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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.

Targets set out by state institutions, with respect to supplying water to deprived communities, seem to be idealistic and not realistic. Study envisioned to assess challenges of financing water infrastructure projects, and determines the role of the state towards infrastructure development by holistically planning and engaging with the private sector.

The study adopted a quantitative approach, whereby a questionnaire survey was conducted among different stakeholders involved in water infrastructure projects in South Africa. Data gathered were analysed using percentages, mean item score and standard deviation.

The study revealed that most challenges affecting the success of the financing of water infrastructure projects in South Africa are corruption, hostility towards private participation, cost recovery constraints, high fiscal deficits by state government, unreliable planning and procurement processes, and a rapid increasing number of municipalities that lack technical and administrative capacity to plan implement, operate and maintain water assets.

This research paper investigates projects’ financing challenges with a broad inspection on the role of the public sector. The apparent role of the international structures such as OECD, IMF and World Bank had no influence in the study. From the findings, it is clear that the central government and state institutions lack the necessary resources to accelerate infrastructure development, water infrastructure in particular. The study, thus, recommends a complete expansion and development of state capacity as well as improved collaborations with the private sector to drive the success delivery of services to the public.

Improved and flexible regulations and legislative guidelines are required to ensure that both sectors fulfil their side of the bargain, with an ultimate goal of meeting the predetermined targets of supplying adequate water to the deprived communities.

Covert research has a mixed reputation within the scientific community. Some are unsure of its moral worth, others would proscribe it entirely. This reputation stems largely from a lack of knowledge about the reasons for choosing the covert method. In this chapter, these reasons will be reconstructed in detail and all the elements that will allow one to judge the level of ethicality of covert research will be laid out for the reader. In particular, the chapter will answer the following questions: What harms can result from covert research to the subjects participating in the research? Is covert research necessarily deceptive? In which cases is it ethically permissible for a researcher to deceive? What is the scientific added value of the covert research, that is, what does covert research discover that overt research does not? What are the risks to researchers acting undercover? Finally, some suggestions will be offered to research ethics reviewers to help in their appraisal of covert research.

Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.

The objective of the chapter is to provide an integrative appraisal of recent participatory research projects with children on violence and maltreatment conducted by members of the COST Action CA 19106 working group on children's participation (WG3) and their colleagues to identify what is working well and what needs to change in future research. The evaluation of research examples clustered around four key questions: Why, when, how and how much do children participate in research? Data were collected using a unified tool designed to characterise participatory research, which was distributed among WG3 members. In addition, chapters of the current book were another source of data about participatory research. Overall, data on 19 studies involving 46,761 children were collected and analysed using Shier's matrix. Findings show that most studies (n = 10) engaged children as consultants to adults in data collection, whereas a few studies (n = 5) demonstrated a more children-led research approach. The analysis uncovered specific areas where more progress is required, including engaging children in decisions about the research topic, involving young children, utilising methods that are more natural and familiar to children, and gaining children's reflective accounts about their participation experience. The authors encourage scholars to publish their work to advance evidence-based knowledge and skills in participatory research with children about sensitive topics.

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.