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Based on an extensive literature review, this chapter outlines key developments in global health and research during the last century with focus on the emergence of violence and child maltreatment as international public health priorities. Violence has been known to humans for millennia, but only in the late 1990s was it recognised as a global public health issue. Every year, an estimated 1 billion children are exposed to trauma, loss, abuse and neglect. Child maltreatment takes a social and economic toll on countries. Research initiated in 1985 found child maltreatment to be associated with increased disease, disability and premature death in adult survivors. The global availability of data on child maltreatment is, however, sporadic with low validity and reliability. Few global experts have consulted and involved the survivors of child maltreatment, as the experts by experience, in their attempts to provide a more comprehensive picture of reality. Youth and adult survivors of child maltreatment are often traumatised by the experience, and it is important to use trauma-informed approaches to prevent re-traumatisation. Participatory and inclusive research on child maltreatment is only in its infancy. There is a need for more inclusive research, designed by survivors for survivors, hereby strengthening local capacity building and informing policymakers from the bottom up. This chapter reviews lessons learnt and provides recommendations for how to enhance the participation and inclusion of the experts by experience in research on child maltreatment.

In order to assess the state of health of Europe’s children, or to appraise the systems and models of healthcare delivery, data about children are essential, with as much precision and accuracy as possible by small group characteristic. Unfortunately, the experience of the Models of Child Health Appraised (MOCHA) project and its scientists shows that this ideal is seldom met, and thus the accuracy of appraisal or planning work is compromised. In the project, we explored the data collected on children by a number of databases used in Europe and globally, to find that although the four quinquennial age bands are common, it is impossible to represent children aged 0–17 years as a legally defined group in statistical analysis. Adolescents, in particular, are the most invisible age group despite this being a time of life when they are rapidly changing and facing increasing challenges. In terms of measurement and monitoring, there is little progress from work of nearly two decades ago that recommended an information system, and no focus on the creation of a policy and ethical framework to allow collaborative analysis of the rich anonymised databases that hold real-world people-based data. In respect of data systems and surveillance, nearly all systems in European society pay lip service to the importance of children, but do not accommodate them in a practical and statistical sense.

The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the scope and role of primary care. An economic analysis was undertaken that sought to explain differences in child health outcomes between countries. The conceptual framework was that of a production function for health, whereby health outputs (or outcomes) are assumed affected by several ‘inputs’. In the case of health, inputs include personal (genes, health behaviours) and socio-economic (income, living standards) factors and the structure, organisation and workforce of the healthcare system. Random effects regression modelling was used, based on countries as the unit of analysis, with data from 2004 to 2016 from international sources and published categorisations of healthcare system. The chapter describes the data deficiencies and measurement conundrums faced, and how these were addressed. In the absence of consistent indicators of child health outcomes across countries, five mortality measures were used: neonatal, infant, under five years, diabetes (0–19 years) and epilepsy (0–19 years). Factors found associated with reductions in mortality were as follows: gross domestic product per capita growth (neonatal, infant, under five years), higher density of paediatricians (neonatal, infant, under five years), less out-of-pocket expenditure (neonatal, diabetes 0–19), state-based service provision (epilepsy 0–19) and lower proportions of children in the population, a proxy for family size (all outcomes). Findings should be interpreted with caution due to the ecological nature of the analysis and the limitations presented by the data and measures employed.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

This chapter examines how established media – that is, print, TV and radio sources which pre-existed the popularisation of social media – use social media to disseminate content. Specifically it examines the manner in which three UK media sources – BBC News, The Guardian and the Daily Mail – used Twitter during the 2014–2015 Ebola crisis. It asks five key questions concerning: the balance between factual reporting and opinion or comment; the degree to which it shifted attention to specific events within the context of the outbreak; whether the dialogical potential of social media was exploited; the degree to which social media acted as a signpost to more detailed information elsewhere, or existed as independent content; and the degree of media reflexivity. It concludes that established media used this new technology within their existing paradigms for reporting rather than exploiting some of its more innovative characteristics.

This final chapter, presented by the book’s three Editors, provides a reflection and discussion of the key findings presented throughout the book. First, it delves into the book’s vision and the process of creation. The findings in the book affirm the continuous growth of the field, highlight the diverse nature of the RMA landscape, and reveal the substantial variation in the status of the profession and the availability of data among regions and countries. To understand the unique features of the RMA profession from multitude of angles and in each country’s context, the Editors emphasize the importance of inviting authors to share their perspectives in their own voices and styles, which became central to the book’s mission. Second, this chapter presents discussions on pivotal findings in four areas: (1) growth of the RMA profession in specific countries and regions, (2) crucial contribution of professional associations to advancing RMA, (3) essential soft skills for RMAs and promotion of diversity, equity, and inclusion, and (4) advancing RMA through increasing training and capacity-building initiatives. This chapter also alludes to potential policy implications and concludes with the Editors’ hope that the book serves as a catalyst for further exploration of the RMA field and RMA professions.

This chapter explains the evolution of Research Management and Administration (RMA) in Nigeria with its achievements and challenges arising from the participation of relevant stakeholders and current practitioners from 24 universities in Nigeria. The layout covers the prerequisites for RMA, its development, and its implementations. Nonetheless, the research shows that the non-professionalisation of RMA in Nigeria is not only a barrier but also a challenge to the emergence of a profession which can be resolved by the implementation of approved/not-approved career structures for RMA in Nigeria. Findings from a survey show that a tripartite group is involved in the present-day RMA. Moreover, submissions by participants show that in the next two decades, RMA is expected to attract both academic and administrative staff with leadership by academic staff. The research supported the hypothesis that academic staff is most suitable to pilot RMA, nonetheless, when core research assignments for academic staff increase shortly, RMA will most likely be directed by administrative staff.

In recent years, there has been a growing dialogue around community-based and systems-based approaches to security risk management through the introduction of top-down and bottom-up knowledge acquisition. In essence, this relates to knowledge elicited from academic experts, or security subject-matter experts, practitioner experts, or field workers themselves and how much these disparate sources of knowledge may converge or diverge. In many ways, this represents a classic tension between organisational and procedural perspectives of knowledge management (i.e. top-down) versus more pragmatic and experience focussed perspectives (i.e. bottom-up).

This chapter considers these approaches and argues that a more consistent approach needs to address the conflict between procedures and experience, help convert field experience into knowledge, and ultimately provide effective training that is relevant to those heading out into demanding work situations. Ultimately, ethics and method are intricately bound together in whichever approach is taken and the security of both staff and at-risk populations depends upon correctly managing the balance between systems and communities.