Establishing a novel community-focussed lactation support service: a descriptive case series

Background Although breastfeeding is widely acknowledged as protecting both infant and maternal health postnatally, a partial or complete shortfall of maternal milk can occur for a range of reasons. In this eventuality, the currently available options for feeding infants are screened donor human milk (DHM), infant formula or unscreened shared human milk. In the UK, DHM has only been widely available in specific clinical contexts for the last 40 years, mainly to reduce the risk of necrotising enterocolitis in extremely preterm infants alongside optimal support for maternal lactation and breastfeeding. The Hearts Milk Bank (HMB) was established in 2017 as an independent, non-profit human milk bank that aimed to ensure equitable, assured access to screened DHM for neonatal units. As a result of the generosity of mothers, a surplus of DHM rapidly became available and together with lactation support, has since been provided to families with a healthcare referral. This programme has now been formalised for families facing lactational challenges, and DHM stocks are permanently maintained to meet their needs. Case series This case series describes the clinical paths of four families who accessed lactation support and DHM from the HMB, along with a description of the process for community provision. To date, the HMB has supported over 300 families. Working collaboratively with key stakeholders, the HMB team has developed a prioritisation strategy based on utilitarian ethical models, protocols that ensure safe handling and appropriateness of use, broader donor recruitment parameters that maintain safety with a pragmatic approach for full term healthy infants, and a process to ensure parents or carers have access to the knowledge needed to give informed consent and use DHM appropriately. Conclusions Stakeholders, including parents, healthcare professionals, and milk banks, will need to discuss priorities for both DHM use and research gaps that can underpin the equitable expansion of services, in partnership with National Health Service (NHS) teams and third-sector organisations that support breastfeeding and maternal mental health.

The Impact of the COVID-19 Pandemic on Those Supported in the Community with Long-Term Mental Health Problems: A Qualitative Analysis of Power, Threat, Meaning and Survival

Research suggests that the COVID-19 pandemic has had a significant impact on those already living with mental health problems, though there is also evidence of resilience. However, to date there has been limited in-depth qualitative investigation. We interviewed 15 people living with long-term mental health problems who, before the pandemic, were being supported by third sector organisations, to explore how they experienced lockdowns and accessing services remotely. Template analysis was informed by the Power Threat Meaning Framework and suggested that participants experienced significant threats to their mental wellbeing and recovery which were exacerbated by current or previous powerlessness and inequality. Although participants described positive coping strategies, several described a return of unhelpful behaviours that had contributed to the original difficulties. The findings illustrate the wider contributions of social and economic context to mental health problems and the importance of ensuring that people do not feel abandoned and are proactively supported.

Sector Distinctiveness v. Cross-Sector Commonalities: Are There Qualitative Differences in Graduate Nonprofit Management Education Offered Through Public Service and Business Programs in the United Kingdom?

Previous research on nonprofit management education (NME) in the United Kingdom (UK) has raised the question of whether NME provided through public service departments will focus more on third sector distinctiveness, while NME provided through business schools will concentrate more on general, cross-sector management skills. We collect data on courses offered within UK graduate degree programs with an NME concentration and compare them using Mirabella’s (2007) taxonomy and find that there is more commonality than differences between graduate NME offered in both business and public service programs in the UK. However, statistically significant differences in the provision of courses as a proportion of total curriculum do exist for courses related to “advocacy, public policy, and community organizing,” “financial management,” and “social enterprise.”

Social Innovation for Work Inclusion – Contributions of Swedish Third Sector Organizations

The innovative contributions of third sector organizations (TSOs) to tackle work-related societal challenges are increasingly acknowledged in policy and research, but rarely in Nordic working life studies. The article helps fill this knowledge gap by an empirical mapping of efforts by Swedish TSOs to promote work inclusion among people considered disadvantaged in the regular labor market, due to age, disabilities, origin, etc. Previous studies of social innovation help distinguish their innovativeness in terms of alternative or complementary ways to perceive and promote work inclusion in regard to Swedish labor market policies. By combining various measures for providing and preparing work opportunities, addressing their participants through individualistic and holistic approaches, and managing work inclusion by varying organization, funding, and alliances, the mapped cases seem to innovatively compensate for government and market failures in the work inclusion domain to some extent, while also being limited by their own voluntary failures.

