their public health role, particularly in relation to teenage pregnancy and breastfeeding. Attachment to GP practices and caseload priorities were perceived barriers to undertaking public health initiatives within practice. There was also a distinct lack of clarity of the public health role, not only of health visitors but also other practitioners, such as school nurses and midwives. The study found collaborative working practices in relation to teenage pregnancy and breastfeeding were dependent on pre-existing personal and professional relationships within practice. Consequently, service provision was inconsistent and haphazard, with a lack of professional and management leadership identified. This directly contributed to the belief that the public health role of health visitors was under valued and not a priority. There is a need for a coordinated approach towards developing and supporting the public health role of health visitors. This requires strong leadership to identify, support and promote the skills and expertise of health visitors within and across disciplines. This approach would not only support current public health policy objectives but also endorse the individual and collective contributions that can be made by the health visitors.