Examining the social construction of surveillance: a critical issue for health visitors and public health nurses working with mothers and children

Aims and objectives In this paper we will critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada. Background The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs. Design We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings. Methods Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance Results Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power Conclusions Health care providers need to understand the different meanings and practices associated with surveillance to effectively inform practice. Relevance to clinical practice Health care providers should be aware of how their positions of expert and privilege within health care systems affect relationships with mothers. A more comprehensive understanding of personal social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families.