Health pathways for children at risk in the Ille et Vilaine administrative division: A French perspective

Abstract Background A regional hospital group located in northeastern Brittany (France) won a national call for improving the care provided to children at risk. Objective Our work analyzed and compared the health paths of children at risk in this administrative territory of the French healthcare system. This work, thanks to its territorial approach, can help to better understand and identify mechanisms for improving the quality of care as well as the mechanisms that contribute to disruptions and inequalities in the access to a Child protection system. Methods This qualitative study was based on a field analysis where 28 people were interviewed. The inclusion criteria were being: in one of the four domains of child protection (justice, health, social services and education), in one of the five target service areas (n=21) and an expert in the field of children at risk (n=7). Results The results showed that the health pathway of abused children was unequal and followed a silo trajectory, with multiple breaks in the support provided. We found many barriers to multi-professional collaboration: institutional, professional, individual and regional. Conclusion In terms of recommendations, we underline the relevance of models that promote greater integration. The article ends with a discussion of evidence to this effect.