Supporting Vulnerable Populations During the Pandemic: Stakeholders’ Experiences and Perceptions of Social Prescribing in Scotland During Covid-19

Social prescribing schemes refer people toward personalized health/wellbeing interventions in local communities. Since schemes hold different representations of social prescribing, responses to the pandemic crisis will vary. Intersectionality states that social divisions build on one another, sustaining unequal health outcomes. We conducted and inductively analysed interviews with twenty-three professional and volunteer stakeholders across three social prescribing schemes in urban and rural Scotland at the start and end of year one of the pandemic. Concerns included identifying and digitally supporting disadvantaged and vulnerable individuals and reduced capacity statutory and third-sector services, obliging link workers to assume new practical and psychological responsibilities. Social prescribing services in Scotland, we argue, represent a collage of practices superimposed on a struggling healthcare system. Those in need of such services are unlikely to break through disadvantage whilst situated within a social texture wherein inequalities of education, health and environmental arrangements broadly intersect with one another.

Civil Society and Philanthropy in Africa: Parallels, Paradoxes and Promise

Civil society and philanthropy in Africa are regularly theorized in formal terms and oft perceived as inherently democratizing forces. Yet, existing evidence exposes the limitations of these assumptions. This article provides an introduction to the symposium issue on civil society and philanthropy in Africa. The objective of the introduction, and the articles contained in the symposium, is to examine important questions related to civil society and philanthropy on the continent: What is the complex history and role of civil society and philanthropy in Africa? How have donor dependence and professionalization affected the effectiveness of the third sector? What are the contours of the relationship between the state and civil society? We ask these crucial questions in an attempt to provide a more nuanced and contextualized understanding of civil society and philanthropy on the continent.

How Do People Who Are Homeless Find Out about Local Health and Social Care Services: A Mixed Method Study

Background: There are significant numbers of people experiencing homelessness both in the UK and internationally. People who are homeless are much more likely to die prematurely and, therefore, need strong access to ongoing health and social care support if we hope to address the health disparity they face. Objectives: The aim of the research was to explore how people who are homeless identify and locate appropriate health and social care services. Design: A mixed methods research study was applied on people who are currently homeless or had previously experienced homelessness. Settings: The research study was based in an urban area in the southwest of England. The area was chosen as it was identified to be in the top 24 local authorities for the number of homeless individuals. Participants: A hundred individuals participated in the survey, of those 32% were living on the streets whilst 68% were living in temporary accommodation such as a charity home, shelter or a hotel paid for by the local authority. In addition, 16 participated in either a focus group or one-to-one interview Methods: The quantitative component consisted of a paper-based questionnaire whilst the qualitative aspect was focus groups/one-to-one interviews. The COREQ criteria were used in the report of the qualitative aspects of the study. Results: Quantitative data identified poor health in 90% of the sample. Access to both healthcare and wider wellbeing services (housing and food) was problematic and support for this was largely through third sector charity organisations. Qualitative data identified numerous systemic, individual and cultural obstacles, leaving difficulty for people in terms of knowing who to contact and how to access services, largely relying on word of mouth of other people who are homeless. Conclusions: In order to address health inequities experienced by people who are homeless, there is a need to review how information regarding local health and wider wellbeing services is provided in local communities.

The Resilience and Adaptative Strategies of Italian Cooperatives during the COVID-19 Pandemic

Third sector organizations, like the rest of the economic system, have been heavily affected by the pandemic. The aim of this work is to study resilience and adaptability to crisis in terms of economic results and innovative outcomes of the cooperative business model in the Italian third sector during the COVID pandemic. It uses new evidence from a recent survey on the Italian third sector and consists of two main parts. In the first, the institutionalist literature on contractual failures is assumed as an interpretative key in the comparison between the business model, governance, and routines in social cooperatives versus other non-profit organizations (NPOs) interpreted as third sector entities. In the second, we use the new data from a third sector survey in the Marche region, collected in the late spring of 2021 at the end of the pandemic outbreak. Empirical assumptions concern organizational resilience and adaptation to unexpected negative shocks in cooperatives and other NPOs. The results show that, in the management of the crisis, cooperatives are better able to preserve their human capital and resort to layoffs less often than other NPOs. Shared decision-making, employee involvement, and the adaptability of the work process emerge as dominant organizational characteristics that support resilience and service innovation in cooperatives. The main policy implication concerns the ability of cooperatives to play a stabilizing and a-cyclical role during the crisis and to fill the supply gaps left open by other organizational forms (private, non-profit and the public sector). The originality of the paper lies in its new approach to cooperative organization and in the analysis of the reaction of cooperatives to the pandemic.