The Role of the Physician in Israel’s Maternal Child Health Centers: Surveys of Professional and Parental Perceptions

Chen Stein Zamir 1,2 Hannah Shoob 1 דינה צימרמן 1
1Jerusalem District Health Office, Ministry of Health
2Braun School of Public Health and Community Medicine, Hebrew University in Jerusalem

Background: Preventative health services are a cornerstone of pediatric health care. In Israel, services are based on Maternal Child Health Clinics (MCHC) and include five physician visits at ages 0-6y. However, the physician`s role is not well-defined. The study goal was to explore the perceptions of physicians (MCHC and non-MCHC), MCHC nurses, and parents regarding the MCHC physician`s role.

Methods: The three professional groups (150 members each) completed self-administered written questionnaires. One thousand parents were interviewed during MCHC visits by a trained research coordinator. The questionnaire included demographic characteristics and list of potential roles (Physical Examination, Abnormal Health Conditions Detection, Developmental Screening, Anticipatory Guidance, Parent- Child Interaction Counseling, MCHC Staff Consultant, Children-at-Risk Detection, Growth Surveillance, Vaccination Counseling, Inter-physician Communication). Agreement with all roles was scored on a 4 point Likert scale. .

Results: Most parents (85.2%) reported having at least one appointment scheduled with the MCHC physician and 83.5% complied. All four groups ranked Physical Examination, Developmental Screening and Detection of Abnormal Health Conditions among the top three roles. However, there were significant differences among groups regarding other roles. Nurses and parents were both less likely to consider growth monitoring, parental counseling and vaccination advice as physician roles. MCHC and non-MCHC physicians had different perceptions regarding vaccination counseling and inter-physician communication, with MCHC physicians less likely to view this as their role.

Conclusions: The MCHC physician is viewed as integral to the preventive care of children. However, the physician role is not well defined and is need for further standardization.

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