White paper: “A true ignorance, even contempt, of the work done in the field”

Since September 2021, the Born in Brussels project has become “Born in Belgium pro”. The target. the goal? Belgium-born Professionals focuses on pregnant women in psychosocial vulnerability situation supporting health and care workers online 0, first and second line ; of the (para) medical and social sectors “, describes his site. This Monday, January 17th, several professional and field actors take carte blanche to request an evaluation in which professionals from the Wallonia-Brussels Federation would participate.

The tool and context *

In concrete terms, it is a question of understanding what the tool consists of and what the signatories of the white card criticize, which are also reported at the bottom of the article. The “Born in Belgium pro” project is funded by Inami and consists of an extension of the “Born in Brussels” tool. More concretely, it is a free web platform for healthcare professionals. The platform is intended as a tool to help healthcare professionals monitor pregnant women. “In the first place, [l’outil] offers the possibility of detecting the psychosocial situation of the pregnant womandetails the official website. On the other hand, it accompanies the assistance and assistance operators who use it by arranging assistance paths appropriate to the situation of the woman and proposing references and procedures.

In addition, the platform shows the affected providers “an overview of the professional network that is active around the pregnant woman.”

The idea is to better monitor the pregnant woman, taking into account a more holistic and broader approach, in order to detect and remedy any problems, such as those related to mental health, for example. This is with regards to what is presented on the official website.

“The goal is to make new savings” *

However, the tool does not cater to a number of players on the pitch. “As perinatal professionals, we are very little used to making our voices heard, but this time we feel the duty to denounce the project called” Born in Belgium pro “(BiB). For us it is incompatible with personalized tracking”: thus begins the carte blanche received by the RTBF editorial staff. They go a step further, describing it “This INAMI-funded project aims to list pregnant women in Belgium by creating a national database. In our view, this program will distort and devalue pregnancy follow-up for low-risk pregnant women. The goal is clearly that of achieving further savings in health care at the expense of women, which is unacceptable “.

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For the signatories of the white paper, “no concrete solution is given to the real problems of future mothers and their families” nor to possible difficulties related to housing precariousness or domestic violence.

“In concrete terms, the will shown is to systematize the screening and treatment of so-called“ vulnerable ”pregnant women, that is, those who present psycho-medical-social risks, thanks to an IT diagnostic tool. , this will especially allow to trace all pregnant women in Belgium “.

The project, born first in Brussels, reaches the rest of the country “Without there having been any real evaluation of its impact or effectiveness” not even one “consultation between the Confederation and the regions in any case competent in matters of prevention”write these actors on the field.

Lack of data protection guarantees

The other strongly criticized element is related to data protection: “Among our complaints, there is in particular the fact that this program requires the encoding of personal data (based on the NISS number), to inform the vulnerabilities of pregnant women. This” screening “tool defines, through an algorithm, the services most able to solve the problem (s) identified. The database created is currently hosted exclusively in a university institution, whose ownership and management are not clearly defined. News shows that Belgium is in default of the rules general information on data protection, what are the guarantees regarding the retention of this data and its use? And the right to be forgotten? A vulnerable situation is not- “Shouldn’t it be able to evolve? If this IT tool isn’t just about helping the front line, we’re surprised it can’t be anonymous, so as not to tag a person. “

A decision algorithm instead of professional competence

“Family socio-economic precariousness is increasing, this phenomenon has been known and followed for some time. As perinatal professionals we didn’t wait for BiB to take care of it! The Birth and Childhood Office (ONE) already offers multidisciplinary support to all future mothers, Belgian and otherwise, vulnerable or not, free of charge and anonymously in cohabiting maternity wards, antenatal counseling and antenatal platforms, without forgetting counseling for children and the childcare facilities the midwives are close to the families and offer constant monitoring from the beginning of the pregnancy until the child is 1. Gynecologists and treating doctors, despite having a more medical angle, remain attentive to vulnerabilities and activate the network as needed. Other professionals such as psychologists, social workers, specialist services, etc. Net.”

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A real lack of knowledge, even contempt, of the work done in the field

If in the eyes of the signatories precariousness represents a factor well known to the actors of the medical and social world, this tool does not seem to provide any solution to the specificities of certain situations.

“Together, around the family, through various consultations and home visits, dialogue and trust established, vulnerabilities are detected and supported by the establishment of specialized structures, such as perinatal support services. , funded by ONE, responsible for supporting women and their families when they have difficulties Vulnerable situations that are currently not detected are those that are not part of prenatal monitoring and flee the medical world.

It is clear that the proposed tool does not provide any solution. Identifying vulnerable women without offering them lasting solutions is unethical. The difficulty is not so much to sift and find an adequate service, but to find an accessible service that can provide a solution in a limited time, the time of pregnancy.

No consideration for the recurrent lack of resources

“Other difficulties can also be added, such as the lack of initiative of the future mother, the poor understanding of the language, the fear of being identified by the official services in the event of an illegal situation, the problem of transport, etc., emphasize the professionals behind the carte blanche initiative. Specific care facilities are already overwhelmed by lack of resources. Many children are hospitalized due to lack of sufficient places in the reception facilities. Pregnant women are waiting for a place in a maternal home, in a mother-child unit. The need is to help the person, not to register them in a database. Only the refinancing of existing facilities will help these families.

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